***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 India has an estimated 2.0 million to 3.1 million people living with HIV ; it has the highest number of HIV-positive people in Asia and ranks third in the world . The Frontiers Prevention Project ( FPP ) was implemented in 2002 to conduct targeted prevention intervention geared towards female sex workers ( FSW ) and men who have sex with men ( MSM ) in the state of And hra Pradesh ( AP ) . This paper reports the overall changes in behaviour and STI outcomes between 2003/4 and 2007 and also describes the changes attributed to the FPP . Methods The evaluation used two cross-sectional surveys among MSM and FSW at 24 sites in AP . Surveys were implemented using a similar methodology . Univariate analyses were conducted by comparing means : baseline vs. four-year follow-up and FPP vs. non-FPP . For both MSM and FSW , r and om and fixed-effects logit regression models at the site level were estimated for condom use with last partner , syphilis sero-positivity and HSV 2 sero-positivity . In addition , for FSW we estimated models for condom use with regular partner , and for MSM we estimated models for condom use with last female partner . Results Among MSM , fixed-effects analysis revealed that FPP was positively correlated with the probability of condom use with last female sexual partner and negatively correlated with the individual probability of sero-positivity to syphilis and HSV 2 . Among FSW , the FPP intervention was significantly correlated with increased condom use with regular partners and with lower probability of STI sero-positivity . Discussion Important changes in behaviours related to an increase in prevention activities translated to reductions in STI sero-prevalence in AP , India . In contrast with non-FPP sites , the FPP sites experienced an intense community approach as part of the FPP intervention , and the general increase in condom use and its effect on STI sero-prevalence reflected the efficacy of these intense prevention activities focused on key population s in AP A peer-led HIV prevention initiative , based on a diffusion of innovation model , was developed for gay men attending gyms in central London . Peer educators were recruited from people who used the gym regularly according to st and ard selection criteria . After initial training , peer educators agreed to talk to gay men at their gym about HIV prevention , focusing on sexual risk and steroid injecting behaviour . Outcome evaluation revealed that the peer education programme had no significant impact on the risk behaviours of gay men using the gyms . Process evaluation , based on interviews with peer educators , the health promotion team and gym managers threw light on this finding . While it was feasible to set up a peer education programme among gay men in central London gyms , attrition was an important factor . Only one in five potential peer educators initially identified remained with the project throughout , thus limiting the potential for diffusion . Those who did work as peer educators reported barriers to communication within the gyms further limiting the extent to which diffusion occurred . In fact , it appears that the critical mass required for diffusion was never established . This could explain why the intervention had no significant impact on gay men 's risk behaviours . A person-time analysis demonstrated that the peer education programme required a substantial input from the health promotion team , equivalent to one team member devoting 2.5 days a week to recruit , train and support peer educators over 18 months . Peer education should not , therefore , be viewed as a low-cost approach to prevention . Many of the insights gained through this process evaluation can inform others planning peer education programmes in other setting Black men who have sex with men ( MSM ) in the United States experience disproportionately high rates of HIV and other sexually transmitted infections ( STIs ) ; however , the number of evidence -based interventions for Black MSM is limited . This study evaluated the efficacy of ManyMen , ManyVoices ( 3MV ) , a small-group HIV/STI prevention intervention developed by Black MSM-serving community-based organizations and a university-based HIV/STI prevention and training program . The study sample included 338 Black MSM of HIV-negative or unknown HIV serostatus residing in New York city . Participants were r and omly assigned to the 3MV intervention condition ( n = 164 ) or wait-list comparison condition ( n = 174 ) . Relative to comparison participants , 3MV participants reported significantly greater reductions in any unprotected anal intercourse with casual male partners ; a trend for consistent condom use during receptive anal intercourse with casual male partners ; and significantly greater reductions in the number of male sex partners and greater increases in HIV testing . This study is the first r and omized trial to demonstrate the efficacy of an HIV/STI prevention intervention for Black MSM This study evaluated the magnitude and distribution of unrecognized HIV infection among young men who have sex with men ( MSM ) and of those with unrecognized infection , the prevalence and correlates of unprotected anal intercourse ( UAI )  , perceived low risk for infection , and delayed HIV testing .  MSM aged 15 - 29 years were approached , interviewed , counseled , and tested for HIV at 263 r and omly sample d venues in 6 US cities from 1994 - 2000 . Of 5649 MSM participants , 573 ( 10 % ) tested positive for HIV . Of these , 91 % of black , 69 % of Hispanic , and 60 % of white MSM ( 77 % overall ) were unaware of their infection . The 439 MSM with unrecognized infection reported a total of 2253 male sex partners in the previous 6 months ; 51 % had UAI ; 59 % perceived that they were at low risk for being infected ; and 55 % had not tested in the previous year . The HIV epidemic among MSM in the United States continues unabated , in part , because many young HIV-infected MSM are unaware of their infection and unknowingly expose their partners to HIV . To advance HIV prevention in the third decade of HIV/AIDS , prevention programs must reduce unrecognized infection among young MSM by increasing the dem and for and availability of HIV testing services Abstract Objective . To test the impact of participation in a peer-based intervention for symptom management for women living with HIV infection on selected outcome measures including , symptom intensity , medication adherence , viral control , and quality of life . Design . R and omized clinical trial . Methods . Participants were recruited using a convenient , consecutive sampling method . Those participants r and omized to the experimental condition attended seven , peer-led sessions over seven weeks . Participants r and omized to the control condition received a copy of HIV Symptom Management Strategies : A Manual for People Living with HIV/AIDS . Participants completed four surveys assessing change over time in the aforementioned outcome variables . Results . Eighty-nine HIV-infected women followed over 14 weeks and there were no differences between the two groups on baseline demographic variables . Mixed-effects regression indicated no significant difference between groups across time in total symptom intensity score and medication adherence . There was a significant difference between groups across time for two of the nine quality of life scales – HIV Mastery ( χ 2=25.08 ; p<0.005 ) and Disclosure Worries ( χ 2=24.67 ; p<0.005 ) . Conclusions . In urban-dwelling women living with HIV/AIDS , results suggest that a peer-based symptom management intervention may not decrease symptom intensity or increase medication adherence . There is positive evidence that suggests that the intervention may increase some important aspects of quality of life . However , further research is warranted to eluci date the effect of peer-based interventions in achieving positive self-management outcomes BACKGROUND Social media technologies offer new approaches to HIV prevention and promotion of testing . We examined the efficacy of the Harnessing Online Peer Education ( HOPE ) social media intervention to increase HIV testing among men who have sex with men ( MSM ) in Peru . METHODS In this cluster r and omised controlled trial , Peruvian MSM from Greater Lima ( including Callao ) who had sex with a man in the past 12 months , were 18 years of age or older , were HIV negative or serostatus unknown , and had a Facebook account or were willing to create one ( N=556 ) were r and omly assigned ( 1:1 ) by concealed allocation to join intervention or control groups on Facebook for 12 weeks . For the intervention , Peruvian MSM were trained and assigned to be HIV prevention mentors ( peer-leaders ) to participants in Facebook groups . The interventions period lasted 12 weeks . Participants in control groups received an enhanced st and ard of care , including st and ard offline HIV prevention available in Peru and participation in Facebook groups ( without peer leaders ) that provided study up date s and HIV testing information . After accepting a request to join the groups , continued participation was voluntary . Participants also completed question naires on HIV risk behaviours and social media use at baseline and 12 week follow-up . The primary outcome was the number of participants who received a free HIV test at a local community clinic . The facebook groups were analysed as clusters to account for intracluster correlations . This trial is registered with Clinical Trials.gov , number NCT01701206 . FINDINGS Of 49 peer-leaders recruited , 34 completed training and were assigned at r and om to the intervention Facebook groups . Between March 19 , 2012 , and June 11 , 2012 , and Sept 26 , 2012 , and Dec 19 , 2012 , 556 participants were r and omly assigned to intervention groups ( N=278 ) or control groups ( N=278 ) ; we analyse data for 252 and 246 . 43 participants ( 17 % ) in the intervention group and 16 ( 7 % ) in the control groups got tested for HIV ( adjusted odds ratio 2·61 , 95 % CI 1·55–4·38 ) . No adverse events were reported . INTERPRETATION Development of peer-mentored social media communities seemed to be an efficacious method to increase HIV testing among high-risk population s in Peru . Results suggest that the HOPE social media intervention could improve HIV testing rates among MSM in Peru . FUNDING National Institute of Mental Health OBJECTIVES We sought to determine whether field outreach with motivational interviewing , as compared with traditional field outreach , leads to increases in HIV counseling and testing and rates of return for test results among young African American men who have sex with men ( MSM ) . METHODS In a r and omized , 2-group , repeated- measures design , 96 young African American MSM completed a motivational interviewing-based field outreach session and 92 young African American MSM completed a traditional field outreach session .  The percentages of participants agreeing to traditional HIV counseling and testing ( an oral swab of the cheek ) and returning for test results were the primary outcome measures . RESULTS More of the participants in the motivational interviewing condition than the control condition received HIV counseling and testing ( 49 % versus 20 % ; chi(2)(1 ) = 17.94 ; P = .000 ) and returned for test results ( 98 % versus 72 % ; chi(2)(1 ) = 10.22 ; P = .001 ) . CONCLUSIONS The addition of motivational interviewing to field outreach is effective in encouraging high-risk young African American MSM to learn their HIV status . Also , peer outreach workers can be effectively trained to reduce health disparities by providing evidence -based brief counseling approaches targeting high-risk minority population 
    Output:
    
Overall , peer-led interventions  increased HIV testing among MSM but more data from high- quality studies are needed to evaluate effects of peer-led interventions on HIV testing among MSM in low- and middle-income countries