title: Cluster-randomized controlled trial of an HIV/sexually transmitted infection risk-reduction intervention for South African men.
abstract: OBJECTIVE
  We tested the efficacy of a sexual risk-reduction intervention for men in South Africa, where heterosexual exposure is the main mode of HIV transmission.
  
  
  METHODS
  Matched-pairs of neighborhoods in Eastern Cape Province, South Africa, were randomly selected and within pairs randomized to 1 of 2 interventions based on social cognitive theory and qualitative research: HIV/sexually transmitted infection (STI) risk-reduction, targeting condom use, or attention-matched control, targeting health issues unrelated to sexual risks. Sexually active men aged 18 to 45 years were eligible. The primary outcome was consistent condom use in the past 3 months.
  
  
  RESULTS
  Of 1181 participants, 1106 (93.6%) completed the 12-month follow-up. HIV and STI risk-reduction participants had higher odds of reporting consistent condom use (odds ratio [OR] = 1.32; 95% confidence interval [CI] = 1.03, 1.71) and condom use at last vaginal intercourse (OR = 1.40; 95% CI = 1.08, 1.82) than did attention-control participants, adjusting for baseline prevalence. No differences were observed on unprotected intercourse or multiple partnerships. Findings did not differ for sex with steady as opposed to casual partners.
  
  
  CONCLUSIONS
  Behavioral interventions specifically targeting men can contribute to efforts to reduce sexual risk behaviors in South Africa.
authors.affiliation: John B. Jemmott III, G. Anita Heeren, and Craig Carty are with the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia. John B. Jemmott III is also with the Annenberg School for Communication, University of Pennsylvania. Loretta S. Jemmott is with the School of Nursing, University of Pennsylvania. Ann O'Leary is with the Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA. Zolani Ngwane is with the Department of Anthropology, Haverford College, Haverford, PA. Larry D. Icard is with the College of Health Professionals and Social Work, Temple University, Philadelphia, PA. Xoliswa Mtose is with the Faculty of Education, University of Fort Hare, East London, South Africa.
authors.forename: John B
authors.initials: JB
authors.lastname: Jemmott
authors.forename: Loretta S
authors.initials: LS
authors.lastname: Jemmott
authors.forename: Ann
authors.initials: A
authors.lastname: O'Leary
authors.forename: Zolani
authors.initials: Z
authors.lastname: Ngwane
authors.forename: Larry D
authors.initials: LD
authors.lastname: Icard
authors.forename: G Anita
authors.initials: GA
authors.lastname: Heeren
authors.forename: Xoliswa
authors.initials: X
authors.lastname: Mtose
authors.forename: Craig
authors.initials: C
authors.lastname: Carty
mesh_terms: D000293:Adolescent; D000328:Adult; D044383:Black People; D016000:Cluster Analysis; D016001:Confidence Intervals; D005500:Follow-Up Studies; D015658:HIV Infections / Q000517:prevention & control*; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D040242:Risk Reduction Behavior; D021841:Safe Sex; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D013019:South Africa; D055815:Young Adult