This paper examines the approaches heterosexual men and women in South Africa use to engage their partners in discussions of HIV and risk factors in their relationships. These strategies entail balancing the risks of infection while managing the challenges of maintaining a relationship. In a context in which there is a great deal of insecurity in relationships it is especially challenging to discuss HIV risks with partners. Our findings reveal that concerns about children or the desire to have children provided a legitimate basis for discussing HIV risk with partners. The focus of these discussions is on the future for their children. Research in South Africa should attend to men’s and women’s desires to have and to raise children. HIV prevention and treatment programs can capitalise on concerns regarding children, and the future of the family, to engage men and women in discussing mutually acceptable strategies for preventing infection and ensuring safe conception. High rates of HIV infection in South Africa, together with the rollout of antiretroviral treatment, mean that increasingly men and women and their families are grappling with long term infection, illness, and the fear of HIV transmission. International research on couples and families has highlighted the struggle to balance disease risks and illness while maintaining healthy relationships van Campenhoudt ; Cusick and Rhodes
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