Trial reportBMJ (Clinical research ed.)2008
Impact of stepping stones on incidence of HIV and HSV-2 and sexual behaviour in rural South Africa: cluster randomised controlled trial.
Trial report in BMJ (Clinical research ed.), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00332878 (RCT of Stepping Stones Behavioural Intervention for HIV), which is not on this map. Cited by 362 papers, 25 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
RCT of Stepping Stones Behavioural Intervention for HIV
Who cites it
362 citing papers in PubMed, 25 syntheses or guidelines pooled it.
- Interventions for adolescent school boys and young men to reduce gender-based violence in low- and middle-income countries: a systematic review.BMC public health · 2025Pooled it
- Use of contraceptives, empowerment and agency of adolescent girls and young women: a systematic review and meta-analysis.BMJ sexual & reproductive health · 2024Pooled it
- Pooled it
- Preventing Sexual Violence: A Behavioral Problem Without a Behaviorally Informed Solution.Psychological science in the public interest : a journal of the American Psychological Society · 2024Pooled it
- Systematic review of cash plus or bundled interventions targeting adolescents in Africa to reduce HIV risk.BMC public health · 2024Pooled it
- Community level youth-led interventions to improve maternal-neonatal outcomes in low- and middle-income countries: A systematic review of randomised trials.Journal of global health · 2023Pooled it
- Gender-Based Violence Interventions in Low- and Middle-Income Countries: A Systematic Review of Interventions at Structural, Community, Interpersonal, Individual, and Multiple Levels.Trauma, violence & abuse · 2023Pooled it
- Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries.The Cochrane database of systematic reviews · 2023Pooled it
- Effectiveness of community mobilisation and group-based interventions for preventing intimate partner violence against women in low- and middle-income countries: A systematic review and meta-analysis.Journal of global health · 2023Pooled it
- Quantitative Methods Used to Evaluate Impact of Combination HIV Prevention Intervention: A Methodological Systematic Review.AIDS and behavior · 2023Pooled it
- Adolescent dating violence prevention programmes: a global systematic review of evaluation studies.The Lancet. Child & adolescent health · 2021Pooled it
- Randomized Controlled Trials of Interventions Addressing Intimate Partner Violence in Sub-Saharan Africa: A Systematic Review.Trauma, violence & abuse · 2020Pooled it
- Psychosocial interventions for intimate partner violence in low and middle income countries: A meta-analysis of randomised controlled trials.Journal of global health · 2020Pooled it
- A systematic review of sexual and reproductive health interventions for young people in humanitarian and lower-and-middle-income country settings.BMC public health · 2020Pooled it
- Characteristics of successful programmes targeting gender inequality and restrictive gender norms for the health and wellbeing of children, adolescents, and young adults: a systematic review.The Lancet. Global health · 2020Pooled it
- Recent levels and trends in HIV incidence rates among adolescent girls and young women in ten high-prevalence African countries: a systematic review and meta-analysis.The Lancet. Global health · 2019Pooled it
- Peer-facilitated community-based interventions for adolescent health in low- and middle-income countries: A systematic review.PloS one · 2019Pooled it
- The effect of HIV educational interventions on HIV-related knowledge, condom use, and HIV incidence in sub-Saharan Africa: a systematic review and meta-analysis.BMC public health · 2018Pooled it
- Evaluations of Structural Interventions for HIV Prevention: A Review of Approaches and Methods.AIDS and behavior · 2018Pooled it
- Theory-based interventions for contraception.The Cochrane database of systematic reviews · 2016Pooled it
302 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectiveTo assess the impact of Stepping Stones, a HIV prevention programme, on incidence of HIV and herpes simplex type 2 (HSV-2) and sexual behaviour.
designCluster randomised controlled trial.
setting70 villages (clusters) in the Eastern Cape province of South Africa.
participants1360 men and 1416 women aged 15-26 years, who were mostly attending schools.
interventionStepping 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 measuresPRIMARY OUTCOME MEASURE: incidence of HIV. Other outcomes: incidence of HSV-2, unwanted pregnancy, reported sexual practices, depression, and substance misuse.
resultsThere 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.
conclusionStepping 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 registrationClinical Trials NCT00332878.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.