***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: Objective : To investigate HIV incidence during a trial of two voluntary counselling and testing ( VCT ) strategies . Counselling may promote beneficial behavioural change , although knowledge of negative status does not appear to contribute further benefit . Design : The parent cluster-r and omized trial demonstrated much greater uptake of VCT when counselling and rapid testing were available on-site ( intensive VCT ) than through pre-paid vouchers to an external provider ( st and ard VCT ) . Anonymous HIV tests had been requested from all employees at enrolment and after 2 years intervention . Methods : The study setting was 22 businesses in Harare , Zimbabwe . Participants were 3146 HIV-negative individuals remaining in employment at the end of intervention , of whom 2966 ( 94.3 % ) consented to repeat testing . VCT linked to basic HIV care was provided and the main outcome measures were HIV incidence under each study arm , as a retrospective secondary analysis . Results : Mean VCT uptake in this cohort was 70.7 and 5.2 % , respectively , in the intensive and st and ard arms . Crude HIV incidence was 1.21 per 100 person-years , with non-significantly higher rates in the intensive VCT arm [ mean site incidence 1.37 and 0.95 per 100 person-years , respectively ; adjusted rate ratio 1.49 ( 95 % confidence interval 0.79–2.80 ) . Conclusions : Highly acceptable VCT did not reduce HIV incidence in this predominantly male cohort .  HIV incidence was highest in the high uptake VCT arm , lending support to a US trial in which rapid testing appeared to have adverse behavioural consequences in some HIV-negative clients . Careful comparison of outcomes under different counselling and testing strategies is needed to maximize HIV prevention from global scale-up of VCT Background HIV counselling and testing is a key component of both HIV care and HIV prevention , but uptake is currently low . We investigated the impact of rapid HIV testing at the workplace on uptake of  voluntary counselling and testing ( VCT ) . Methods and Findings The study was a cluster-r and omised trial of two VCT strategies , with business occupational health clinics as the unit of r and omisation . VCT was directly offered to all employees , followed by 2 y of open access to VCT and basic HIV care .  Businesses were r and omised to either on-site rapid HIV testing at their occupational clinic ( 11 businesses ) or to vouchers for off-site VCT at a chain of free-st and ing centres also using rapid tests ( 11 businesses ) . Baseline anonymised HIV serology was requested from all employees . HIV prevalence was 19.8 % and 18.4 % , respectively , at businesses r and omised to on-site and off-site VCT . In total , 1,957 of 3,950 employees at clinics r and omised to on-site testing had VCT ( mean uptake by site 51.1 % ) compared to 586 of 3,532 employees taking vouchers at clinics r and omised to off-site testing ( mean uptake by site 19.2 % ) . The risk ratio for on-site VCT compared to voucher uptake was 2.8 ( 95 % confidence interval 1.8 to 3.8 ) after adjustment for potential confounders . Only 125 employees ( mean uptake by site 4.3 % ) reported using their voucher , so that the true adjusted risk ratio for on-site compared to off-site VCT may have been as high as 12.5 ( 95 % confidence interval 8.2 to 16.8 ) . Conclusions High-impact VCT strategies are urgently needed to maximise HIV prevention and access to care in Africa . VCT at the workplace offers the potential for high uptake when offered on-site and linked to basic HIV care . Convenience and accessibility appear to have critical roles in the acceptability of community-based VCT Objectives : To assess self‐ selection in a population ‐based voluntary HIV testing and counseling ( VTC ) program by comparing the HIV risk characteristics of users and nonusers of VTC in rural Ug and a. Design : A 1994 to 1995 community‐r and omized trial in the Rakai District of Ug and a enrolled adults aged 15 to 59 years and ascertained their HIV status , sociodemographic characteristics , risk behaviors , and AIDS‐associated symptoms . All subjects were offered confidential individual VTC at no cost . Methods : We compared users and nonusers of VTC among 10,950 participants ( 4764 male and 6186 female ) enrolled at baseline using multivariate logistic regression . Results : Women were significantly less likely to  receive VTC  than men ( 31.5 % vs. 34.8 % , p < .001 ) . In multivariate analysis , younger age , HIV‐positive status , and having no sexual partners in the past 5 years ( and , significant for women only , having 2 or more sexual partners ) were associated with lower VTC participation for both men and women . Among women ,  higher VTC participation was associated with symptoms suggestive of AIDS and other illnesses and shopkeeper occupations . Conclusions : During the initial phase of a population ‐based  free VTC program in rural Ug and a , certain high‐risk groups were underrepresented among VTC recipients . There is a need to target VTC to ensure participation by high‐risk individuals most in need of services Recent debate about the evaluation of community based , HIV/AIDS behavioural interventions has focused on the appropriateness of the r and omised controlled trial ( RCT ) design , and the difficulty of obtaining reliable outcome measures . A  community based HIV AIDS behavioural change RCT , recently conducted in rural Ug and a , used HIV incidence as the principal outcome measure . This paper examines the acceptability of the trial from the community perspective . It asks whether , in a rural African setting , it is possible to implement a scientifically rigorous evaluation without compromising acceptability of the trial to the community . Opinions of the trial held by community members working as trial field workers were collected by semi-structured interview ( n = 37 ) , and focus group discussion s ( 4 ) Community opinions of the trial were ascertained through 10 focus groups . For both field workers and the community , the sero-survey was more salient than the intervention , and the source of many rumours and disputes . Despite intensive mobilisation and close monitoring of field workers , it was impossible to ensure the veracity of explanations about the survey at ground level , and to protect each individual from coercion . The community expected a reward in return on their blood . Although the introduction of incentives at the final survey round increased the acceptability of the trial , they not only created jealousies and tensions , but also led to expectations of greater rewards in future . We conclude that RCTs in poor , rural communities are feasible , but the challenges involved should not be underestimated . Obtaining community support for the trial , respecting established hierarchies , and close supervision of field workers are all essential , but even then , controversies should be anticipated . There is an urgent need for relevant guidelines to help research ers navigate the complex ethical issues involved The Zimbabwe AIDS Prevention Project ( ZAPP ) conducted a r and omized trial to investigate the effectiveness of peer education in preventing  HIV infection . Initial research revealed that if health education could successfully promote a reduction in the number of sex partners and condom use , HIV risk could be greatly reduced . In 1993 , ZAPP began enrolling men working at 40 factories in a study . The men were tested for sexually transmitted diseases ( STD ) and HIV every six months and had access to a ZAPP clinic for counseling , testing , and STD treatment . In June 1994 , ZAPP r and omly chose 20 factories to receive an additional peer education intervention .  Educators were trained for a week and were given refresher courses every six months . Comparison of the incidence of HIV between the control and intervention groups was measured by determining incidence for all individuals and by comparing overall incidence at each factory . Of the 2219 men who were HIV negative after the introduction of peer education  , 78 % completed one follow-up , and HIV incidence  was 2.52%/year . Controlling for time enrolled in the program revealed that the peer education result ed in significantly fewer new HIV infections . Because the voluntary testing and counseling were available at factories with control and intervention programs , this study exposed the independent impact of  peer education .  It is concluded that  peer education , condom distribution , and treatment of STDs should be the cornerstone of HIV prevention policies BACKGROUND In the early years of the worldwide p and emic , there were no reported cases of acquired immunodeficiency syndrome in Lesotho , a small , mountainous country in South Africa . Since 1986 , when the first case of acquired immunodeficiency syndrome was identified , reported diagnoses have risen precipitously . The initiation of the Lesotho Highl and s Water Project has result ed in the influx of a migrant workforce of predominantly single males into a relatively isolated , mountainous area where human immunodeficiency virus ( HIV ) was previously unknown . OBJECTIVE To ascertain the HIV seroprevalence among a cohort of laborers at the Katse Dam construction site in Bokong , Lesotho . METHODS During the 5-week study period in late 1992 , construction workers ( age range , 15 to 59 years ) who were first-time clinic users for any chief complaint were r and omly selected for serological study . Surveillance complied with the Lesotho National AIDS Control Programme guidelines , which required unlinked , anonymous testing . Serum sample s were screened by an enzyme-linked immunosorbent assay ; the results were confirmed by the Western blot technique . RESULTS Unlinked , anonymous HIV testing of 486 persons revealed a seroprevalence of 5.3 % ( 26/486 ; 95 % confidence interval , 3.3 % to 7.3 % ) . These data contrasted with a 0.8 % seroprevalence in a similar age group in nearby villages that surrounded the construction project . CONCLUSIONS Lesotho , in the early phase of the HIV/acquired immunodeficiency syndrome epidemic in Africa in the 1980s , was seemingly protected by its relative isolation . Grave concern is now warranted as the country is destined to experience a rapid rise in HIV seroprevalence . Increased surveillance , health education opportunities , and aggressive prevention activities at the Katse Dam construction site are imperative to arrest the spread of HIV from construction workers to nearby villagers OBJECTIVE The study was aim ed at assessing the knowledge of the drivers and conductors  on HIV/AIDS epidemic and its preventive measures . METHODS This descriptive study was prospect ively conducted among r and omly selected city commuter-bus drivers and conductors from December 2006 to April 2007 in Dar Es Salaam , Tanzania . The study parameters included the general knowledge of the respondents on HIV/AIDS , treatment by anti-retroviral therapy and different types of preventive measures . Data was collected through face-to-face interviews using semi- structured question naires . RESULTS A total of 333 respondents voluntarily participated in the study . It was found that out of all respondents who had heard about HIV/AIDS , 93.9 % heard it from the media particularly radios , televisions and newspapers . The results further showed no significant difference ( p=0.08 ) of knowledge on HIV/AIDS between the drivers and conductors . Drivers ( 84.3 % ) and conductors ( 80.1 % ) pointed out condom as the common method of prevention from contracting HIV/AIDS . Among other preventive measures known to them , 75.5 % and 52.9 % of the drivers and conductors pointed out faithfulness respectively . However results indicated that 49.30 % of the respondents were practicing faithfulness to their partners as a preventive measure while 40.9 % were using condoms and only 9.6 % were practicing abstinence . CONCLUSION This study has shown that city commuter-bus drivers and conductors in Dar Es Salaam , have " adequate " knowledge on HIV/AIDS and preventive measures and the major source of this knowledge is through the public media Objectives : To measure the prevalence of HIV and other STIs in communities neighbouring new large scale gold mines in northern Tanzania in order to inform the design of a targeted HIV/STI intervention programme . Methods : Cross sectional surveys were conducted in adults aged 16–54 years from different sectors of communities neighbouring two newly opened , large scale gold mines near Lake Victoria . Mine workers , men , women , and female food and recreational facility workers ( FRFW ) from the community were r and omly selected for interview and HIV and STI testing . Results : 207 male Tanzanian mine workers , 206 FRFW , 202 other male and 205 female community members were enrolled . Overall , 42 % of FRFW were HIV positive , compared to 6 % of male mine workers , and 16 % and 18 % of other community men and women respectively . HIV prevalence in FRFW was significantly associated with alcohol consumption ( adjusted odds ratio ( aOR ) = 2.5 , 95 % confidence interval ( CI ) 1.1 to 5.5 ) , past or present syphilis ( TPPA+ ) ( aOR = 2.7 , 95 % CI 1.4 to 5.1 ) and single status ( aOR = 3.8 , 95 % CI 1.2 to 11.9 ) . Among FRFW , 24 % had active syphilis ( RPR+ , TPPA+ ) , 9 % Chlamydia trachomatis , and 4 % Neisseria gonorrhoeae . Overall , 50 % of FRFW and 50 % of community men never used condoms during sex , and 55 % mineworkers , 61 % 
    Output:
    
Workplace interventions to prevent HIV are feasible .
There is moderate quality evidence that VCT offered at the work site increases the uptake of testing .
Even though this did no lower HIV-incidence , there was a decrease in self-reported sexual transmitted diseases and a decrease in risky sexual behaviour .
There is low quality evidence that educational interventions decrease sexually transmitted diseases , unprotected sex and sex with commercial sex workers but not sex with multiple partners and the use of alcohol before sex .