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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.

Participants 1360 men and 1416 women aged 15-26 years, who were mostly attending schools.

Stepping Stones is a participatory HIV prevention programme that aims to improve sexual health through building stronger, more gender equitable relationships.

We conducted a trial to assess the impact of Stepping Stones on the incidence of HIV and HSV-2 and sexual practices among men and women in rural areas in the Eastern Cape province of South Africa.

In each cluster we recruited about 20 men and 20 women volunteers.

Those eligible were aged 16-23, normally resident in the village where they were at school, and mature enough to understand the study and the consent process.

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The area has two sizeable towns, seven small towns, and many villages.

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