***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: OBJECTIVES We evaluated the efficacy of skills training design ed to increase  female condom use among women . METHODS We conducted a r and omized controlled trial of 409 women , recruited from family planning clinics in northern California , who were r and omly assigned to the experimental 4-session female condom skills training intervention or the comparison 4-session women 's general health promotion intervention .  Participants received condom use instructions at baseline and male and female condoms during the study . They completed audio computer-assisted self-interviews at baseline and at 3 and 6 months . RESULTS At 3 and 6 months , women in the experimental group were more likely than those in the comparison group to have used the female condom at least once in the prior 3 months . The increase in the percentage of sexual acts protected by female condoms from baseline to the 6-month follow-up was greater for the experimental group . The percentage of sexual acts during which any condom was employed was higher in the experimental group at 6 months . There were no group differences in male condom use . CONCLUSIONS Outcomes suggest that skills training can increase female condom use and protected sexual acts without reducing male condom use among women PURPOSE We conducted an intervention to improve the implementation of a high school condom availability program , and evaluated its effect on  students ' awareness of the program and acquisition of condoms . METHODS Twelve public high schools in the Los Angeles , CA area participated , half each in the intervention and control conditions . Project staff facilitated intervention schools ' self- assessment of compliance with the school district 's condom availability policy , creating an action plan by determining which m and atory program elements were lacking and identifying steps to improve compliance . Staff provided technical assistance and follow-up to assist schools in improving program implementation . From 2005 to 2009 ( T1-T5 ) , 29,823 students were r and omly selected by classroom and they completed surveys . We tested for changes in students ' awareness and acquisition of condoms over time between conditions using mixed model logistic regression analyses . Records of condom orders by schools also were review ed . RESULTS Awareness increased significantly among intervention versus control participants from T1 to T3 ( adjusted odds ratio [ AOR ] : 1.28 ; 95 % confidence interval [ CI ] : 1.01 , 1.62 ) , T4 ( AOR : 2.17 ; 95 % CI : 1.70 , 2.76 ) , and T5 ( AOR : 2.78 ; 95 % CI : 2.18 , 3.56 ) . Acquisition of condoms increased significantly among intervention versus control participants from T1 to T4 ( AOR : 1.69 ; 95 % CI : 1.23 , 2.32 ) and T5 ( AOR : 1.81 ; 95 % CI : 1.32 , 2.49 ) . Results were similar across gender and different levels of sexual experience . Orders of condoms increased markedly in intervention schools by T5 . CONCLUSIONS Feasible minor enhancements to condom availability program implementation improved program delivery , result ing in increased student awareness of the program and acquisition of condoms BACKGROUND HIV prevention intervention  efficacy is often assessed in the short term . Thus , we conducted a long-term ( mean 4.4 years ) follow-up of a woman-focused HIV intervention for African American crack smokers , for which we had previously observed beneficial short-term gains . METHODS 455 out-of-treatment African American women in central North Carolina participated in a r and omized field experiment and were followed up to determine sustainability of intervention effects across three conditions : the woman-focused intervention , a modified NIDA intervention , and a delayed-treatment control condition . We compared these groups in terms of HIV risk behavior at short-term follow-up ( STFU ; 3 - 6 months ) and long-term follow-up ( LTFU ; average 4 years ) . RESULTS The analyses revealed two distinct groups at STFU : women who either eliminated or greatly reduced their risk behaviors ( low-risk class ) and women who retained high levels of risk across multiple risk domains ( high-risk class ) . At STFU , women in the woman-focused intervention were more likely to be in the low HIV risk group than the women in control conditions , but this effect was not statistically significant at LTFU . However , low-risk participants at STFU were less likely to be retained at LTFU , and this retention rate was lowest among women in the woman-focused intervention . CONCLUSIONS Short-term intervention effects were not observed over 4 years later , possibly due to differential retention across conditions . The retention of the highest risk women presents an opportunity to extend intervention effects through booster sessions for these women As part of the evaluation of a community-level HIV prevention program for women , this study examined predictors of exposure to print media and community outreach and assessed the relationship between exposure to the intervention and condom use behavior . Data from interviews with 479 women r and omly selected from the intervention community in 1995 and 1996 were examined . Analysis of demographic and risk characteristics were conducted to identify predictors of exposure to the project 's HIV prevention messages . Additionally , logistic regression analyses were conducted to examine the effects of intervention exposure on condom use , controlling for factors related to exposure . The results revealed that the print media campaign reached the largest number of women . However , women at highest risk did not have high rates of exposure to print media , but had greater exposure to outreach . Exposure to print media had an effect on increased communication with a main partner about condom use , but was not significantly related to condom use last time had sex . There were no significant main effects for exposure to outreach on condom use behavior . An important finding of this analysis was that each intervention strategy was successful in reaching a different portion of the target population and that exposure had differential effects on the condom use behavior of particular segments of the target population OBJECTIVES To analyze the benefits of a school-based condom availability program relative to the risks that such a program may incur . METHODS A confidentially-administered survey instrument was completed by 152 r and omly selected high-school students ( approximately 14 % of the entire student population ) . RESULTS The respondents had a mean age of 15.9 years ( range : 14 - 19 years ) and a proportionate gender distribution . Ninety-three percent of all respondents had " heard of " the school 's program and knew from whom they could receive condoms . Twenty-six percent of the respondents had received condoms from the program with 67 % using them . Of those receiving condoms but not using them , more than half did not need them , owing to absence of anticipated sexual activity . Of the nonreceivers , 53 % had never had sexual intercourse and 27 % received condoms from other sources . The benefit of the program by aiding a sexually-active student was found to be more than three times as great as the risk of encouraging a nonsexually active student to have sexual intercourse ( RR = 3.2 ; 95 % C.I. = 2.1 , 4.9 ) . The prevalence of sexual activity among all respondents was not significantly higher than the state 's average based on gender and age ( 59.8 % vs. 54.5 % ; z = 1.24 , p > .05 , n.s . ) . CONCLUSION Given the lack of increased sexual activity and the favorable benefit-risk ratio , we conclude that school-based condom availability is successfully utilized by sexually-active adolescents and may be an effective means to reduce potentially harmful outcomes , such as unintended pregnancy and sexually-transmitted diseases Despite strong protests from a minority group of critics , the New York City Board of Education adopted a measure February 27 , 1991 , approving universal availability of condoms in city high schools to students without the need for parental consent . This exp and ed HIV education program allows the system 's 261,000 students in 120 public high schools to procure condoms from any of 17 clinics and any teacher or staff member volunteering for the program . While a few , small U.S. school districts have implemented such programs in efforts to curb the incidence of HIV and other sexually transmitted diseases infections , and unwanted pregnancies , this move by New York city 's enormous school district could set the trend for similar action by other large school systems . The Centers for Disease Control document 691 cases of AIDS in youths aged 13 - 19 , and 7,303 among those aged 20 - 24 . More than 20 % of U.S. AIDS cases are among those aged 20 - 29 . Given the long incubation period for HIV , many if not most of these case probably stem from HIV infection during the teenage years . New York City accounts for 20 % of all reported AIDS cases among youths aged 13 - 21 , placing New York teens at disproportionate risk for infection . The number of infected adolescents doubles every 14 months . More than adults , these youths are likely to have contracted HIV through heterosexual contact instead of through IV-drug use or homosexual intercourse . Making condoms readily and confidentially available to adolescents , youths vulnerable to HIV infection will no longer fail to procure them due to embarrassment , fear of resistance from store clerks , and cost . The Youth News Service reveals youths to have been most supportive of the new program for several months , and anxious for its implementation . A r and om poll of adults found support for condom distribution in high schools and junior high schools to be 64 % and 47 % , respectively 
    Output:
    
Lack of biological outcomes precludes assessing the link between CDI and HIV incidence