RESEARCH ARTICLE The Impact of Gender Norms on Condom Use among HIV-Positive Adults in KwaZulu-

Critical to preventing the spread of HIV is promoting condom use among HIV-positive indi-viduals. Previous studies suggest that gender norms (social and cultural constructions of the ways that women and men are expected to behave) may be an important determinant of condom use. However, the relationship has not been evaluated among HIV-positive women and men in South Africa. We examined gender norms and condom use at last sex among 550 partnerships reported by 530 sexually-active HIV-positive women (372) and men (158) who had sought care, but not yet initiated antiretroviral therapy in a high HIV-prevalence rural setting in KwaZulu-Natal, South Africa between January 2009 and March 2011. Partic-ipants enrolled in the cohort study completed a baseline questionnaire that detailed their socio-demographic characteristics, socio-economic circumstances, religion, HIV testing history and disclosure of HIV status, stigma, social capital, gender norms and self-efficacy. Gender norms did not statistically differ between women and men (p = 0.18). Overall, con-doms were used at last sex in 58 % of partnerships. Although participants disclosed their HIV status in 66 % of the partnerships, 60 % did not have knowledge of their partner’s HI