HIV Infections Clinical Trial
Official title:
RCT of Stepping Stones Behavioural Intervention for HIV
This study will evaluate the effectiveness of Stepping Stones, an HIV-prevention education program, versus a brief HIV-focused intervention, in improving sexual health and preventing HIV infection in young residents of rural South African communities.
HIV is arguably the most important problem currently facing the South African population. It
is possible that biotechnology will eventually be able to lessen the disease's threat by
introducing a vaccine or vaginal microbicide, but these are not expected to be available
within the next 5 to 10 years. It is therefore extremely important to prevent HIV infection
by modifying sexual behaviors. Voluntary counseling and testing have been shown to have an
important impact on sexual behavior, but it is essential that other approaches to HIV
prevention are developed and evaluated. Little research, however, has been done on
behavioral interventions, relative to the amount of research that has been devoted to
biotechnology development. Stepping Stones is an approach to HIV prevention that aims to
improve sexual health through building stronger, more gender-equitable relationships with
better communication between partners. This study will evaluate the effectiveness of the
Stepping Stones program versus a brief HIV-focused intervention in improving sexual health
and preventing HIV infection in young residents of rural South African communities.
Participants in this open-label study will be randomly assigned to take part in either the
Stepping Stones program or the brief HIV-focused intervention (control). All participants
will first attend a baseline study visit, which will include an interview and HIV testing.
The control intervention will entail a single 2- to 3-hour meeting among same-sex peer
groups, and will include exercises about HIV and safer sex practices that will be drawn from
the Stepping Stones program. Stepping Stones will entail 17 sessions with same-sex peer
groups, and will be implemented over a period of 3 to 12 weeks. Sessions will involve
discussions on a variety of sexual health issues, including the following topics:
reflections on love; sexual health joys and problems; body mapping; menstruation;
contraception and conception, including infertility; sexual problems; unwanted pregnancy;
HIV; STDs; safer sex; gender-based violence; motivations for sexual behavior; and dealing
with grief and loss. Peer groups will come together for 3 of the 17 meetings to build
assertive communication skills by leading presentations on exercises from the Stepping
Stones program. HIV testing will be performed again after 12 and 24 months to assess program
effectiveness. Face-to-face interviews will be held at Months 6, 12, and 24 to assess the
impact of the intervention on behavior, attitude, and beliefs.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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