Impact of Stepping Stones on incidence of HIV and HSV-2 and sexual behaviour in rural South Africa: cluster randomised controlled trial.

摘要: Objective To assess the impact of Stepping Stones, a HIV prevention programme, on incidence and herpes simplex type 2 (HSV-2) sexual behaviour. Design Cluster randomised controlled trial. Setting 70 villages (clusters) in Eastern Cape province South Africa. Participants 1360 men 1416 women aged 15-26 years, who were mostly attending schools. Intervention 50 hour aims to improve health by using participatory learning approaches build knowledge, risk awareness, communication skills stimulate critical reflection. Villages receive either this or three intervention safer sex. Interviewers administered questionnaires at baseline 12 24 months blood was tested for HSV-2. Main outcome measures Primary measure: HIV. Other outcomes: HSV-2, unwanted pregnancy, reported practices, depression, substance misuse. Results There no evidence that Stones lowered (adjusted rate ratio 0.95, 95% confidence interval 0.67 1.35). The programme associated with reduction about 33% HSV-2 (0.67, 0.46 0.97; P=0.036)—that is, reduced number new infections over two year period 34.9 (1.6 68.2) per 1000 people exposed. significantly improved behaviours men, lower proportion reporting perpetration intimate partner violence across years follow-up less transactional sex problem drinking months. In desired behaviour changes not those more Conclusion did reduce but had an several factors HIV—notably, violence. Trial Registration Clinical Trials NCT00332878.