***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 AND OBJECTIVE : Sexual assault is a major cause of injury , unplanned pregnancy , HIV infection , and mental health problems worldwide . In parts of sub-Saharan Africa , sexual assault has reached epidemic proportions . This study evaluated the efficacy of an empowerment and self-defense intervention for adolescent girls to decrease the incidence of sexual assault and harassment in Nairobi ’s large informal settlements . METHODS : A prospect i ve cohort of 1978 adolescents from 4 neighborhoods near Nairobi were taught empowerment , deescalation , and self-defense skills in six 2-hour sessions . The st and ard-of-care ( SOC ) group ( n = 428 ) received a life skills class .  Self-reported , anonymous survey data were collected at baseline and 10.5 months after intervention . RESULTS : Annual sexual assault rates decreased from 17.9/100 person-years at baseline to 11.1 at follow-up ( rate ratio = 1.61 ; 95 % confidence interval [ CI ] , 1.26–1.86 ; P < .001 ) ; there was no significant change in the SOC group ( 14.3 to 14.0 , rate ratio = 1.02 ; 95 % CI , 0.67–1.57 , P = .92 ) . Sexual assault disclosure in the intervention group increased from 56 % to 75 % ( P = .006 ) , compared with a constant incidence of disclosure ( 53 % ) in the SOC group . The majority ( 52.3 % ) of adolescents in the intervention group reported using skills learned to stop an assault . CONCLUSIONS : This intervention decreased sexual assault rates  among adolescent girls in Kenya . The intervention was also associated with an increase in the disclosure of assaults , thereby enabling survivors to seek care and support and possibly leading to the identification and prosecution of perpetrators . This model should be adaptable to other setting s both in Africa and globally Background Gender-based violence against women , including intimate partner violence ( IPV ) , is a pervasive health and human rights concern . However , relatively little intervention research has been conducted on how to reduce IPV in setting s impacted by conflict . The current study reports on the evaluation of the incremental impact of adding “ gender dialogue groups ” to an economic empowerment group savings program on levels of IPV . This study took place in north and northwestern rural Côte d’Ivoire . Methods Between 2010 and 2012 , we conducted a two-armed , non-blinded r and omized-controlled trial ( RCT ) comparing group savings only ( control ) to “ gender dialogue groups ” added to group savings ( treatment ) . The gender dialogue group consisted of eight sessions that targeted women and their male partner . Eligible Ivorian women ( 18 + years , no prior experience with group savings ) were invited to participate . 934 out of 981 ( 95.2 % ) partnered women completed baseline and endline data collection . The primary trial outcome measure was an overall measure of past-year physical and /or sexual IPV . Past year physical IPV , sexual IPV , and economic abuse were also separately assessed , as were attitudes towards justification of wife beating and a woman ’s ability to refuse sex with her husb and . Results Intent to treat analyses revealed that compared to groups savings alone , the addition of gender dialogue groups result ed in a slightly lower odds of reporting past year physical and /or sexual IPV ( OR : 0.92 ; 95 % CI : 0.58 , 1.47 ; not statistically significant ) . Reductions in reporting of physical IPV and sexual IPV were also observed ( not statistically significant ) . Women in the treatment group were significantly less likely to report economic abuse than control group counterparts ( OR = 0.39 ; 95 % CI : 0.25 , 0.60 , p < .0001 ) . Acceptance of wife beating was significantly reduced among the treatment group ( β = -0.97 ; 95 % CI : -1.67 , -0.28 , p = 0.006 ) , while attitudes towards refusal of sex did not significantly change Per protocol analysis suggests that compared to control women , treatment women attending more than 75 % of intervention sessions with their male partner were less likely to report physical IPV ( a OR : 0.45 ; 95 % CI : 0.21 , 0.94 ; p = .04 ) and report fewer justifications for wife beating ( adjusted β = -1.14 ; 95 % CI : -2.01 , -0.28 , p = 0.01 ) ; and both low and high adherent women reported significantly decreased economic abuse ( a OR : 0.31 ; 95 % CI : 0.18 , 0.52 , p < 0.0001 ; a OR : 0.47 ; 95 % CI : 0.27 , 0.81 , p = 01 , respectively ) . No significant reductions were observed for physical and /or sexual IPV , or sexual IPV alone . Conclusions Results from this pilot RCT suggest the importance of addressing household gender inequities alongside economic programming , because this type of combined intervention has potential to reduce levels of IPV . Additional large-scale intervention research is needed to replicate these findings .Trial registration Registration Number : NCT01629472 OBJECTIVE To assess the efficacy of trauma-focused cognitive behavioral therapy ( TF-CBT ) delivered by non clinical facilitators in reducing posttraumatic stress , depression , and anxiety and conduct problems and increasing prosocial behavior in a group of war-affected , sexually exploited girls in a single-blind , parallel- design , r and omized,+ controlled trial . METHOD Fifty-two 12- to 17-year-old , war-affected girls exposed to rape and inappropriate sexual touch in the Democratic Republic of Congo were screened for trauma , depression and anxiety , conduct problems , and prosocial behavior . They were then r and omized to a 15 session , group-based , culturally modified TF-CBT ( n = 24 ) group or a wait-list control group ( n = 28 ) . Primary analysis , by intention-to-treat , involving all r and omly assigned participants occurred at pre- and postintervention and at 3-month follow-up ( intervention group only ) . RESULTS Compared to the wait list control , the TF-CBT group experienced significantly greater reductions in trauma symptoms ( F(1,49 ) = 52.708 , p<0·001 , χ(p)2 = 0.518 ) . In addition , the TF-CBT group showed a highly significant improvement in symptoms of depression and anxiety , conduct problems , and prosocial behavior . At 3-months follow-up the effect size ( Cohen 's d ) for the TF-CBT group was 2.04 ( trauma symptoms ) , 2.45 ( depression and anxiety ) , 0.95 ( conduct problems ) , and -1.57 ( prosocial behavior ) . CONCLUSIONS A group-based , culturally modified , TF-CBT intervention delivered by non clinical ly trained Congolese facilitators result ed in a large , statistically significant reduction in posttraumatic stress symptoms and psychosocial difficulties among war-affected girls exposed to rape or sexual violence . Clinical trial registration information-An RCT of TF-CBT with sexually-exploited , war-affected girls in the DRC ; http:// clinical trials.gov/ ; NCT01483261 AIMS To evaluate whether an alcohol harm reduction intervention was associated with reduced interpersonal violence or engagement in sex work among female sex workers ( FSWs ) in Mombasa , Kenya . DESIGN R and omized controlled trial . SETTING HIV prevention drop-in centers in Mombasa , Kenya . PARTICIPANTS 818 women 18 or older in Mombasa who visited HIV prevention drop-in centers , were moderate-risk drinkers and engaged in transactional sex in past six months ( 410 and 408 in intervention and control arms , respectively ) . INTERVENTION 6 session alcohol harm reduction intervention . COMPARATOR 6 session non-alcohol related nutrition intervention . MEASUREMENTS In-person interviews were conducted at enrollment , immediately post-intervention and 6-months post-intervention . General linear mixed models examined associations between intervention assignment and recent violence ( physical violence , verbal abuse , and being robbed in the past 30 days ) from paying and non-paying sex partners and engagement in sex work in the past 30 days . FINDINGS The alcohol intervention was associated with statistically significant decreases in physical violence from paying partners at 6 months post-intervention and verbal abuse from paying partners immediately post-intervention and 6-months post-intervention . Those assigned to the alcohol intervention had significantly reduced odds of engaging in sex work immediately post-intervention and 6-months post-intervention . CONCLUSIONS The alcohol intervention was associated with reductions in some forms of violence and with reductions in engagement in sex work among FSWs in Mombasa , Kenya The broad objective of this study was to underst and the incidence and severity of aggression among sexually abused girls who were trafficked and who were then further used for commercial sexual exploitation ( referred to subsequently as sexually abused trafficked girls ) . In addition , the impact of counseling for minimizing aggression in these girls was investigated . A group of 120 sexually abused trafficked Indian girls and a group of 120 nonsexually abused Indian girls , aged 13 to 18 , participated in the study . The sexually abused trafficked girls were purposively selected from four shelters located in and around Kolkata , India . The nonsexually abused girls were selected r and omly from four schools situated near the shelters , and these girls were matched by age with the sexually abused trafficked girls . Data were collected using a Background Information Schedule and a st and ardized psychological test , that is , The Aggression Scale . Results revealed that 16.7 % of the girls were first sexually abused between 6 and 9 years of age , 37.5 % between 10 and 13 years of age , and 45.8 % between 14 and 17 years of age . Findings further revealed that 4.2 % of the sexually abused trafficked girls demonstrated saturated aggression , and 26.7 % were highly aggressive , that is , extremely frustrated and rebellious . Across age groups , the sexually abused trafficked girls suffered from more aggression ( p < .05 ) , compared with the nonvictimized girls . Psychological interventions , such as individual and group counseling , were found to have a positive impact on the sexually abused trafficked girls . These findings should motivate counselors to deal with sexually abused children . It is also hoped that authorities in welfare homes will underst and the importance of counseling for sexually abused trafficked children , and will appoint more counselors for this purpose OBJECTIVES We evaluated changes in social capital following group-based cognitive processing therapy ( CPT ) for female survivors of sexual violence . METHODS We compared CPT with individual support in a cluster-r and omized trial in villages in South Kivu province , Democratic Republic of the Congo . Local psychosocial assistants delivered the interventions from April through July 2011 . We evaluated differences between CPT and individual support conditions  for structural social capital ( i.e. , time spent with nonkin social network , group membership and participation , and the size of financial and instrumental support networks ) and emotional support seeking . We analyzed intervention effects with longitudinal r and om effects models . RESULTS We obtained small to medium effect size differences for 2 study outcomes . Women in the CPT villages increased group membership and participation at 6-month follow-up and emotional support seeking after the intervention compared with women in the individual support villages . CONCLUSIONS Results support the efficacy of group CPT to increase dimensions of social capital among survivors of sexual violence in a low-income conflict-affected context PURPOSE Little is known about whether effectiveness of  intimate partner violence prevention programming varies for women who were married as child brides , given their additional social vulnerabilities . This sub analysis sought to assess treatment heterogeneity based on child marriage status for an intervention seeking to reduce intimate partner violence . METHODS A r and omized controlled trial assessing the incremental effectiveness of gender dialogue groups in addition to group savings on changing past-year intimate partner violence was conducted in Côte d'Ivoire ( 2010 - 2012 ) . Stratified models were constructed based on child marriage status to assess for effect modification . Analysis was restricted to married women with data on age at marriage ( n = 682 ) . RESULTS For child brides ( N = 202 ) , there were no statistically or marginally significant decreases in physical and /or sexual violence , physical violence , or sexual violence . The odds of reporting economic abuse in the past year were lower in the intervention arm for child brides relative to control group child brides ( odds ratio [ OR ] = .33 ; 95 % confidence interval [ CI ] = .13-.85 ; p = .02 ) . For nonchild brides ( N = 480 ) , women were less likely to report physical and /or sexual violence ( OR = .54 ; 95 % CI = .28 - 1.04 ; p = .06 ) , emotional violence ( OR = .44 ; 95 % CI = .25-.77 ; p = .004 ) , and economic abuse ( OR = .36 ; 95 % CI = .20-.66 ; p = .001 ) in the combined intervention arm than their group savings-only counterparts . CONCLUSIONS Findings suggest that intervention participants with a history of child marriage may have greater difficulty benefiting from interventions that seek to reduce intimate partner violence BACKGROUND Survivors of sexual violence have high rates of depression , anxiety , and post-traumatic stress disorder ( PTSD 
    Output:
    
There is some evidence that interventions targeting alcohol use , both among perpetrators and survivors , may be effective at reducing VAW through secondary prevention , and that psychotherapy might be effective for survivors of non-partner sexual violence through tertiary prevention .
Finally , some evidence exists for crisis centres increasing survivors ’ access to services ( through both secondary and tertiary prevention ) , however , assessment of their impact on future VAW are needed .