Bibtex article online dating

Within each stratum, equal numbers of clusters were allocated to each arm.The study statistician (JL) based in Pretoria, who had no knowledge of the study area, randomly generated the allocation sequence for each stratum.Names were taken and the group was asked to decide on the 40 people who were most likely to be able to participate in the study.The presenter read aloud the study’s consent form to the 40 and gave an opportunity for questions.Objective To assess the impact of Stepping Stones, a HIV prevention programme, on incidence of HIV and herpes simplex type 2 (HSV-2) and sexual behaviour. Setting 70 villages (clusters) in the Eastern Cape province of South Africa.Participants 1360 men and 1416 women aged 15-26 years, who were mostly attending schools.

Stepping Stones significantly improved a number of reported risk behaviours in men, with a lower proportion of men reporting perpetration of intimate partner violence across two years of follow-up and less transactional sex and problem drinking at 12 months.

In women desired behaviour changes were not reported and those in the Stepping Stones programme reported more transactional sex at 12 months.

Conclusion Stepping Stones did not reduce incidence of HIV but had an impact on several risk factors for HIV—notably, HSV-2 and perpetration of intimate partner violence. Change in sexual behaviour is the cornerstone of HIV prevention, yet relatively little research and development has been invested in interventions aimed at behaviour change in any setting.1 School based HIV/AIDS programmes for young people in sub-Saharan Africa have generally not been rigorously evaluated but are often weakly designed, and evaluations suggest they have little impact on sexual behaviours.2 In this respect they are no different from programmes for adolescents in other countries that have rarely shown sustained behaviour change.3 Three randomised controlled trials have been conducted in Africa with both behavioural and other interventions (management of sexually transmitted infection, microfinance, community action, or health service strengthening) in community and school settings.4 5 6 Two studies showed no effectiveness in prevention of sexually transmitted infections,5 6 but one had a positive effect on self reported behaviour.5 The third showed that the intervention was associated with a reduced prevalence of curable sexually transmitted infections.

Other outcomes: incidence of HSV-2, unwanted pregnancy, reported sexual practices, depression, and substance misuse.

Results There was no evidence that Stepping Stones lowered the incidence of HIV (adjusted incidence rate ratio 0.95, 95% confidence interval 0.67 to 1.35).

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The incidence of herpes simplex type 2 virus (HSV-2) was lower in the group that had only a behavioural intervention but not in the group that had both this and treatment for sexually transmitted infections, and so the authors do not attribute the effect in the behavioural arm to success of their intervention.4 The failure to show a biological impact is a particularly important weakness as there are known limitations to the validity of self reported change in sexual behaviour, with a potential for interventions to bias reporting towards socially desirable behaviours, and because an effect on sexually transmitted infections is the ultimate objective of these interventions.5 7 8None of the intervention programmes previously evaluated was established and widely used before the research was conducted.

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