***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: CONTEXT The female condom remains the only female-initiated method for preventing pregnancy and STDs , including HIV . Innovative methods for promoting its use , and for involving male partners in its use , are needed . METHODS A sample of 217 women and their main male sexual partners were r and omly assigned to one of three study conditions : a six-session relationship-based STD prevention intervention provided to the couple together , the same intervention provided to the woman only or a single-session education control provided to the woman only . Assessment s were conducted at baseline and three months postintervention . Contrast coding was used to examine whether the effects of the two active interventions differed from those of the control intervention , and whether the effects of the two active interventions differed from each other . Regression analyses were used to estimate treatment effects . RESULTS During follow-up , participants in either active intervention were more likely to use a female condom with their study partner and with all partners , and used female condoms at a higher rate with all partners , than individuals assigned to the control intervention ; at the end of three months , they were more likely to intend to use the condom in the next 90 days . No significant differences in outcomes were found between the active intervention groups . CONCLUSIONS Focusing on both a woman and her main male sexual partner is efficacious in increasing female condom use and intention to use among heterosexual couples at risk for HIV and other STDs The efficacy and differential effects of specialized ( S ) and traditional ( T ) AIDS education programs on cognitive , behavioral , and psychological outcomes were investigated . The sample consisted of 858 impoverished African-American and Latina women ( S = 448 , T = 410 ) . At baseline , women in the traditional group reported significantly higher distress , greater knowledge of AIDS , and less problem-focused coping . Significant improvements over the 2-week intervention interval were found for participants of both AIDS education programs for appraisal of threat , concerns , knowledge , and attitudes about AIDS , emotion-focused coping , number of sexual partners , IV and non-IV drug use , depression , and distress . However , multivariate analysis indicated that the traditional group had slightly better posttest scores on concerns , emotion-focused coping , knowledge of AIDS , and number of partners than the specialized group . The specialized group reported greater use of problem-focused coping . These differences do not detract from the substantial improvement found for both groups , but they do reinforce the conclusion that the specialized program was not more effective than its st and ard counterpart Objective : To assess effects of a combined microfinance and training intervention on HIV risk behavior  among young female participants in rural South Africa . Design : Secondary analysis of quantitative and qualitative data from a cluster r and omized trial , the Intervention with Microfinance for AIDS and Gender Equity study . Methods : Eight villages were pair-matched and r and omly allocated to receive the intervention . At baseline and after 2 years , HIV risk behavior was assessed among female participants aged 14–35 years . Their responses were compared with women of the same age and poverty group from control villages . Intervention effects were calculated using adjusted risk ratios employing village level summaries . Qualitative data collected during the study explored participants ' responses to the intervention including HIV risk behavior . Results : After 2 years of follow-up , when compared with controls , young participants had higher levels of HIV-related communication ( adjusted risk ratio 1.46 , 95 % confidence interval 1.01–2.12 ) , were more likely to have accessed voluntary counseling and testing ( adjusted risk ratio 1.64 , 95 % confidence interval 1.06–2.56 ) , and less likely to have had unprotected sex at last intercourse with a nonspousal partner ( adjusted risk ratio 0.76 , 95 % confidence interval 0.60–0.96 ) . Qualitative data suggest a greater acceptance of intrahousehold communication about HIV and sexuality . Although women noted challenges associated with acceptance of condoms by men , increased confidence and skills associated with participation in the intervention supported their introduction in sexual relationships . Conclusions : In addition to impacts on economic well being , women 's empowerment and intimate partner violence , interventions addressing the economic and social vulnerability of women may contribute to reductions in HIV risk behavior The research design of the r and omised controlled trial is primarily associated today with medicine . It tends either to be ignored or regarded with suspicion by many in such disciplines as health promotion , public policy , social welfare , criminal justice , and education . However , all professional interventions in people 's lives are subject to essentially the same questions about acceptability and effectiveness . As the social reformers Sidney and Beatrice Webb pointed out in 1932 , there is far more experimentation going on in “ the world sociological laboratory in which we all live ” than in any other kind of laboratory , but most of this social experimentation is “ wrapped in secrecy ” and thus yields “ nothing to science.”1 # # # Summary points Many social scientists argue that r and omised controlled trials are inappropriate for evaluating social interventions , but they ignore a considerable history , mainly in the United States , of the use of r and omised controlled trials to assess different approaches to public policy and health promotion A tradition of experimental sociology was well established by the 1930s , built on the early use of controlled experiments in psychology and education From the early 1960s to early 1980s r and omised experiments were considered the optimal design for evaluating public policy interventions in the United States , and major evaluations using this design were carried out This approach became less popular as policy makers reacted negatively to evidence of “ near zero ” effects Lessons to be learnt about implementing r and omised controlled trials in real life setting s include the difficulty of assessing complex multi-level interventions and the challenge of integrating qualitative data The Webbs argued for a more “ scientific ” social policy , with social scientists being trained in experimental methods and evaluations of social interventions being carried out by independent investigators . They were apparently unaware that a strong tradition in experimental sociology had already been established , mainly in the United States . Investigators examined the 6-month impact of three cognitive-behavioral HIV risk-reduction programs on behavioral factors ( substance use and sexual risk behaviors ) and cognitive and psychological re sources of 325 women who resided in emergency or sober-living shelters and their 308 intimate sexual partners . Participants were r and omized by shelter to a peer-mentored , a nurse case-managed , or a st and ard care HIV risk-reduction program . Significant improvements were observed in all groups in all behavioral factors and cognitive and psychological re sources except for self-esteem . Participants in the peer-mentored and nurse case-managed groups did not differ significantly from the st and ard group in self-esteem , life satisfaction , psychological well-being , use of noninjection drugs , sex with multiple partners , and unprotected sex at 6 months ( n = 633 ) . It was concluded that a st and ard approach by health care professionals appears to effectively modify HIV risk behaviors for a majority of homeless participants and may have important economic and policy implication s. Further , the impact of short-term programs that address psychological vulnerabilities of impoverished population s needs to be studied further The purpose of this study was to document the effectiveness of small group condom motivation education in reducing new and reinfection rates of sexually transmitted diseases ( STD ) among female teenagers . Two hundred and five ( 205 ) female adolescents ( age 13 - 20 ) with a current STD were studied at two sites of a Teen Health Clinic . There were 86 teens in the Study Group and 119 in the Comparison Group . Patients were sample d from December 1992 to July 1993 . The patients in the Study Group received a condom motivation class given by the clinic STD educator in small groups of four or more adolescents . The Comparison Group , comparable in age and ethnicity , received treatment for their STD but did not participate in condom motivation classes . All teens were given treatment and condoms . The sample was followed for 6 months . The total number of patients returning with new infections was 21 ( 14.7 % ) . The total number of patients with reinfections was 14 ( 9.8 % ) . There were no significant differences between the Study and Comparison Group on return rates , new and reinfection rates or on any socio-demographic variables . The comparison of these groups suggests that a specific condom motivation class has minimal effectiveness in urban teens . However , almost 70 % of the teens returned to the clinic for their scheduled visits . It is suggested that adolescent clinics which combine family planning and STD treatment services maintain high client enrollment and therefore may be ideal locations to initiate new and continuous interventions for condom use especially for high risk teens OBJECTIVES Women in impoverished inner-city neighborhoods are at high risk for contracting HIV . A r and omized , multisite community-level HIV prevention trial was undertaken with women living in 18 low-income housing developments in 5 US cities . METHODS Baseline and 12-month follow-up population risk characteristics were assessed by surveying 690 women at both time points . In the 9 intervention condition housing developments , a community-level intervention was undertaken that included HIV risk reduction workshops and community HIV prevention events implemented by women who were popular opinion leaders among their peers . RESULTS The proportion of women in the intervention developments who had any unprotected intercourse in the past 2 months declined from 50 % to 37.6 % , and the percentage of women 's acts of intercourse protected by condoms increased from 30.2 % to 47.2 % . Among women exposed to intervention activities , the mean frequency of unprotected acts of intercourse in the past 2 months tended to be lower at follow-up ( mean = 4.0 ) than at baseline ( mean = 6.0 ) . These changes were corroborated by changes in other risk indicators . CONCLUSIONS Community-level interventions that involve and engage women in neighborhood-based HIV prevention activities can bring about reductions in high-risk sexual behaviors 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 Background : The Information-Motivation-Behavioral Skills ( IMB ) model of HIV preventive behavior ( 1–4 ) specifies that treatment effects on behavior occur largely as the result of treatment effects on behavioral skills , which follow from effects on information and motivation . Purpose : The objective was to determine whether the variables specified by the IMB model of HIV preventive behavior ( 1–4 ) accounted for the relation between an IMB-based treatment and result ing HIV preventive behavior ( condom use ) . Method : Women ( n = 557 ) living in 18 low-income housing developments in 5 geographically dispersed cities were recruited to participate in an HIV-prevention study . Women ( within housing developments ) were r and omly assigned to receive an IMB-based , HIV risk-avoidance intervention or a comparison intervention . Baseline and posttreatment ( 16 months after baseline ) data were collected on condom use information , motivation ( social norms , attitudes , intentions , and perceived risk ) , enactment of behavioral skills ( condom negotiation and procurement ) , and rates of condom use in the past 2 months . Results : The IMB intervention led to a 12 % to 16 % increase in condom use rates over the course , whereas the comparison intervention led to 2 % decrease . In addition , the IMB treatment led to greater increases in condom use information , in the intentions and social norms components of motivation and the condom procurement and condom conversations components of behavioral skills . The IMB model provided an acceptable fit to the data ( root mean square error of approximation < .05 ) and accounted for 50 % of the variance inposttreatment condom use among the sample . Treatment effects on condom use were almost entirely mediated by the IMB variables ; specifically , motivation and enactment of behavioral skills mediated the intervention ’s impact on condom use . Conclusions : These results provide supporting evidence as to how theoretical variables operate to effect change within a theory-based intervention and provide evidence as to the applicability of a prevailing theory of HIV risk behavior among low-income minority We conducted a cluster-r and omized community intervention trial at Kenyan agricultural sites to measure the impact of female condom introduction on  sexually transmitted infection ( STI ) prevalence . We present male and female condom use data here . Six Intervention sites received a community risk-reduction campaign and distribution of female condoms and male condoms , while 6 Control sites  received the same campaign with male condoms only .  Male and female condom distribution increased throughout follow-up . Self-reported male condom use increased substantially during follow-up to over 60 % of the participants . The proportion of consistent male condom users at Control sites was higher than at Intervention sites , 23 % vs 14 % at 6 months and 24 % vs 22 % at 12 months . At Intervention sites , 11 % and 7 % of women used the female condoms all the time at 6 and 12 months , respectively , while the percentage of female condom non-users grew . Male and female condom use was hindered by male partner objections ; suspicion of 
    Output:
    
A variety of STIs were addressed including HIV and chlamydia .
None of the trials explicitly mentioned HPV or cervical cancer prevention .
Statistically significant effects for behavioural outcomes ( e.g. increasing condom use ) were common , though not universal and varied according to the type of outcome .
There were no statistically significant effects of abstaining from or reducing sexual activity .
There were few statistically significant effects on biological ( STI ) outcomes .
Behavioural interventions for young women which aim to promote sexual behaviours protective of STI transmission can be effective , primarily at encouraging condom use .