***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 describe HIV-related media events in the context of first-time HIV-1-antibody testing trends at a London genitourinary medicine clinic . Design Demographic and behavioural data were collected prospect ively for individuals tested for HIV-1 antibodies between September 1985 and September 1993 , at the genitourinary medicine clinic of St Mary 's Hospital , London . Results A total of 19242 individuals were tested of whom 37 % were women . Of the men tested 60 % were heterosexual . The women at first time of testing were significantly younger [ 29.3 years ; 95 % confidence interval ( CI ) , 28.8–29.7 ] than the men ( 32.5 years ; 95 % CI , 29.2–35.8 ) ; mean ages for both sexes did not change significantly over time . Overall , 199 women and 1539 men tested HIV-antibody-positive .  The proportions of women testing positive increased significantly over time ( χ2 = 21.7 , degrees of freedom = 1 ; P < 0.001 ) , whereas the proportion of HIV-positive men remained constant for all sexual orientation groups . The proportion of heterosexual women testing positive ( 2.8 % ) was similar to the proportion of HIV-positive heterosexual men ( 2.9 % ) . HIV-positive individuals were significantly older for both sexes . Throughout the study period numerous education campaigns were run using a variety of media complemented by a number of other HIV-related media events . Conclusions Peak periods of attendance for HIV testing generally corresponded with increased HIV-related media activity and the greatest testing rates were observed when various HIV media events occurred concurrently . The increase in the number of heterosexuals tested suggests that the risk of heterosexual transmission of HIV has been recognized , at least among older individuals . The exact role of HIV-related media events , including celebrities disclosing their HIV-positive status , remains to be eluci date d. Whether the relative under-representation of younger people is due to a lack of awareness , increased use of safer sex practice s or reluctance to use the service also remains to be addressed . Given the increasing number of HIV-positive women and the relatively constant rate of HIV-positive tests in the male attendees an urgent need exists to assess the impact and effectiveness of specific HIV media campaigns BACKGROUND Access to HIV-1 voluntary counselling and testing ( VCT ) is severely limited in less-developed countries . We undertook a multisite trial of HIV-1 VCT to assess its impact , cost , and cost-effectiveness in less-developed country setting s. METHODS The cost-effectiveness of HIV-1 VCT was estimated for a hypothetical cohort of 10000 people seeking VCT in urban east Africa . Outcomes were modelled based on results from a r and omised controlled trial of  HIV-1 VCT in Tanzania and Kenya . Our main outcome measures included programme cost , number of HIV-1 infections averted , cost per HIV-1 infection averted , and cost per disability-adjusted life-year ( DALY ) saved . We also modelled the impact of targeting VCT by HIV-1 prevalence of the client population , and the proportion of clients who receive  VCT  as a couple compared with as individuals . Sensitivity analysis was done on all model parameters . FINDINGS HIV-1 VCT was estimated to avert 1104 HIV-1 infections in Kenya and 895 in Tanzania during the subsequent year . The cost per HIV-1 infection averted was US$ 249 and $ 346 , respectively , and the cost per DALY saved was $ 12.77 and $ 17.78 . The intervention was most cost-effective for HIV-1-infected people and those who received VCT as a couple . The cost-effectiveness of VCT was robust , with a range for the average cost per DALY saved of $ 5.16 - 27.36 in Kenya , and $ 6.58 - 45.03 in Tanzania . Analysis of targeting showed that increasing the proportion of couples to 70 % reduces the cost per DALY saved to $ 10.71 in Kenya and $ 13.39 in Tanzania , and that targeting a population with HIV-1 prevalence of 45 % decreased the cost per DALY saved to $ 8.36 in Kenya and $ 11.74 in Tanzania . INTERPRETATION HIV-1 VCT is highly cost-effective in urban east African setting s , but slightly less so than interventions such as improvement of sexually transmitted disease services and universal provision of nevirapine to pregnant women in high-prevalence setting s. With the targeting of  VCT  to population s with high HIV-1 prevalence and couples the cost-effectiveness of VCT is improved significantly Abstract Objective : To determine the uptake and acceptability of different methods of a universal offer of voluntary HIV testing to pregnant women . Design : R and omised controlled trial involving four combinations of written and verbal communication , followed by the direct offer of a test . The control group received no information and no direct offer of a test , although testing was available on request . Setting : Hospital antenatal clinic covering most of the population of the city of Edinburgh . Subjects : 3024 pregnant women booking at the clinic over a 10 month period . Main outcome measures : Uptake of HIV testing and women 's knowledge , satisfaction , and anxiety . Results : Uptake rates were 6 % for those in the control group and 35 % for those directly offered the test . Neither the style of leaflet nor the length of discussion had an effect on uptake . Significant independent predictors of uptake were a direct test offer ; the midwife seen ; and being unmarried , previously tested , and younger age . Knowledge of the specific benefits of testing increased with the amount of information given , but neither satisfaction nor anxiety was affected by the type of offer . Conclusions : The universal offer of HIV testing is not intrusive and is acceptable to pregnant women . A policy of offering the HIV test to all women result ed in higher uptake and did not increase anxiety or dissatisfaction . Uptake depends more on the midwife than the method of offering the test . Low uptake rates and inadequate detection of HIV infection point to the need to assess a more routine approach to testing . Key messages HIV testing in pregnancy is beneficial , but uptake rates are not high Offering the test to women attending antenatal clinics increases uptake without increasing anxiety or dissatisfaction The extent of information given is not important in terms of whether women take the test and whether they find the procedure acceptable Uptake depends more on the midwife than the method of offering the test Low uptake rates and inadequate detection of HIV infection point to the need to assess a more routine approach to This study compared the effectiveness of 4 videotaped educational programs design ed to motivate HIV testing among low-income , ethnic minority women . Four hundred eighty women were assigned r and omly to watch one of 2 gain-framed or 2 loss-framed videos . Consistent with prospect theory , participants ' perceptions of the certainty of the outcome of an HIV test moderated the effects of framing on self-reported testing behavior 6 months after video exposure . Among participants who reported being certain of the test 's outcome , those who saw a gain-framed video reported a higher rate of testing than those who saw a loss-framed message . Among women who perceived the outcome of HIV testing as relatively uncertain , gain- and loss-framed videos led to similar rates of self-reported testing , with some advantage for the loss-framed message African American women ( N = 100 ) recruited from an urban clinic were r and omly assigned to view 1 of 3 experimental videotapes promoting HIV testing : ( a ) an ethnicity-matched information control videotape ; ( b ) the same ethnicity-matched videotape presented by an African American woman ( gender-ethnicity-matched control condition ) ; or ( c ) an experimental videotape with a culturally relevant context that embedded HIV-testing information within a frame of reference emphasizing personal loss . Consistent with D. Kahneman and A. Tversky 's ( 1979 ) prospect theory , women who viewed the context -framing videotape were most likely to have been tested during a 2-week follow-up interval . Among women who expressed intentions to get tested after viewing the videotapes , 63 % of those in the message-framing condition were tested for HIV during a 2-week period compared with 23 % in the gender-ethnicity-matched condition , and none in the ethnicity-matched condition OBJECTIVES The purpose of this study was to assess the effects of an HIV antibody testing , counseling and education programme on the knowledge and practice s of low-income Los Angeles Latina women . METHODS The study design was prospect i ve and longitudinal involving pre-test , post-test and retest measures over a 2-year period . The study employed an experimental group and a comparison group which did not receive the intervention . The study group was comprised of a convenience sample of 508 low-income Latina women who were recruited from the Public Health Service nutrition programme for women , infants and children ( WIC ) . The comparison group ( n = 51 ) was recruited from the same setting . A battery of instruments was selected to measure HIV knowledge and practice s , the social support received , self-esteem , the level of acculturation and sociodemographic characteristics . The instruments were administered at pre-test , 2 weeks post-test and 1 year retest . The HIV antibody serostatus was assessed at pre-test and retest . An intervention protocol based on cultural competence , women as traditional health care givers and the major transmission categories was provided after the pre-test and was reinforced post-test . Finally , qualitative data were collected from the focus group participants ( n = 55 ) to evaluate the intervention protocol . RESULTS The participants in the study made significant improvements in HIV knowledge and reported condom use practice s from pre-test to post-test that were retained on retest . The comparison group subjects did not make significant pre-test-post-test improvements on these measures . CONCLUSIONS It should be noted that the changes in practice s made by the study group did not necessarily reduce their risk of HIV infection or transmission and were not related to the demonstrated knowledge and skills improvement . Of special significance to programme planners , educators and research ers , both the quantitative and qualitative data revealed problem areas with the intervention protocol related to cultural norms and the possible fragmentation of information based on the behavioral transmission categories 
    Output:
    
Mass media interventions have immediate and overall effects in promotion of HIV testing .
No long-term effects were seen .