Impact of Stepping Stones on incidence of HIV and HSV-2 and sexual behaviour in rural South Africa: cluster randomised controlled trial
BMJPublished 7 August 2008Open access
Rachel Jewkes, Mzikazi Nduna, Jonathan Levin, Nwabisa Jama, Kristin Dunkle, Adrian Puren
Citations751
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TL;DR
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.
Abstract
Clinical Trials NCT00332878.
Keywords
Social SciencesMedicineHealth Professions
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