***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND This paper aims to describe factors associated with HIV sero-status in young , rural South African women and the relationship between intimate partner violence ( IPV ) and HIV . METHODS A total of 1295 sexually active female volunteers , aged 15 - 26 , from 70 villages were recruited to participate in a cluster r and omized controlled trial of an HIV behavioural intervention . The main measures were HIV sero-status , and IPV and sexual practice s measured using a question naire administered during baseline interviews . RESULTS About 12.4 % of women had HIV and 26.6 % had experienced more than one episode of physical or sexual IPV . After adjusting for age , HIV infection was associated with having three or more past year partners [ odds ratio ( OR ) 2.39 ; 95 % confidence interval ( 95 % CI ) 1.48 - 3.85 ] , sex in past 3 months ( OR 3.33 ; 95 % CI 1.87 - 5.94 ) , a partner three or more years older ( OR 1.69 ; 95 % CI 1.16 - 2.48 ) , and a more educated partner ( OR 1.91 ; 95 % CI 1.30 - 2.78 ) . IPV was associated with HIV in two-way analyses ( OR 1.56 ; 95 % CI 1.08 - 2.23 ) , but the effect was non-significant after adjusting for HIV risk behaviours . The experience of IPV was strongly associated with past year partner numbers , time of last sex , and partner 's education ; it was also marginally associated with partner age difference . Adverse experiences in childhood , including sexual abuse , increased the likelihood of having more past year partners ( OR 1.43 ; 95 % CI 1.21 - 1.69 ) . CONCLUSIONS IPV was strongly associated with most of the identified HIV risk factors . Our findings provide further evidence of links between IPV and HIV among women and the importance of joint prevention 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 . Design Cluster r and omised controlled trial . 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 . Intervention Stepping Stones , a 50 hour programme , aims to improve sexual health by using participatory learning approaches to build knowledge , risk awareness , and communication skills and to stimulate critical reflection . Villages were r and omised to receive either this or a three hour intervention on HIV and safer sex . Interviewers administered question naires at baseline and 12 and 24 months and blood was tested for HIV and HSV-2 . Main outcome measures Primary outcome measure : incidence of HIV . Other outcomes : incidence of HSV-2 , unwanted pregnancy , reported sexual practice s , 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 ) . The programme was associated with a reduction of about 33 % in the incidence of HSV-2 ( 0.67 , 0.46 to 0.97 ; P=0.036)—that is , Stepping Stones reduced the number of new HSV-2 infections over a two year period by 34.9 ( 1.6 to 68.2 ) per 1000 people exposed . 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 . Trial Registration Clinical Trials NCT00332878 OBJECTIVE To describe the study design , methods and baseline findings of a behavioural intervention trial aim ed at reducing HIV incidence . METHOD A cluster r and omized-controlled trial ( RCT ) conducted in 70 villages in rural South Africa . A behavioural intervention , Stepping Stones , was implemented in 35 communities in two workshops of 20 men and 20 women in each community who met for 17 sessions ( 50 h ) over a period of 3 - 12 weeks . Individuals in the control arm communities attended a single session of about 3 h on HIV and safer sex . Impact assessment was conducted through two question naire and serological surveys at 12-month intervals . The primary outcome was HIV incidence and secondary measures included changes in knowledge , attitude and sexual behaviours . Qualitative research was also undertaken with 10 men and 10 women from two sites receiving the intervention ( one rural and one urban ) and five men and five women from one village in the control arm . They were interviewed individually three times prior to the workshops and then 9 - 12 months later . RESULTS A total of 2776 participants ( 1409 intervention and 1367 control ) were enrolled at baseline and had an interview , and HIV sero-status was established .  HIV baseline prevalence rates  in women were 9.8 % in the intervention arm and 12.8 % in the control arm . In men the prevalence was 1.7 % in the intervention arm and 2.1 % in the control arm . Demographic and behavioural characteristics were similar in the two arms . In the intervention groups 59.9 % of participants attended more than 75 % of the sessions . In the control group 66.3 % attended the control session . CONCLUSION This is the third RCT to be conducted in sub-Saharan Africa evaluating a behavioural intervention using HIV incidence as a primary outcome . It is of particular interest as the intervention in question is used in many developing countries . There is good baseline comparability between the study arms and the process data on the workshops suggested that the interventions were feasible and adequately implemented The same sexual behaviours that transmit HIV are implicated in the transmission of certain other STDs , including chlamydia , gonorrhoea , and syphilis . Consequently , it is often assumed that preventive methods that are effective against HIV should be equally effective against other STDs . The purpose of this study was to examine this assumption . We applied a mathematical model of HIV/STD transmission to empirical data from a large HIV prevention intervention that stressed sexual behaviour change . We modelled the effects of two behavioural strategies - reducing the number of sex partners and increasing condom use — on the proportionate change in intervention participants ' cumulative risk of acquiring HIV or a highly-infectious STD , such as gonorrhoea . The results of this modelling exercise indicate that decreasing the number of partners is a more effective strategy for reducing STD risk than it is for HIV risk . In contrast , condoms are somewhat more effective at reducing the cumulative transmission risk for HIV than for highly infectious STDs . The protection provided by condoms for multiple acts of intercourse critically depends on the infectiousness of the STD . The results of this study suggest caution in extrapolating from one STD to another , or from one behavioural risk reduction strategy to another Background : Young women in sub-Saharan Africa are at very high risk of HIV acquisition , and high prevalence levels have been observed among women reporting one lifetime partner and few sexual contacts . Such findings have led to hypotheses that the probability of HIV transmission from men to women must be far higher than previously appreciated . Methods : We used the  data from a cross-sectional national household survey of HIV among South African women aged 15–24 years to estimate the per-partnership transmission probability from men to women . Estimates were obtained using maximum likelihood methods and a transmission probability model allowing for r and om error in the self-reported number of lifetime partners . Sensitivity analyses were employed to assess the robustness of the per-partnership transmission probability estimates to the assumed HIV prevalence in male partners . Results : HIV prevalence in women was 21.2 % ( 95 % confidence interval 17.9–24.5 ) . The mean reported number of lifetime partners was 2.3 . A significant increase in prevalence was observed with increasing lifetime partner numbers ( P = 0.02 ) . For a range of plausible values of the partner prevalence , the estimated per-partnership transmission probability varied from 0.74 to 1.00 with 95 % confidence intervals ranging from 0.56 to 1.00 . Discussion : The per-partnership probability of HIV transmission from men to women in this population was very high . Before this , the majority of studies examining per-partnership transmission probabilities estimated values below 50 % . Identifying the factors that may drive the efficient spread of HIV in sub-Saharan Africa is essential for the development of effective prevention interventions Objective : The impact of a multicomponent intervention programme on the  sexual health of adolescents was assessed in rural Tanzania . Design : A community-r and omized trial . Methods : Twenty communities were r and omly allocated to receive either a specially design ed programme of interventions ( intervention group ) or st and ard activities ( comparison group ) . The intervention had four components : community activities ; teacher-led , peer-assisted sexual health education in years 5–7 of primary school ; training and supervision of health workers to provide ‘ youth-friendly ’ sexual health services ; and peer condom social marketing . Impacts on HIV incidence , herpes simplex virus 2 ( HSV2 ) and other sexual health outcomes were evaluated over approximately 3 years in 9645 adolescents recruited in late 1998 before entering years 5 , 6 or 7 of primary school . Results : The intervention had a significant impact on knowledge and reported attitudes , reported sexually transmitted infection symptoms , and several behavioural outcomes . Only five HIV seroconversions occurred in boys , whereas in girls the adjusted rate ratio ( intervention versus comparison ) was 0.75 [ 95 % confidence interval ( CI ) 0.34 , 1.66 ] . Overall HSV2 prevalences at follow-up were 11.9 % in male and 21.1 % in female participants , with adjusted prevalence ratios of 0.92 ( CI 0.69 , 1.22 ) and 1.05 ( CI 0.83 , 1.32 ) , respectively . There was no consistent beneficial or adverse impact on other biological outcomes . The beneficial impact on knowledge and reported attitudes was confirmed by results of a school examination in a separate group of students in mid-2002 . Conclusion : The intervention substantially improved knowledge , reported attitudes and some reported sexual behaviours , especially in boys , but had no consistent impact on biological outcomes within the 3-year trial period Community-based behavioural interventions aim ed at reducing risky sexual behaviour have yet to be shown to be effective in the developing world . Stepping Stones is a participatory STI/HIV prevention workshop programme based on empowerment techniques , which has been adapted to an infertility prevention framework for The Gambia . This paper describes a preliminary evaluation in two villages where the intervention was carried out compared to two control villages . Methods used include : participatory evaluation ; 84  in-depth interviews ; seven focus group discussion s ; a knowledge , attitudes and practice question naire administered to a r and om sample of 25 % of the adult population at three time points ; and monitoring of condom supply . The structure of the evaluation is based on the themes derived from the qualitative data . The infertility prevention approach made it possible to overcome resistance to discussing the topics of sexual and reproductive health . An atmosphere of trust was created and men were persuaded to participate in the programme as they felt that their own needs were being addressed . Participants enjoyed the programme and found the content relevant . Knowledge of the modes of transmission of HIV and sexually transmitted infections and levels of risk awareness increased . The value of condoms in particular situations was recognised : for sex before marriage , within marriage ( when the woman is breastfeeding ) and with non-marital partners . Women reported that they would insist on condom use outside marriage and even ask their husb and s to use condoms for non-marital sex . Condom monitoring data suggested that condom uptake had increased . It was reported that there was significant increase in dialogue within marriage with the consequence that there were fewer disagreements and incidents of domestic violence . Diffusion of the messages of Stepping Stones appeared to have taken place with non- participants including children . The evaluation techniques used can now be refined in order to generate further evidence on a larger scale and over a longer period 
    Output:
    
No se demostró cambio en la incidencia del VIH a pesar del incremento en el uso del condón , sin embargo HSV-2 disminuyo en el ECA .
La información sobre VIH y la comunicación entre parejas , familias y comunidades mejoró .
Cambios en la desigualdad de género y la violencia contra la mujer variaban entre culturas .
El alto riesgo en el abuso de alcohol , sustancias y estigmatización ha disminuido pero los índices de parejas múltiples y sexo transaccional fueron mixtos .