***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 : Sexually transmitted disease ( STD ) , including AIDS , disproportionately affects African-American and Hispanic women . Goal : To evaluate efficacy of st and ard and enhanced ( addition of optional support groups ) gender- and culture-specific , small-group behavioral interventions , compared to interactive STD counseling , in high risk minority women for two years . Methods : Women with a non-viral STD were treated and enrolled in a r and omized trial . Follow-up screens and interviews occurred at 6 months , 1 year , 18 months ( short interview , optional exam ) and 2 years . The primary outcome was subsequent infection with chlamydia and /or gonorrhea . Secondary outcomes included risky sexual behaviors . We employed logistic regression based on intention-to-treat . Results : Data from 775 women were included ; the retention rate was 91 % . Adjusted infection rates were higher in the controls in Year 1 ( 26.8 % ) , Year 2 ( 23.1 % ) , and cumulatively ( 39.8 % ) than in the enhanced ( 15.4 % , P = 0.004 ; 14.8 % , P < 0.03 ; 23.7 % , P < 0.001 , respectively ) and st and ard ( 15.7 % , P = 0.006 ; 14.7 % , P = 0.03 ; 26.2 % , P < 0.008 , respectively ) intervention arms at these time points . Enhanced-intervention women who opted to attend support groups ( attendees ) had the lowest adjusted infection rates in Year 1 ( 12.0 % ) and cumulatively ( 21.8 % ) . Intervention women in general , but particularly attendees , were significantly less likely than controls to have repeat infections . Multiple partners and unprotected sex with an untreated or incompletely treated partner helped explain group differences in infection . Conclusions : Risk-reduction interventions significantly decreased both single and multiple infective episodes with chlamydia and /or gonorrhea and risky sexual behaviors in the two-year study period . Support-group attendance appeared to contribute additional risk reduction in Year 1 Abstract Objective : To determine the effectiveness of a brief cognitive behavioural intervention in reducing the incidence of sexually transmitted infections among gay men . Design : R and omised controlled trial with 12 months ' follow up . Setting : Sexual health clinic in London . Participants : 343 gay men with an acute sexually transmitted infection or who reported having had unprotected anal intercourse in the past year . Main outcome measures : Number of new sexually transmitted infections diagnosed during follow up and self reported incidence of unprotected anal intercourse . Results : 72 % ( 361/499 ) of men invited to enter the study did so . 90 % ( 308/343 ) of participants returned at least one follow up question naire or re-attended the clinic and requested a check up for sexually transmitted infections during follow up . At baseline , 37 % ( 63/172 ) of the intervention group and 30 % ( 50/166 ) of the control group reported having had unprotected anal intercourse in the past month . At 12 months , the proportions were 27 % ( 31/114 ) and 32 % ( 39/124 ) respectively ( P=0.56 ) . However , 31 % ( 38/123 ) of the intervention group and 21 % ( 35/168 ) of controls had had at least one new infection diagnosed at the clinic ( adjusted odds ratio 1.66 , 95 % confidence interval 1.00 to 2.74 ) . Considering only men who requested a check up for sexually transmitted infections , the proportion diagnosed with a new infection was 58 % ( 53/91 ) for men in the intervention group and 43 % ( 35/81 ) for men in the control group ( adjusted odds ratio 1.84 , 0.99 to 3.40 ) . Using a regional data base that includes information from 23 sexual health clinics in London , we determined that few participants had attended other sexual health clinics . Conclusions : This behavioural intervention was acceptable and feasible to deliver , but it did not reduce the risk of acquiring a new sexually transmitted infection among these gay men at high risk . Even carefully design ed interventions should not be assumed to bring benefit . It is important to evaluate their effects in r and omised trials with objective clinical end points . What is already known on this topic The need for effective HIV prevention strategies based on reducing sexual risk behaviour remains important Few interventions to reduce sexual risk behaviour have been rigorously evaluated using r and omised controlled trials What this study adds This is the first r and omised controlled trial of an intervention addressing sexual behaviour in homosexual men that uses sexually transmitted infections and self reported behaviour as end points The intervention was brief and feasible to use in a busy clinic , but it did not reduce the risk of participants acquiring new infections The potential for behavioural interventions to do more harm than good needs to be taken Objective : The objective of this study was to assess whether providing a choice of condoms would increase condom acceptability , increase self-reported use , and decrease incident sexually transmitted infection . Study : We r and omized 414 men presenting with urethral discharge in Jamaica to receive either the  “ st and ard ” clinic condom or a choice of 4 different types of condoms . Men were treated presumptively at enrollment and followed up at 1 , 2 , 4 , and 6 months . Results : Participants in the choice group had a strong preference ( P < 0.01 ) for the most popular condom available in Jamaica . This preference did not translate into higher condom use ( P = 0.16 ) . The 6-month cumulative probability of first incidence of gonorrhea , chlamydia , or trichomoniasis was slightly higher in the choice group ( 21 % ; 95 % confidence interval [ CI ] , 15–28 % ) versus the control group ( 17 % ; 95 % CI , 11–23 % ) ; the difference in the survival curves was not significant ( P = 0.35 ) . Conclusion : A choice of condoms may increase perceived acceptability but not lead to increased condom use and subsequently lower sexually transmitted infection rates Abstract Objective To examine the extent and nature of outcome reporting bias in a broad cohort of published r and omised trials . Design Retrospective review of publications and follow up survey of authors . Cohort All journal articles of r and omised trials indexed in PubMed whose primary publication appeared in December 2000 . Main outcome measures Prevalence of incompletely reported outcomes per trial ; reasons for not reporting outcomes ; association between completeness of reporting and statistical significance . Results 519 trials with 553 publications and 10 557 outcomes were identified . Survey responders ( response rate 69 % ) provided information on unreported outcomes but were often unreliable — for 32 % of those who denied the existence of such outcomes there was evidence to the contrary in their publications . On average , over 20 % of the outcomes measured in a parallel group trial were incompletely reported . Within a trial , such outcomes had a higher odds of being statistically non-significant compared with fully reported outcomes ( odds ratio 2.0 ( 95 % confidence interval 1.6 to 2.7 ) for efficacy outcomes ; 1.9 ( 1.1 to 3.5 ) for harm outcomes ) . The most commonly reported reasons for omitting efficacy outcomes included space constraints , lack of clinical importance , and lack of statistical significance . Conclusions Incomplete reporting of outcomes within published articles of r and omised trials is common and is associated with statistical non- significance . The medical literature therefore represents a selective and biased subset of study outcomes , and trial protocol s should be made publicly available BACKGROUND Effective interventions are needed to prevent acquisition of HIV infection in men who have sex with men . To date , no behavioural interventions specifically for this risk group have been tested with HIV infection as the primary outcome . METHODS This multisite two-group r and omised controlled phase IIb trial tested the efficacy of a behavioural intervention in preventing HIV infection among 4295 men who have sex with men . The experimental intervention consisted of ten one-on-one counselling sessions followed by maintenance sessions every 3 months . The st and ard condition was twice-yearly Project RESPECT individual counselling . Twice-yearly follow-up visits included testing for HIV antibody and assessment of behavioural outcomes . FINDINGS The rate of acquisition of HIV infection was 18.2 % ( 95 % CI -4.7 to 36.0 ) lower in the intervention group than the st and ard group . Adjustment for baseline covariates attenuated the intervention effect to 15.7 % ( -8.4 to 34.4 ) . The effect was more favourable in the first 12 - 18 months of follow-up . The occurrence of unprotected receptive anal intercourse with HIV-positive and unknown-status partners was 20.5 % ( 10.9 to 29.0 ) lower in the intervention than in the st and ard group . INTERPRETATION The results from the primary analyses allow us to rule out that the experimental intervention is associated with a 35 % lower rate of HIV acquisition than in the st and ard group . The overall estimate of a difference of 18.2 % , more favourable estimates of effect in the first 12 - 18 months , and similar effects on risk behaviours suggest that prevention of HIV infection among men who have sex with men by a behavioural intervention is feasible . Further work should be done to develop more effective interventions This study compared two interventions design ed to decrease denial of  sexually transmitted disease (STD)/human immunodeficiency virus ( HIV ) risk , to increase purchase of and intent to use condoms , and to decrease sexual risk behaviors .  One hundred and fifty sexually active male and female undergraduates were assessed at baseline for  denial of  STD/HIV risk  ,  knowledge of sexual risk behaviors  , and  self-reports of sexual behavior  and were r and omly assigned to either a motivational or cognitive intervention or a control condition . After the intervention , subjects were offered the opportunity to purchase condoms and were assessed for denial and intent to use condoms . Two months later , sexual risk behaviors and denial were measured . The motivational approach was most effective in reducing denial and in increasing intent to use condoms immediately following the intervention and in reducing sexual risk behaviors 2 months later BACKGROUND As many as one in three HIV-positive people continue unprotected sexual practice s after learning that they are HIV infected . This article reports the outcomes of a theory-based intervention to reduce risk of HIV transmission for people living with HIV infection . METHODS Men ( n=233 ) and women ( n=99 ) living with HIV-AIDS were r and omly assigned to receive either ( 1 ) a five-session group intervention focused on strategies for practicing safer sexual behavior , or ( 2 ) a five-session , contact-matched , health-maintenance support group ( st and ard-of-care comparison ) . Participants were followed for 6 months post-intervention . RESULTS The intervention to reduce risk of HIV transmission result ed in significantly less unprotected intercourse and greater condom use at follow-up . Transmission-risk behaviors with non-HIV-positive sexual partners and estimated HIV transmission rates over a 1-year horizon were also significantly lower for the behavioral risk-reduction intervention group . CONCLUSIONS This study is among the first to demonstrate successful HIV-transmission risk reduction result ing from a behavioral intervention tailored for HIV-positive men and women Testing behavioral interventions to increase safer sex practice s of HIV+ individuals has the potential to significantly reduce the number of new infections . This study evaluated a behavioral intervention design ed to reduce the sexual risk behaviors of HIV+ individuals . HIV+ individuals ( N = 387 ) who reported engaging in unprotected sex with HIV- or partners of unknown serostatus were r and omly assigned to ( a ) a single counseling session targeting problem areas identified by the participant in 3 possible intervention domains ( i.e. , condom use , negotiation , disclosure ) ; ( b ) a single-session comprehensive intervention that covered all 3 intervention domains ; ( c ) the same comprehensive intervention , plus 2 monthly booster sessions ; or ( d ) a 3-session diet and exercise attention-control condition . The median number of unprotectedsex acts decreasedfrom 14 at baseline to6 , 6 , and 4 at 4- , 8- , and 12-month follow-ups , respectively . A repeated measures analysis of variance revealed a significant decrease in unprotected sex acts across all groups across time . A significant Group x Time interaction revealed that the comprehensive-with-boosters group had the most unprotected sex at 8-month follow-up as compared to the other 3 groups . These findings suggest that a brief intervention can result in large reductions in HIV transmission risks among HIV+ individuals , but the relative benefit of one intervention approach over another remains unclear Abstract Objective : To determine whether a theoretically based sex education programme for adolescents ( SHARE ) delivered by teachers reduced unsafe sexual intercourse compared with current practice . Design : Cluster r and omised trial with follow up two years after baseline ( six months after intervention ) . A process evaluation investigated the delivery of sex education and broader features of each school . Setting : Twenty five secondary schools in east Scotl and . Participants : 8430 pupils aged 13 - 15 years ; 7616 completed the baseline question naire and 5854 completed the two year follow up question naire . Intervention : SHARE programme ( intervention group ) versus existing sex education ( control programme ) . Main outcome measures : Self reported exposure to sexually transmitted disease , use of condoms and contraceptives at first and most recent sexual intercourse , and unwanted pregnancies . Results : When the intervention group was compared with the conventional sex education group in an intention 
    Output:
    
Despite the public health importance of increasing condom use there is little reliable evidence on the effectiveness of condom promotion interventions