Effect of a structural intervention for the prevention of intimate-partner violence and HIV in rural South Africa: a cluster randomised trial

Pronyk, Paul; Hargreaves, James; Kim, Julia C.; Morison, Linda; Phetla, Godfrey; Watts, Charlotte; Busza, Joanna; Porter, John D.

doi:10.1016/s0140-6736(06)69744-4

Cited by 769 publications

(775 citation statements)

References 19 publications

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“…Seven studies were undertaken in SSA, three in Asia and one in Latin America. Study design varied: six were RCTs [54–57,60,64], four were quasi-experimental [59,61–63,76] and one was cross-sectional [58]. The additional gender transformative components varied widely.…”

Section: Resultsmentioning

confidence: 99%

“…The others all worked with women in group settings, such as VSLAs. Nine reported HIV outcomes and four IPV outcomes (only two reported both [54,60]).…”

Section: Resultsmentioning

confidence: 99%

“…For HIV-related outcomes, six reported significant improvements in condoms use [23,58,60,62–64], while two reported non-significant improvements [59,77] and one reported no change [56]. Other changes in reported HIV risks included a reduction in STIs [62] and a reduction in the number of sexual partners [63,64], all in sex worker populations.…”

Section: Resultsmentioning

confidence: 99%

“…Four studies reported IPV-related outcomes [54,55,57,60]. Three reported significant reductions on IPV [23,57,60] and one a non-significant but positive outcome [55].…”

Section: Resultsmentioning

confidence: 99%

“…Three reported significant reductions on IPV [23,57,60] and one a non-significant but positive outcome [55]. One study also reported a reduction in economic abuse from their partner ( p < 0.0001) in female participants [55].…”

Section: Resultsmentioning

confidence: 99%

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A global comprehensive review of economic interventions to prevent intimate partner violence and HIV risk behaviours

Gibbs

Jacobson²,

Wilson³

2017

Global Health Action

113

112

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Background: Intimate partner violence (IPV) and HIV are co-occurring global epidemics, with similar root causes of gender and economic inequalities. Economic interventions have become a central approach to preventing IPV and HIV.Objective/Methods: We undertook a comprehensive scoping review of published evaluations of economic interventions that sought to prevent IPV and/or HIV risk behaviours.Results: Forty-five separate analyses of interventions met our criteria. Broadly, unconditional cash transfer interventions showed either flat or positive outcomes; economic strengthening interventions had mixed outcomes, with some negative, flat and positive results reported; interventions combining economic strengthening and gender transformative interventions tended to have positive outcomes.Conclusions: The review highlighted a number of gaps. Specifically, there were limited studies evaluating the impact of economic interventions on female sex workers, young women, and men. In addition, there were missed opportunities, with many evaluations only reporting either IPV- or HIV-related outcomes, rather than both, despite overlaps.

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Section: Resultsmentioning

confidence: 99%

“…The others all worked with women in group settings, such as VSLAs. Nine reported HIV outcomes and four IPV outcomes (only two reported both [54,60]).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Four studies reported IPV-related outcomes [54,55,57,60]. Three reported significant reductions on IPV [23,57,60] and one a non-significant but positive outcome [55].…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

A global comprehensive review of economic interventions to prevent intimate partner violence and HIV risk behaviours

Gibbs

Jacobson²,

Wilson³

2017

Global Health Action

113

112

View full text Add to dashboard Cite

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School-Based Randomized Controlled Trial of an HIV/STD Risk-Reduction Intervention for South African Adolescents

Jemmott¹,

Jemmott²,

O’Leary³

et al. 2010

Arch Pediatr Adolesc Med

101

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To test the efficacy of a school-based human immunodeficiency virus/sexually transmitted disease (HIV/STD) risk-reduction intervention for South African adolescents.Design: A cluster-randomized, controlled design with assessments of self-reported sexual behavior collected before intervention and 3, 6, and 12 months after intervention.Setting: Primary schools in a large, black township and a neighboring rural settlement in Eastern Cape Province, South Africa.Participants: Nine of 17 matched pairs of schools were randomly selected. Sixth-grade students with parent or guardian consent were eligible.Interventions: Two 6-session interventions based on behavior-change theories and qualitative research. The HIV/STD risk-reduction intervention targeted sexual risk behaviors; the attention-matched health promotion control intervention targeted health issues unrelated to sexual behavior.Outcome Measures: The primary outcome was self report of unprotected vaginal intercourse in the previous 3 months averaged over the 3 follow-ups. Secondary outcomes were other sexual behaviors.Results: A total of 1057 (94.5%) of 1118 eligible students (mean age,12.4 years) participated, with 96.7% retained at the 12-month follow-up. Generalized estimating equation analyses adjusted for clustering from 18 schools revealed that, averaged over the 3 follow-ups, a significantly smaller percentage of HIV/STD risk-reduction intervention participants reported having unprotected vaginal intercourse (odds ratio [OR] ,0.51; 95% confidence interval [CI], 0.30-0.85), vaginal intercourse (OR,0.62; 95% CI, 0.42-0.94), and multiple sexual partners (OR,0.50; 95% CI, 0.28-0.89), when adjusted for baseline prevalences, compared with health-promotion control participants. Conclusion:This is the first large-scale, community-level, randomized intervention trial to show significant effects on the HIV/STD sexual risk behavior of South African adolescents in the earliest stages of entry into sexual activity.

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Updated Recommendations for Cost-effectiveness Studies

Jan

Wiseman

2017

JAMA

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To the Editor Cost-effectiveness is a relatively new discipline, for which guidelines continue to be developed and refined. The article by Dr Sanders and colleagues 1 offered updated reference cases and perspectives as well as a checklist in an attempt to improve standards and minimize bias in published studies.There is evidence that cost-effectiveness studies sponsored by pharmaceutical companies are more likely to report positive cost-effective results. 2 As a means to address this and other potential biases, we agree with the authors' recommendations to require a true societal health care perspective and include an impact inventory.The authors included in the checklist that an analytic plan be described within the article. We propose that not only should the analytic plan be described in the methods section, but it should also be made public prior to the analysis. This would hold cost-effectiveness studies to the same standards as systematic reviews and randomized clinical trials, both of which have guidelines that require registration of studies that detail the methods and outcomes prior to execution. 3,4 Registration of systematic reviews and randomized clinical trials have been incorporated into guidelines in an effort to address the problems of multiple comparisons and selective outcomes reporting.Requiring cost-effectiveness investigators to commit to a prespecified analytic plan would promote transparency and differentiation between a priori and post hoc analyses. This differentiation would encourage investigators to develop robust analytic plans prior to performing their analysis and would limit the risk of manipulation of the model until the desired result is obtained, a problem similar to that found in multiple comparisons. The additional transparency would allow readers to understand more thoroughly how the investigators arrived at their results and see what modifications they made along the way.Cost-effectiveness methodology has developed significantly during the last few decades and these new recommendations should help advance it even further. An added recommendation of trial registration would be another means of guarding against bias in a field just coming of age.

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Effect of a structural intervention for the prevention of intimate-partner violence and HIV in rural South Africa: a cluster randomised trial

Cited by 769 publications

References 19 publications

A global comprehensive review of economic interventions to prevent intimate partner violence and HIV risk behaviours

A global comprehensive review of economic interventions to prevent intimate partner violence and HIV risk behaviours

School-Based Randomized Controlled Trial of an HIV/STD Risk-Reduction Intervention for South African Adolescents

Updated Recommendations for Cost-effectiveness Studies

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