The study sought to explore sugar mommy practices regarding their occurrence, acceptability as well as perceived reasons why older women and younger men enter into sugar mommy relationships. An exploratory qualitative study involving 135 participants from 11 diverse focus groups in terms of age, gender (females=27%) and geotype throughout the nine South African provinces was conducted. Data on the participants' views, opinions and experiences of sugar mommy practices were collected using focus group interviews. The data were thematically analyzed. The study found that sugar mommy practices were prevalent in South Africa. The perceived reasons for acceptability were: love, survival, and correctness. Perceived reasons why older women have sexual relationships with younger men included: sexual fulfilment, domination, reduction of stress, physical attraction, procreation, lack of self-control, youthful feeling, migrancy, difficulty in finding partners of compatible age and young men being seen as not demanding. Perceived reasons why younger men have sexual relationships with older women included: material gain, reduction of stress, being enticed, rejection by women of compatible age, peer influence and belief that older women are purer. Given the increase in sugar mommy practices, which may have significant implications for the prevalence of HIV/AIDS, it is necessary to understand the underlying perceptions of these practices, in order to develop culturally relevant and socially acceptable intervention programmes.

This study investigated the influences of job characteristics on job satisfaction, stress and depression among South African white collar workers. Participants were managers in full-time employment with large organisations. They completed the Job Diagnostic Survey, the Perceived Stress Scale and the Beck Depression Inventory. A regression approach was used to predict job satisfaction, stress and depression from job characteristics. Job characteristics (skill variety, task identity, task significance, autonomy and feedback) predicted job satisfaction, as well as stress and depression. Job characteristics are weak predictors of perceived stress and depression. Work related factors, such as interpersonal relations and organisational culture, may better predict mental health in work settings.

This study sought to adapt a battery of Western speech and language assessment tools to a rural Kenyan setting. The tool was developed for children whose first language was KiGiryama, a Bantu language. A total of 539 Kenyan children (males=271, females=268, ethnicity=100% Kigiryama. Data were collected from 303 children admitted to hospital with severe malaria and 206 age-matched children recruited from the village communities. The language assessments were based upon the Content, Form and Use (C/F/U) model. The assessment was based upon the adapted versions of the Peabody Picture Vocabulary Test, Test for the Reception of Grammar, Renfrew Action Picture Test, Pragmatics Profile of Everyday Communication Skills in Children, Test of Word Finding and language specific tests of lexical semantics, higher level language. Preliminary measures of construct validity suggested that the theoretical assumptions behind the construction of the assessments were appropriate and re-test and inter-rater reliability scores were acceptable. These findings illustrate the potential to adapt Western speech and language assessments in other languages and settings, particularly those in which there is a paucity of standardised tools.

This article considers a eudaimonic approach to psychological well-being built on the integration of developmental, existential and humanistic formulations as well as distant writings of Aristotle. Eudaimonia emphasizes meaning-making, self realization and growth, quality connections to others, self-knowledge, managing life, and marching to one's own drummer. These qualities may be of particular importance in the confrontation with significant life challenges. Prior formulations of resilience are reviewed to underscore the unique features of a eudaimonic approach. Empirical findings on meaning making and self realization are then reviewed to document the capacity of some to maintain high well-being in the face of socioeconomic inequality, the challenges of aging, and in dealing with specific challenges (child abuse, cancer, loss of spouse). Moreover, those who sustain or deepen their well-being as they deal with adversity, show better health profiles, thereby underscoring broader benefits of eudaimonia. How meaning is made and personal capacities realized in the confrontation with challenge is revealed by narrative accounts. Thus, the latter half of the article illustrates human resilience in action via the personal stories of three individuals (Mark Mathabane, Ben Mattlin, Victor Frankl) who endured unimaginable hardship, but prevailed and grew in the face of it. The essential roles of strong social ties and the capacity to derive meaning and realize personal growth in grappling with adversity are unmistakable in all three cases.

This study explores organisational and individual provider influences on prevention of mother-to-child transmission (PMTCT) implementation at 12 community health centres (CHCs) in a rural South African setting. Clinic staff members ( = 103; females = 86%, nurse managers = 9.7%, nurses = 54.4%, lay health workers = 35.9%) were surveyed on PMTCT implementation acceptability and skills. The data were analysed using descriptive statistics comparing PMTCT protocol implementation achievements and clinic-level PMTCT indicators. Results indicate that staff were very positive about the frequency at which each element of the PMTCT protocol was achieved. Several areas where gaps in conformity to the PMTCT protocol were identified including delivery at the clinic, HIV retesting, provision of anti-retroviral treatment (ART) and six-week polymerase chain reaction (PCR) testing. It was unclear what organisational or individual characteristics contributed to this variation. Overall, providers' perception of barriers to care and human resource capacity were unrelated to performance and fidelity of protocol implementation.

The aim of the study was to determine the prevalence of intimate partner violence (IPV) and associated factors among pregnant HIV-infected women in primary health care facilities in Nkangala and Gert Sibande districts, Mpumalanga, South Africa. Participants were 673 women who were, on average, 28.39 ± 5.73 years old. Data were collected through Audio Computer Assisted Self Interview (ACASI), and analysed using the IBM Statistical Package for Social Sciences (SPSS). Overall, 56.3% reported having experienced either psychological or physical IPV, and 19.6% reported physical IPV. In logistic multivariable regression analyses, higher levels of depressive symptoms and greater perceived stigma were associated with combined physical and psychological IPV. Psychological IPV and physical IPV were also individually associated with greater perceived stigma and higher levels of depressive symptoms. The design and implementation of evidence-informed interventions that can empower and protect HIV-infected pregnant women from IPV is essential to managing their health-related quality of life.

This study investigated the prevalence and social and health correlates of insomnia symptoms among middle- and older-adults in rural South Africa. We analysed baseline survey data from the Health and Aging in Africa: A Longitudinal Study of an INDEPTH community in South Africa (HAALSI) ( = 5 059; females = 53.6%; largely African Shangaan/Tsonga-speaking). In all, 8.0% of the adults had three insomnia symptoms, 8.9% of participants had difficulty initiating sleep, 13.6% had difficulty in sleep maintenance, and 6.5% had poor sleep quality. In adjusted logistic regression, lower education, perceived unsafe neighbourhood, poorer self-rated health status, vision difficulty, pain, depressive symptoms, and posttraumatic stress disorder (PTSD) symptoms increased the odds of having insomnia symptoms. Insomnia symptoms are common in middle- and older-age adults in rural South Africa, and various risk factors were identified. This can help in improving insomnia prevention treatment in this population.

This study aimed to assess sexual risk behaviour and its social correlates in HIV-infected women living in rural South Africa at six and twelve months post-partum. Participants were 699 HIV-positive women recruited prenatally by systematic sampling from twelve community health centres in Mpumalanga province, South Africa (mean age = 28.4 years, SD = 5.7; married =41.1%; serodiscordant or unknown partner status = 74.9%). They self-reported on their sexual activity six to twelve months after delivery; including use of condoms and partner involvement. Generalised linear mixed models were utilised to estimate unsafe sex outcomes from a prevention of mother to child transmission (PMTCT) intervention, socio-demographic factors, disclosure, and male involvement. About 20% of sexually active women in the past week had used condoms inconsistently at six and twelve months after delivery. Moreover, 16% and 18% of the women had not used a condom at last sex and 11% and 13% had unprotected sex with HIV-uninfected or unknown-status partners following delivery at six and twelve months, respectively. Higher inconsistent condom use was likely with lower male involvement. Promotion of condom use post-partum, as well as male involvement in sexual decisions, are important for safer sex post-partum by seropositive women.

This study investigated mental morbidity and its association with socio-behavioural health and chronic health conditions among rural middle-older persons in South African ( = 5 059 adults; females = 53.6%; mean age = 62.4 years, SD = 13.1 years). We analysed baseline data from the Health and Aging in Africa Longitudinal Study (HAALSI), which included questions on socio-demographic, clinical, health, depression, and posttraumatic stress disorder (PTSD). Seventeen percent of the participants screened positive for depression and 4.8% for PTSD. The percentage of depression and/or PTSD was significantly higher in individuals with anaemia, angina, cataract, diabetes, dyslipidaemia, chronic bronchitis, heart failure, stroke, kidney disease, and tuberculosis. In multivariable logistic regression, being female, older age, being underweight, and having multi-morbidity portended higher risk for depression. Multi-morbidity and being physically inactive but not obese increased the odds for PTSD. Multi-layered interventions are needed to investigate the mental health burden of this aging rural population.