Please refer to usage guidelines at https://researchonline.lshtm.ac.uk/policies.html or alternatively contact researchonline@lshtm.ac.uk. Available under license: http://creativecommons.org/licenses/by-nc-nd/2.5/ 1. Evidence of the effects of gender inequality among African women was substantial. Interventions to address this will need to be wide-ranging, from policy advocacy and structural change, to micro-financing initiatives and provision of skills training to enable women to better

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... e the sexual relationships they desire. Such interventions need to take account of evidence from, and work in partnership with, other sectors to try and bring about structural level change. 2. Instigate community development initiatives and extend interventions to boost the confidence of people with diagnosed HIV to better negotiate happy and healthy relationships. 3. Devise strategies to highlight people in sero-discordant relationships where both partners are happy, settled and in control, and who are willing to act as role models in their communities. 4. Provide sustained, couple-based therapeutic support enabling shared discussion of concerns and thoughts for the future within the relationship.