***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 determine whether condom use among high-risk female adolescents could be increased by a behavioral intervention , with the use of infection with Chlamydia trachomatis as a biomarker of condom practice s. DESIGN Prospect i ve , r and omized , controlled intervention . SETTING Urban family planning and sexually transmitted disease clinics . PARTICIPANTS Two hundred nine female adolescents , aged 15 through 19 years , who were treated for C. trachomatis genitourinary infection , were r and omly assigned to st and ard ( control ) or experimental ( behavioral intervention ) groups . One hundred twelve subjects returned for follow-up 5 to 7 months after enrollment and comprise the study subjects . MEASUREMENTS Subjects completed a multiinstrument question naire measuring sexual behavior , condom practice s , attitudes and beliefs , cognitive complexity , sociodemographics , and motivation at enrollment and follow-up . Endourethral and endocervical sites were sample d for C. trachomatis . RESULTS Among the 112 subjects who returned for repeated examination , those who had received the experimental intervention reported increased use of condoms by their sexual partners for protection against sexually transmitted diseases ( odds ratio = 2.4 ; p = 0.02 ) and for vaginal intercourse ( odds ratio = 3.1 ; p = 0.005 ) at the 6-month follow-up . Multivariable logistic regression analysis controlling for condom use at enrollment demonstrated that the experimental intervention ( odds ratio = 2.8 ; p = 0.03 ) and the higher cognitive complexity ( odds ratio = 4.6 ; p = 0.02 ) independently contributed to greater condom use at follow-up . Despite greater use of condoms among the group who had received the intervention , use remained inconsistent and rates of reinfection with C. trachomatis were not significantly different ( 26 % vs 17 % ; p = 0.3 ) . CONCLUSION Although a brief behavioral intervention among high-risk female adolescents can increase condom use by their sexual partners , incident infection does not appear to be reduced , because condom use remained inconsistent Objective To assess the short- and long-term impact of a 6-month pilot intervention program on condom use among prostitutes in Accra , Ghana . Design The 4-year prospect i ve study follows-up cohorts enrolled in the intervention in 1987 and 1988 , comparing condom use in 1991 with that among a comparison group not enrolled in the intervention . Setting The community-based intervention was initiated in Accra , Ghana in 1987 . Participants Self-identified female prostitutes who volunteered participation . InterventionThe educational intervention used local health workers to train and support selected prostitutes to be health educators and condom distributers to their peers . Outcome measures Self-reported condom use with clients . Results Reported condom use increased dramatically between 1987 and 1988 during the first 6 months of the intervention . In 1991 , after 3 years of program relapse , 107 ( 43 % ) of the 248 women who had enrolled in 1987 or 1988 were still in prostitution and located for interview . Their level of condom use in 1991 was higher than pre-enrollment but similar to use among prostitutes never enrolled . Sixty-four per cent of those followed-up reported always using condoms with clients in 1991 . These ‘ always users ' were more likely to have maintained informal contact with project staff , know that HIV can be transmitted by healthy clients , and report that clients frequently initiate condom use . Conclusions Findings support the development of long-range educational strategies that recognize the career longevity of prostitutes , available channels for informal program diffusion , individual changes in condom use over time , and the role of clients in condom negotiation OBJECTIVE To evaluate the efficacy of a community-based social skills human immunodeficiency virus ( HIV ) prevention intervention to enhance consistent condom use . DESIGN A r and omized , single-blind controlled trial . SETTING Bayview-Hunter 's Point neighborhood of San Francisco , Calif , a predominantly African-American community that is economically disadvantaged . PARTICIPANTS A sample of 128 sexually active , heterosexual , African-American women 18 through 29 years of age was recruited using street outreach techniques . Participants completed a structured baseline interview ; 100 women ( 78.1 % ) completed 3-month follow-up interviews . INTERVENTION Women r and omized to the social skills intervention completed five sessions that emphasized ethnic and gender pride , HIV risk-reduction information , sexual self-control , sexual assertiveness and communication skills , proper condom use skills , and developing partner norms supportive of consistent condom use . Women r and omized to the HIV education condition participated in a single session that provided HIV risk-reduction information . Women r and omized to the delayed HIV education control condition received no HIV risk-reduction information until all follow-up interviews were completed . MAIN OUTCOME MEASURES Consistent condom use , HIV risk-reduction knowledge , sexual self-control , sexual assertiveness , sexual communication , and partner norms supportive of consistent condom use . RESULTS Compared with the delayed HIV education control condition , women in the social skills intervention demonstrated increased consistent condom use ( adjusted odds ratio [ OR ] , 2.1 ; 95 % confidence interval [ CI ] , 1.03 to 4.15 ; P = .04 ) , greater sexual self-control ( adjusted OR , 1.9 ; 95 % CI , 1.00 to 3.60 ; P = .05 ) , greater sexual communication ( adjusted OR , 4.1 ; 95 % CI , 1.67 to 10.01 ; P = .002 ) , greater sexual assertiveness ( adjusted OR , 1.8 ; 95 % CI , 1.01 to 3.27 ; P = .05 ) , and increased partners ' adoption of norms supporting consistent condom use ( adjusted OR , 2.1 ; 95 % CI , 1.08 to 3.87 ; P = .03 ) . No statistically significant differences in outcome variables were observed between the HIV education condition relative to the delayed HIV education control condition . CONCLUSION Community-based HIV risk-reduction programs that are gender relevant and culturally sensitive and provide social skills training can effectively enhance consistent condom use An intervention combining AIDS information with condom eroticization , condom normalization , and communication skills training was found to increase both AIDS-related knowledge and condom use among Canadian college students . 112 unmarried female undergraduates ( mean age , 18 years ) were r and omly assigned to this combination intervention ( n = 49 ) , an information-only intervention ( n = 44 ) , or a pre-test/post-test control group ( n = 19 ) . 80 % of students had engaged in vaginal intercourse and 14 % in anal intercourse . 84 % of coitally active women had engaged in unprotected intercourse in the past year and 48 % had not used condoms consistently with any sexual partner . Condom use in the pre-intervention period was associated with positive attitudes toward the method and the perception that condom use was normative among peers . One month after the interventions , both the combination and information groups , but not controls , showed an increase over baseline in AIDS-related knowledge . However , among the 36 students who were coitally active in the 1-month periods before and after the intervention , only the combination intervention was associated with increased condom use . In the combination group , the percentage of episodes of intercourse protected by condoms increased from an average of 21.8 % in the month preceding the study to 50 % during the 4-week follow-up period . Due to the small sample size and design of the study , it was not possible to determine which component of the multifaceted educational intervention was most responsible for this change OBJECTIVES To assess the consequences of  human immunodeficiency virus ( HIV ) counseling and testing for seronegative women in terms of sexual behavior and psychological outcomes . DESIGN The design is prospect i ve and longitudinal , using repeated measures . Participants were interviewed at recruitment , 2 weeks later ( when tested women received results ) , and 3 months later . SETTING Four community health clinics in southern Connecticut ; all provide HIV counseling and testing and other specialized and primary health care services . STUDY PARTICIPANTS A sequential sample of women were recruited for two study groups : those seeking HIV counseling and testing ( n = 152 ) , and a comparison group never tested for HIV ( n = 78 ) , matched by clinic , race , and age . MAIN OUTCOME MEASURES A composite measure of sexual risk was developed , based on sexual activity , condom use , and partner risk factors . Psychometrically valid and reliable measures of general psychological functioning and acquired immunodeficiency syndrome (AIDS)--specific psychological indicators were also used . RESULTS Average level of sexual risk was lower for tested than nontested women at all three interviews . For both groups , there was no significant change in sexual risk from baseline to 3-month follow-up . At the individual level , there was no difference in the number of women who decreased or increased sexual risk . For tested women , intrusive thoughts about AIDS and estimated chance of getting AIDS decreased after counseling and testing . CONCLUSIONS Behavioral and psychological consequences of HIV counseling and testing for women at risk for HIV were limited . These results have implication s for further prevention interventions OBJECTIVES Interventions to lower HIV risk behavior among drug users have concentrated on reduction of high risk injection practice s. Less attention has been directed to non-injecting drug users and drug-involved women . Female non-injecting drug users ( e.g. , women who abuse alcohol or crack cocaine ) are also at substantial risk for sexual transmission of HIV due to multiple partners , partners who self-inject and share needles , exchange of sex for drugs , coerced sex , high rates of sexually transmitted diseases , and low rates of condom use . This study compared the effectiveness of an educational intervention ( EC ) against the behavior skills training intervention ( BST ) in reducing sexual risk behavior among women ( N = 117 ) court-ordered into inpatient drug treatment . METHODS Participants were assessed at baseline , post intervention , and 2 months after discharge from the drug treatment facility . RESULTS Women in both conditions reported high rates of sexual risk behavior prior to the intervention . Women in both conditions had more positive attitudes toward HIV prevention and reported greater partner agreement with condom use at the post intervention assessment . However , these changes were not maintained at follow-up for women in the EC condition , whereas women in BST continued to show improvement post discharge . Women in the BST condition showed marked , while women in EC showed little improvement in communication skills and no improvement in condom application skill . At follow-up , women in both conditions had reduced drug use and drug-related high risk sex activities . BST women had increased their condom use while women in EC evidence d a decrease . Condom use increased from 35.7 % to 49.5 % of vaginal intercourse occasions for BST women and decreased from 28.8 % to 15.8 % for women in EC . CONCLUSIONS Results suggest a brief skills training intervention embedded in drug treatment programs can reduce sexual risk for HIV-infection after discharge College students are engaging in high rates of behavior related to risk of infection from Human Immunodeficiency Virus ( HIV ) and other sexually transmitted diseases ( STDs ) . A cognitive-behavioral skills training program for heterosexual college females focused on sexual assertiveness skills and the reduction of risk-related behaviors was design ed and evaluated compared with an education-only program . Participants completed pre-intervention , post-intervention , and one-month follow-up assessment s of : ( a ) HIV/STD-related knowledge and beliefs ; ( b ) sexual , alcohol , and drug-related behaviors ; and ( c ) sexual assertiveness role-plays . Skills training participants compared to education-only participants scored higher on sexual assertiveness skills , specific knowledge of HIV infection , and self-efficacy to perform lower risk sexual behaviors and reported a reduction in risk-related behaviors at post-intervention and follow-up assessment s. The effectiveness of behavioral skills in HIV risk-reduction programs for college students is discussed OBJECTIVE To develop and test an HIV intervention targeting sex workers and madams in the brothels of Bombay . SUBJECTS AND METHODS In a controlled intervention trial , with measurements before and after the intervention , 334 sex workers and 20 madams were recruited from an intervention site , and 207 and 17 , respectively , from a similar control site , both in red-light areas of Bombay . All sex workers were tested for antibodies to HIV and syphilis , and for hepatitis B surface antigen . Information on sexual practice s , condom use and knowledge of HIV was collected by interviewer-administered question naire . All subjects in the intervention group underwent a 6-month program of educational videos , small group discussion s and pictorial educational material s ; free condoms were also distributed . The blood tests and the question naire were readministered to all subjects at both sites immediately after the intervention . Both groups were followed for approximately 1 year . RESULTS The baseline level of knowledge about HIV and experience with condoms was extremely low among both sex workers and madams . The baseline prevalence of HIV antibodies was 47 % in the intervention group and 41 % in the control group ( P = 0.17 ) . The incidence densities for HIV and sexually transmitted diseases were significantly different in the two groups ( all P < 0.005 ) : 0.05 and 0.16 per person-year of follow-up for HIV , 0.08 and 0.22 per person-year for antibodies to syphilis , and 0.04 and 0.12 per person-year for hepatitis B surface antigen in the intervention and control women , respectively . Following the intervention , women reported increased levels of condom use , and some ( 41 % ) 
    Output:
    
It was concluded that educational interventions targeting socially and economically disadvantaged women in which information provision is complemented by sexual negotiation skill development can encourage at least short-term sexual risk reduction behaviour .
This effect has the potential to reduce the transmission of HPV and thus possibly reduce the incidence of cervical carcinoma