***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 The purpose of this study was to test the effects of an  education program in Tanzania  design ed to reduce children 's risk of human immunodeficiency virus ( HIV ) infection and to improve their tolerance of and care for people with acquired immunodeficiency syndrome ( AIDS ) . METHODS A r and omized controlled community trial including baseline and 12-month follow-up surveys was employed . Public primary schools in the Arusha and Kilimanjaro regions of Tanzania were stratified according to location and r and omly assigned to intervention ( n = 6 ) or comparison ( n = 12 ) conditions . Of the 1063 sixth- grade students ( average age : 13.6 years ) who participated at baseline , 814 participated in the follow-up survey . RESULTS At follow-up , statistically significant effects favoring the intervention group were observed for exposure to AIDS information and communication , AIDS knowledge , attitudes toward people with AIDS , and subjective norms and behavioral intentions toward having sexual intercourse . A consistent positive but nonsignificant trend was seen for attitudes toward having sexual intercourse and for initiation of sexual intercourse during the previous year ( 7 % vs 17 % ) . CONCLUSIONS It is feasible and effective to train local teachers and health workers to provide HIV/AIDS education to Tanzanian primary school children PURPOSE To evaluate an intervention ( based on one which had previously been successful in reducing adolescent human immunodeficiency virus ( HIV ) risk behaviors in the United States ) among adolescents residing in Namibia , a country located in sub-Saharan Africa . METHODS A r and omized trial of a 14-session face-to-face intervention emphasizing abstinence and safer sex was conducted among 515 youth ( median age 17 years ; median grade 11 ) attending 10 secondary schools located in two districts in Namibia .  Knowledge , attitudes , intentions , and HIV risk behaviors were assessed at baseline and in the immediate postintervention period . RESULTS Knowledge increased significantly among intervention compared to control youth ( 88 % vs. 82 % ; correct responses , p < .0001 ) . At postintervention follow-up , more intervention than control youth believed that they could be intimate without having sex , could have a girlfriend or boyfriend for a long time without having sex , could explain the process of impregnation , knew how to use a condom , and could ask for condoms in a clinic . Fewer intervention than control youth believed that if a girl refused to have sex with her boyfriend it was permissible for him to strike her , and that condoms took away a boy 's pleasure . More intervention than control youth anticipated using a condom when they did have sex , and fewer expected to drink alcohol . Finally , after intervention , there was a trend for increased condom use . There were significant gender-related differences at baseline , although intervention impact was generally equivalent . CONCLUSIONS These findings provide support for the judicious adaptation of successful Western HIV prevention programs in other cultural setting s. A single intervention approach appears to be effective in short-term follow-up with both genders This study investigated whether there were any changes in knowledge and normative beliefs regarding abstinence and condoms and personal risk perception of acquiring HIV among Zambian secondary -school students who were exposed to a peer sexual health intervention .  Schools were r and omly assigned to intervention and control groups . A baseline assessment that measured knowledge , normative beliefs about abstinence and condoms and personal risk perception was conducted in all schools . Students in the intervention group were exposed for a 1-hour- and -45-minute-long in-class peer sexual health intervention . Students in the control schools were exposed to a 1-hour-long in-class peer water purification intervention . A follow-up assessment of students was conducted after the intervention . Logistic regression analyses were conducted to determine whether significant differences between intervention and control groups emerged at follow-up . Relative to students in the control group , knowledge was higher and normative beliefs about abstinence and condoms were significantly more positive among students in the intervention schools . Students in the intervention schools also had a higher personal risk perception of acquiring HIV than students in control schools . These findings show that a school-based peer sexual health intervention implemented in Zambia was effective in increasing knowledge , positive normative beliefs about abstinence and condoms , and personal risk perception PURPOSE The purpose of this study was to evaluate phase I of a theoretically informed media campaign design ed by youth in Zambia to encourage their peers to adopt risk-reduction practice s to protect themselves from sexually transmitted infections and human immunodeficiency virus ( HIV ) . The Helping Each other Act Responsibly Together ( HEART ) campaign conveys information for young people ages 13 to 19 years about sexually transmitted infections , HIV , and acquired immune deficiency syndrome transmission and prevention , and promotes abstinence , a return to abstinence , or consistent condom use as viable risk-reduction practice s. METHODS Separate sample baseline and follow-up design s were used to evaluate phase I of the HEART campaign among adolescents aged 13 to 19 years . The 1999 baseline survey had a sample of 368 male and 533 female adolescents ; the 2000 follow-up survey comprised 496 male and 660 female adolescents . RESULTS Controlling for age , sex , educational attainment , and urban or rural residence , logistic regression analyses demonstrated that , compared with nonviewers , campaign viewers were 1.61 times more likely to report primary or secondary abstinence and 2.38 times more likely to have ever used a condom . The odds ratio of condom use during last sex was 2.1 for respondents who recalled at least 3 television spot advertisements compared with other respondents . CONCLUSIONS The positive correlations between HEART campaign viewership and HIV risk-reduction practice s demonstrate that mediated messages can influence adolescents . The HEART campaign is among a range of programs in Zambia design ed to enable young people to protect their reproductive health . Future research should capture the independent as well as the synergistic effects of multiple campaigns and interventions PURPOSE To determine whether adolescents '  normative beliefs about abstinence and condoms , their personal risk perception , and safer sex practice s changed after the implementation of a peer sexual health education intervention implemented in Zambian secondary schools . METHODS The peer intervention was implemented during the first week of September 2000 in Lusaka , Zambia . A quasi-experimental , longitudinal panel design was used to evaluate its impact . Three schools were r and omly assigned to the intervention condition and two to the control condition . Three rounds of data from male and female adolescents in grade s 10 and 11 were collected at baseline in July 2000 , at first follow-up in the second half of September 2000 , and at second follow-up in early April 2001 . A total of 416 respondents aged 14 - 23 ( at baseline ) were interviewed in all three survey rounds . A mixed-effects logistic regression growth curve analysis was used to calculate adjusted odds ratios to compare intervention and control groups on the outcome variables . RESULTS Student self-reports showed positive changes in normative beliefs about abstinence immediately after the intervention , and these improvements were largely sustained until 6 months after the intervention . Students became more likely to approve of condom use and to intend using condoms immediately after the intervention , but these positive outcomes could not be sustained during the 6 months that followed the intervention . Normative beliefs regarding condom use took longer to develop : these were only observed at 6 months follow-up . Students reported reductions in multiple regular partnerships . There was no change in condom use . CONCLUSIONS A single session school-based peer sexual health intervention result ed in the development of normative beliefs about abstinence that were sustained over a 6-month period . Normative beliefs about condoms took longer to develop . More regular efforts may be required to sustain the approval of , and the intention to use , condoms . The intervention was successful in reducing multiple regular partnerships Objective : To evaluate an  HIV risk-reduction intervention among Namibian adolescents . Methods : A r and omized trial of a 14-session face-to-face intervention emphasizing abstinence and safer sexual practice s conducted among 515 youths ( median age 17 years and median grade 11 ) attending 10 secondary schools located in two districts in Namibia . Youths were r and omly assigned to the intervention or control condition at the level of the individual . HIV risk behaviours , intentions and perceptions were assessed at baseline , immediately post-intervention and at 6 and 12 months post-intervention . Results : Among all 515 youths who enrolled in the programme , rates of either abstinence or sex with a condom were not different between control and intervention youths at baseline or in the follow-up period . However , analyses conducted among the subset of youths who were sexually inexperienced at baseline ( n = 255 ) revealed that a higher percentage of intervention youths ( 17 % ) than control youths ( 9 % , P < 0.05 ) remained sexually inexperienced one year later . Moreover , in the immediate post-intervention period , among baseline virgins who subsequently initiated sex , intervention youths were more likely than control youths to use a condom ( 18 versus 10 % , P < 0.05 ) . Additional HIV-related risk behaviours ( failure to discuss previous HIV risk exposure with one 's sexual partner and alcohol use ) , intentions to use condoms , and perceptions of the ability to use condoms were positively affected by the intervention . Conclusions : There is evidence that the ‘ My Future is My Choice ’ ( MFMC ) intervention is reducing HIV risk behaviours among sexually inexperienced participants aged 15–18 . Related risk behaviours and perceptions are also positively impacted by the intervention 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 PURPOSE To assess the impact of exposure to life skills education by youth in KwaZulu-Natal Province ( KZN , South Africa ) on knowledge and behaviors associated with the spread of HIV/AIDS . METHODS Data come from a panel study of 2222 youth from several population subgroups in KZN . The youth were aged 14 - 24 years when interviewed in 1999 and 2001 . The intervention was a full coverage life skills education program for all students in middle and secondary schools . Impact was measured as net dose-response relationships between life skills exposure and outcomes . Econometric methods were used to control for nonr and om exposure to life skills education . Outcomes included sexual behavior and condom use indicators . RESULTS Significant effects , albeit modest in magnitude , were observed on selected areas of sexual-reproductive health knowledge and perceived condom self-efficacy , along with larger effects on condom use at first and last sex . No consistent effects on age at sexual initiation , secondary abstinence , or partnering behaviors were observed among these youth . CONCLUSIONS School-based life skills education appears capable of communicating key information and helping youth develop skills relevant to reducing HIV risk . However , the South African national program has yet to be fully implemented , and whether this initiative will result in sustained behavior modification among youth on a sufficient scale to affect the HIV/AIDS epidemic is uncertain PURPOSE To describe the implementation and evaluation of an  adolescent reproductive health peer education program  in West Africa . The program , known as the West African Youth Initiative ( WAYI ) , was developed to improve knowledge of sexuality and reproductive health , and promote safer sex behaviors and contraceptive use among sexually active adolescents in Nigeria and Ghana . METHODS Between November 1994 and April 1997 , two organizations , the Association for Reproductive and Family Health ( ARFH ) , based in Nigeria , and Advocates for Youth , based in Washington D.C. , supported community-based youth-serving organizations in the two countries to implement peer education projects . Consultants from the African Regional 
    Output:
    
Sex education and condom promotion among youth did not increase sexual behaviour as well as risky sexual behaviour .