Stepping Stones (Eastern Cape) — South Africa's Cluster-Randomised Trial of a 50-Hour Gender and HIV Programme for Young People

Stepping Stones is a participatory programme of about 50 hours, delivered in single-sex peer groups and cross-gender sessions, building skills in communication, relationships and gender norms. This trial compared it with a three-hour session on HIV and safer sex in 70 clusters (64 villages and six townships) of the Eastern Cape, South Africa, enrolling 1,360 men and 1,416 women aged 15–26, mostly in school, with follow-up at about 12 and 24 months.
Results were mixed. HIV incidence did not differ (adjusted IRR 0.95, 95% CI 0.67–1.35), while HSV-2 incidence was lower (RR 0.67). Fewer men reported perpetrating intimate partner violence more than once: 11.4% vs 14.9% at 12 months (aOR 0.73, 0.50–1.06) and 6.2% vs 9.6% at 24 months (aOR 0.62, 0.38–1.01, p=0.054) — a consistent direction but borderline statistical significance at each time point. Women's reported experience of IPV did not differ, and women reported more transactional sex at 12 months.
The authors concluded the programme did not reduce HIV, but changed several risk behaviours among men. It is a cautionary example: well-evaluated, widely adapted, with a modest and mainly male-side behavioural signal, no measured benefit for women, and no cost data. Behaviour data are self-reported.

Read the full analysis: https://www.endvawnow.org/uploads/browser/files/Evaluation_StepStones_Jewkes_BMJ_2008.pdf