***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 Violence against adolescent girls in humanitarian setting s is of urgent concern given their additional vulnerabilities to violence and unique health and well-being needs that have largely been overlooked by the humanitarian community . In order to underst and what works to prevent violence against adolescent girls , a multi-component curriculum-based safe spaces program ( Creating Opportunities through Mentorship , Parental involvement and Safe Spaces – COMPASS ) will be implemented and evaluated . The objectives of this multi-country study are to underst and the feasibility , acceptability and effectiveness of COMPASS programming to prevent violence against adolescent girls in diverse humanitarian setting s. Methods / design Two wait-listed cluster-r and omized controlled trials are being implemented in conflict-affected communities in eastern Democratic Republic of Congo ( N = 886 girls aged 10–14 years ) and in refugee camps in western Ethiopia ( N = 919 girls aged 13–19 years ) . The intervention consists of structured facilitated sessions delivered in safe spaces by young female mentors , caregiver discussion groups , capacity-building activities with service providers , and community engagement . In Ethiopia , the research centers on the overall impact of COMPASS compared to a wait-list group . In DRC , the research objective is to underst and the incremental effectiveness of the caregiver component in addition to the other COMPASS activities as compared to a wait-list group . The primary outcome is change in sexual violence . Secondary outcomes include decreased physical and emotional abuse , reduced early marriage , improved gender norms , and positive interpersonal relationships , among others . Qualitative method ologies seek to underst and girls ’ perceptions of safety within their communities , key challenges they face , and to identify potential pathways of change . Discussion These trials will add much needed evidence for the humanitarian community to meet the unique needs of adolescent girls and to promote their safety and well-being , as well as contributing to how multi-component empowerment programming for adolescent girls could be adapted across humanitarian setting s . Trial registration Clinical Trials NCT02384642 ( Registered : 2/24/15 ) & NCT02506543 ( Registered : 7/19/15 ) Women who exchange sex for money or other goods , that is , female sex workers , are at increased risk of experiencing physical and sexual violence from both paying and intimate partners . Exposure to violence can be exacerbated by alcohol use and HIV/STI risk . The purpose of this study is to examine the efficacy of a HIV/STI risk reduction and enhanced HIV/STI risk reduction intervention at decreasing paying and intimate partner violence against Mongolian women who exchange sex and engage in harmful alcohol use . Women are recruited and r and omized to either ( a ) four sessions of a relationship-based HIV/STI risk reduction intervention ( n = 49 ) , ( b ) the same HIV/STI risk reduction intervention plus two additional motivational interviewing sessions ( n = 58 ) , or ( c ) a four session control condition focused on wellness promotion ( n = 59 ) . All the respondents complete assessment s at baseline ( preintervention ) as well as at immediate posttest , 3 and 6 months postintervention . A multilevel logistic model finds that women who participated in the HIV/STI risk reduction group ( OR = 0.14 , p < .00 ) , HIV/STI risk reduction and motivational interview group ( OR = 0.46 , p = .02 ) , and wellness ( OR = 0.20 , p < .00 ) group reduced their exposure to physical and sexual violence in the past 90 days . No significant differences in effects are observed between conditions . This study demonstrates the efficacy of a  relationship-based HIV/STI risk reduction intervention , a relationship-based HIV/STI risk reduction intervention combined with motivational interviewing , and a wellness promotion intervention in reducing intimate and paying partner violence against women who exchange sex in Mongolia . The findings have significant implication s for the impact of minimal intervention and the potential role of peer networks and social support in reducing women ’s experiences of violence in re source poor setting 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 Adolescents and young adults in sub-Saharan Africa ( SSA ) are particularly vulnerable to human immunodeficiency virus ( HIV ) and acquired immune deficiency syndrome ( AIDS ) infection . Adolescents orphaned as a direct result of HIV/AIDS are at an elevated risk of acquiring HIV/AIDS and other sexually transmitted infections . However , limited empirical evidence exists on HIV knowledge and prevention programs , especially those design ed to address HIV information gaps among adolescents . This study evaluates the effect of a peer mentorship program provided in addition to other supportive services on HIV/AIDS knowledge , beliefs , and prevention attitudes , among school-going orphaned adolescents in southern Ug and a. We utilize data from the Bridges to the Future Study , a 5-year longitudinal r and omized experimental study funded by the National Institute of Child Health and Human Development . Out of the 1410 adolescents enrolled in the study ( average age = 12.7 at study initiation ) , 855 of them participated in a nine-session , curriculum based peer mentorship program .  We analyzed data collected at baseline and 12-months post intervention initiation . The results from bivariate and regression analysis indicate that , controlling for socioeconomic characteristics , adolescents who participated in a peer mentorship program were more likely than non- participants to report increased scores on HIV/AIDS knowledge ; better scores on desired HIV/AIDS-related beliefs ; and better scores on HIV/AIDS prevention attitudes . Overall , the study findings point to the potential role of a peer mentorship program in promoting the much-desired HIV/AIDS knowledge , beliefs , and prevention attitudes among orphaned adolescents . Future programs and policies that support AIDS-orphaned adolescents in sub-Saharan Africa should consider incorporating peer mentoring programs that provide correct , age , and culturally appropriate HIV information to help protect orphaned adolescents and reduce the risk of HIV infections Background “ Let Us Protect Our Future ” is a sexual risk-reduction intervention for sixth- grade adolescents in South Africa . Tested in a cluster-r and omized controlled trial , the intervention significantly reduced self-reported intercourse and unprotected intercourse during a 12-month follow-up period . Purpose The present analyses were conducted to identify moderators of the intervention ’s efficacy as well as , which theory-based variables mediated the intervention ’s effects . Methods Intervention efficacy over the 3- , 6- , and 12-month follow-up was tested using generalized estimating equation models . Results Living with their father in the home , parental strictness , and religiosity moderated the efficacy of the intervention in reducing unprotected intercourse . Self-efficacy to avoid risky situations and expected parental disapproval of their having intercourse , derived from Social Cognitive Theory , significantly mediated the intervention ’s effect on abstinence . Conclusions This is the first study to demonstrate that Social Cognitive variables mediate the efficacy of a sexual risk-reduction intervention among South African adolescents Background Among women at high risk for HIV and other sexually transmitted diseases ( STIs ) , gender and economic issues limit the impact of behavioral prevention strategies . Women in Kazakhstan with dual risks of sex trading and drug use face elevated risk for HIV and STIs and may benefit from an economic empowerment intervention which combines HIV-risk reduction ( HIVRR ) education with financial skills-building and asset-building to promote reduced reliance on sex trading for income . Methods / design The study employs a two-arm , cluster-r and omized controlled trial ( c- RCT ) design . We will use cluster r and omization to assign 350 women in approximately 50 cohorts to a traditional four-session HIV-risk-reduction intervention combined with a six-session financial literacy intervention , enrollment in a 24-session vocational training program and receipt of matched savings ( HIVRR+MF ) ; or to the four-session HIV-risk-reduction intervention alone ( HIVRR ) . Repeated behavioral and biological assessment s will be conducted at baseline , then at 6 , 9 , and 15 months post r and omization/session 1 . Discussion This study responds to an identified need in the academic literature for rigorous testing of structural interventions , including combination microfinance and HIV-prevention interventions .Trial registration Clinical Trials.gov , ID : NCT02406482 . Registered on 30 March 2015 Children comprise the largest proportion of the population in sub-Saharan Africa . Of these , millions are orphaned . Orphanhood increases the likelihood of growing up in poverty , dropping out of school , and becoming infected with HIV . Therefore , programs aim ed at securing a healthy developmental trajectory for these orphaned children are desperately needed . We conducted a two-arm cluster-r and omized controlled trial to evaluate the effectiveness of a family-level economic strengthening intervention with regard to school attendance , school grade s , and self-esteem in AIDS-orphaned adolescents aged 12–16 years from 10 public rural primary schools in southern Ug and a. Children were r and omly assigned to receive usual care ( counseling , school uniforms , school lunch , notebooks , and textbooks ) , “ bolstered ” with mentorship from a near-peer ( control condition , n = 167 ) , or to receive bolstered usual care plus a family-level economic strengthening intervention in the form of a matched Child Savings Account ( Suubi-Maka treatment arm , n = 179 ) . The two groups did not differ at baseline , but 24 months later , children in the Suubi-Maka treatment arm reported significantly better educational outcomes , lower levels of hopelessness , and higher levels of self-concept compared to participants in the control condition . Our study contributes to the ongoing debate on how to address the developmental impacts of the increasing numbers of orphaned and vulnerable children and adolescents in sub-Saharan Africa , especially those affected by HIV/AIDS . Our findings indicate that innovative family-level economic strengthening programs , over and above bolstered usual care that includes psychosocial interventions for young people , may have positive developmental impacts related to education , health , and psychosocial functioning This study examined the efficacy of an enhanced intervention to reduce sexual risk of HIV/STI and harmful alcohol use among female sex workers in Mongolia . Women ( n = 166 ) were recruited and r and omized to either ( 1 ) a relationship-based HIV sexual risk reduction intervention ; ( 2 ) the same sexual risk reduction intervention plus motivational interviewing ; or ( 3 ) a control condition focused on wellness promotion . At three and six month follow-up , both treatment interventions and the wellness promotion condition were effective in reducing the percentage and the number of unprotected acts of vaginal sex with paying partners in the past 90 days . All three conditions demonstrated efficacy in reducing harmful alcohol use . No significant differences in effects were observed between conditions . Findings suggest that even low impact behavioral interventions can achieve considerable reductions of HIV/STI risk and harmful alcohol use with a highly vulnerable population in a low re source d setting Background Some studies show orphanhood to be associated with increased sexual risk-taking while others have not established this relationship , but have found factors other than orphanhood as predictors of sexual risk behaviours and outcomes among adolescents . This study examines community members ’ perceptions of how poverty influences  adolescent sexual behaviour and outcomes in four districts of Nyanza Province , Kenya . Methods Eight study sites within the four districts were r and omly selected .  Focus group discussion s were conducted with a purposive sample of adolescents , parents and caregivers .  Key informant interviews were undertaken with a purposive sample of community leaders , child welfare and healthcare workers , and adolescents . The two methods elicited information on factors perceived to predispose adolescent orphans and non-orphans to sexual risks . Data were analysed through line-by-line coding , grouped into families and retrieved as themes and sub-themes . Results Participants included 147 adolescents and parents/caregivers in 14 focus groups and 13 key informants . Poverty emerged as a key predisposing factor to sexual risk behaviour among orphans and non 
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Discussion When WESW have access to more capital and /or alternative forms of employment and start earning formal income outside of sex work , they may be better able to improve their skills and employability for professional advancement , thereby reducing their STI/HIV risk .