What Works for Women and Girls

An evaluation of the Stepping Stones program for young people in the Eastern CapeProvince of South Africa found that the program was effective in reducing sexual risktaking and violence perpetuation among young, rural African men. The evaluation wasdesigned using the gold standard of evaluation, a random controlled trial. Women in theintervention arm had 15% fewer new HIV infections than those in the control arm and31% fewer HSV 2 infections, although neither was significant at the 5% level (Jewkeset al., 2008). Findings also showed that men reporting fewer partners, higher condomuse, and less transactional sex, perpetration of intimate partner violence, and substanceuse. Among the women, there was an increase in transactional sex. Stepping Stones,originally designed for use in Uganda in the mid-1990s, is among the most widelyused prevention interventions around the world, having been used in over 40 countries(Jewkes et al. 2007). Stepping Stones is a gender transformative approach designed toimprove sexual health through building stronger and more gender-equitable relationshipsamong partners, including better communication. Stepping Stones uses participatorylearning approaches to increase knowledge of sexual health, and build awarenessof risks and the consequences of risk taking. The program included a 50 hour program(with a comparison group receiving a 3-hour intervention on HIV and safer sex) (Jewkeset al., 2006b). (Gray II) (violence, condoms, sex behavior, South Africa)An evaluation of a curriculum-based intervention for youth to address gender normsand HIV field tested with 130 young men in 2006 and 145 young women in 2007in Tanzania found that there was a significant positive change in decision makingconcerning safer sex practices, with a 30% increase in young men seeking HIV testing.Among the young women, condom use with partners increased by 10% and an increaseof 20% in HIV testing (Magige et al., 2008). (Gray III) (youth, HIV testing, condom use,Tanzania)A participatory group education intervention to address gender norms and HIV withpre-post intervention survey among young women ages 16 to 28 in India found thatthe young women significantly shifted to more gender equitable attitudes and reportedusing condoms at last sex (50% following the intervention as compared to 15% priorto the intervention (Khandekar et al., 2008). (Gray III) (education, gender norms, youth,gender equity, condom use, India)In Tanzania, evaluation of Tuelimishane (Let’s Educate One Another), a communitybasedHIV and violence program for young men in Dar es Salaam that combinedcommunity-based drama and peer education, found that the project resulted in significantchanges in attitudes and norms related to gender roles and partner violence andsome risk behaviors, including condom use. Two of the six variables measuring HIV riskbehaviors were found to be significant. Men in the intervention community were significantlymore likely to have used a condom during their last sexual experience, and theywere less likely to report using condoms less than half the time in the past six months.There were no significant differences regarding reported use of violence, however men294 CHAPTER 11 STRENGTHENING THE ENABLING ENVIRONMENT