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In women desired behaviour changes were not reported replica handbags 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 IntroductionChange in sexual behaviour is the cornerstone of HIV prevention, yet relatively little research and development has been invested in interventions aimed at behaviour change in any setting.1 School based HIV/AIDS programmes for young people in sub Saharan Africa have generally not been rigorously evaluated but are often weakly designed, and evaluations suggest they have little impact on sexual behaviours.2 In this respect they are no different from programmes for adolescents in other countries that have rarely shown sustained behaviour change.3 Three randomised controlled trials have been conducted in Africa with both behavioural and other interventions (management of sexually transmitted infection, microfinance, community action, or health service strengthening) in community and school settings.4 5 6 Two studies showed no effectiveness in prevention of sexually transmitted infections,5 6 but one had a positive effect on self reported behaviour.5 The third showed that the intervention was associated with a reduced prevalence of curable sexually transmitted infections. This is potentially an important weakness as development of interventions is an iterative process, and interventions are generally strengthened by being more extensively tested and adapted.9 In this respect Stepping Stones is a quite different intervention as it has been widely used for many years.10 It was originally developed for use in Uganda in 1995 and has been used in over 40 countries, adapted for 17 settings (including South Africa in 199811), translated into 13 languages, and used with hundreds of thousands of individuals.12 It is almost certainly the most widely used intervention of its kind in the world. Stepping Stones is a participatory HIV prevention programme that aims to improve sexual health through building stronger, cheap replica handbags more gender equitable relationships.
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This was not exactly a comfortable field assignment, but Sweet was thrilled to be right in the action despite snakes, 100F degree temperatures, and bat guano raining down from the sky. Sweet says, “If you really want to see into the animal’s lives, you have to go into the animal’s world. Having the privilege and being able to go and just experience and document what they’re replica bags doing is amazing.”.