Abstract:
OBJECTIVE:To assess the impact of Stepping Stones, a HIV prevention programme, on incidence of HIV and herpes simplex type 2 (HSV-2) and sexual behaviour. DESIGN:Cluster randomised controlled trial. SETTING:70 villages (clusters) in the Eastern Cape province of South Africa. PARTICIPANTS:1360 men and 1416 women aged 15-26 years, who were mostly attending schools. INTERVENTION:Stepping Stones, a 50 hour programme, aims to improve sexual health by using participatory learning approaches to build knowledge, risk awareness, and communication skills and to stimulate critical reflection. Villages were randomised to receive either this or a three hour intervention on HIV and safer sex. Interviewers administered questionnaires at baseline and 12 and 24 months and blood was tested for HIV and HSV-2. MAIN OUTCOME MEASURES: PRIMARY OUTCOME MEASURE:incidence of HIV. Other outcomes: incidence of HSV-2, unwanted pregnancy, reported sexual practices, depression, and substance misuse. RESULTS:There was no evidence that Stepping Stones lowered the incidence of HIV (adjusted incidence rate ratio 0.95, 95% confidence interval 0.67 to 1.35). The programme was associated with a reduction of about 33% in the incidence of HSV-2 (0.67, 0.46 to 0.97; P=0.036)-that is, Stepping Stones reduced the number of new HSV-2 infections over a two year period by 34.9 (1.6 to 68.2) per 1000 people exposed. Stepping Stones significantly improved a number of reported risk behaviours in men, with a lower proportion of men reporting perpetration of intimate partner violence across two years of follow-up and less transactional sex and problem drinking at 12 months. In women desired behaviour changes were not reported and those in the Stepping Stones programme reported more transactional sex at 12 months. CONCLUSION:Stepping Stones did not reduce incidence of HIV but had an impact on several risk factors for HIV-notably, HSV-2 and perpetration of intimate partner violence. TRIAL REGISTRATION:Clinical Trials NCT00332878.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Jewkes R,Nduna M,Levin J,Jama N,Dunkle K,Puren A,Duvvury Ndoi
10.1136/bmj.a506subject
Has Abstractpub_date
2008-08-07 00:00:00pages
a506eissn
0959-8138issn
1756-1833journal_volume
337pub_type
杂志文章,多中心研究,随机对照试验abstract:OBJECTIVE:To identify the attitudes of general practitioners towards the use of thermometers in general practice. DESIGN:Postal questionnaire survey. SETTING:All general practitioners in the catchment area of Frimley Park Hospital, Surrey. SUBJECTS:145 general practitioners. MAIN OUTCOME MEASURES:Answers to questio...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.304.6832.961
更新日期:1992-04-11 00:00:00
abstract::The studyTaylor RS, Walker S, Ciani O, et al. Exercise-based cardiac rehabilitation for chronic heart failure: the EXTRAMATCH II individual participant data meta-analysis. Health Technol Assess 2019;23:1-98.This project was funded by the NIHR Health Technology Assessment Programme (project number 15/80/30).To read the...
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更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:To determine whether cognitive therapy is effective in preventing the worsening of emerging psychotic symptoms experienced by help seeking young people deemed to be at risk for serious conditions such as schizophrenia. DESIGN:Multisite single blind randomised controlled trial. SETTING:Diverse services at fi...
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doi:10.1136/bmj.e2233
更新日期:2012-04-05 00:00:00
abstract:OBJECTIVE:To examine how the relaxation of the one child policy and policies to reduce caesarean section rates might have affected trends over time in caesarean section rates and perinatal and pregnancy related mortality in China. DESIGN:Observational study. SETTING:China's National Maternal Near Miss Surveillance Sy...
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doi:10.1136/bmj.k817
更新日期:2018-03-05 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.317.7150.13
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doi:10.1136/bmj.38731.622975.3A
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abstract:OBJECTIVE:To compare four potential screening strategies, and subsequent interventions, for the prevention and treatment of type 2 diabetes: (a) screening for type 2 diabetes to enable early detection and treatment, (b) screening for type 2 diabetes and impaired glucose tolerance, intervening with lifestyle interventio...
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doi:10.1136/bmj.39545.585289.25
更新日期:2008-05-24 00:00:00
abstract:OBJECTIVE:To identify and explore parents' concerns when young children become acutely ill. DESIGN:Qualitative study making use of semi-structured one to one and group interviews with parents of preschool children. SETTING:Disadvantaged inner city community. SUBJECTS:95 parents of preschool children. RESULTS:Fever,...
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pub_type: 杂志文章
doi:10.1136/bmj.313.7063.983
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abstract:OBJECTIVE:To evaluate the relative efficacy of the World Health Organization 2005 campaign (WHO-5) and other interventions to promote hand hygiene among healthcare workers in hospital settings and to summarize associated information on use of resources. DESIGN:Systematic review and network meta-analysis. DATA SOURCES...
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pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.h3728
更新日期:2015-07-28 00:00:00
abstract:OBJECTIVE:To assess the effectiveness of a teacher led intervention to improve teenagers' knowledge about emergency contraception. DESIGN:Cluster randomised controlled trial. SETTING:24 mixed sex, state secondary schools in Avon, south west England. PARTICIPANTS:1974 boys and 1820 girls in year 10 (14-15 year olds)....
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pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.324.7347.1179
更新日期:2002-05-18 00:00:00
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pub_type: 杂志文章
doi:10.1136/bmj.310.6990.1315
更新日期:1995-05-20 00:00:00
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pub_type: 杂志文章
doi:10.1136/bmj.297.6648.601
更新日期:1988-09-03 00:00:00
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pub_type: 杂志文章
doi:10.1136/bmj.314.7085.942
更新日期:1997-03-29 00:00:00
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pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.b4460
更新日期:2009-11-10 00:00:00
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pub_type: 杂志文章
doi:10.1136/bmj.f6187
更新日期:2013-10-30 00:00:00
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pub_type: 临床试验,杂志文章
doi:10.1136/bmj.298.6680.1061
更新日期:1989-04-22 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2014-10-06 00:00:00
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pub_type: 杂志文章
doi:10.1136/bmj.298.6665.18
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pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.319.7219.1241
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pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.l6461
更新日期:2019-12-11 00:00:00
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pub_type: 杂志文章,meta分析
doi:10.1136/bmj.l1079
更新日期:2019-03-27 00:00:00
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pub_type: 杂志文章
doi:10.1136/bmj.302.6770.207
更新日期:1991-01-26 00:00:00
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pub_type: 杂志文章
doi:10.1136/bmj.316.7141.1356
更新日期:1998-05-02 00:00:00
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doi:10.1136/bmj.h3084
更新日期:2015-07-03 00:00:00
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pub_type: 杂志文章
doi:10.1136/bmj.301.6746.266
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pub_type: 新闻
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更新日期:1998-12-05 00:00:00
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pub_type: 评论,杂志文章
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更新日期:2019-08-27 00:00:00
abstract:OBJECTIVE:To assess the effectiveness of health checks by nurses in reducing risk factors for cardiovascular disease in patients from general practice. DESIGN:Randomised controlled trial. SETTING:Five urban general practices in Bedfordshire. SUBJECTS:2136 patients receiving an initial health check in 1989-91 and sch...
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pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-01-29 00:00:00
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pub_type: 杂志文章
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更新日期:2010-06-16 00:00:00
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pub_type: 杂志文章
doi:10.1136/bmj.318.7190.1035
更新日期:1999-04-17 00:00:00