Impact of Stepping Stones on HIV and HSV-2 in South Africa
Author Information
Author(s): Rachel Jewkes, Nduna M, Levin J, Jama N, Dunkle K, Puren A, Duvvury N
Primary Institution: Medical Research Council, South Africa
Hypothesis
Does the Stepping Stones HIV prevention programme reduce the incidence of HIV and HSV-2 and change sexual behaviour among young people in rural South Africa?
Conclusion
The Stepping Stones programme did not reduce the incidence of HIV but was associated with a reduction in HSV-2 infections and some changes in risk behaviours among men.
Supporting Evidence
- Stepping Stones reduced the incidence of HSV-2 by about 33%.
- Men in the Stepping Stones program reported less intimate partner violence.
- Women in the program reported more transactional sex at 12 months.
Takeaway
The Stepping Stones program didn't stop people from getting HIV, but it did help reduce another virus called HSV-2 and changed some men's risky behaviors.
Methodology
Cluster randomised controlled trial conducted in 70 villages with participants aged 15-26, comparing a 50-hour Stepping Stones intervention to a 3-hour control intervention.
Potential Biases
Potential for differential reporting bias, particularly among women regarding sexual activity.
Limitations
The trial's design may limit generalizability, and the sample size calculations were based on optimistic assumptions about effect size.
Participant Demographics
1360 men and 1416 women aged 15-26, mostly attending schools.
Statistical Information
P-Value
0.036
Confidence Interval
0.67 to 1.35
Statistical Significance
p=0.036
Digital Object Identifier (DOI)
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