You will be provided with the titles and abstracts of a collection of medical RCT reports studying a clinical question -- for instance, the efficacy of an intervention on some medical outcome. Please write a few sentences synthesizing the findings of these reports, which could serve as a conclusion section for a systematic review article. Your response should not include any other text. The RCT reports are below.



Title 1:
HIV testing: changing trends.
Abstract 1:
nan


Title 2:
Uptake and acceptability of antenatal HIV testing: randomised controlled trial of different methods of offering the test.
Abstract 2:
To determine the uptake and acceptability of different methods of a universal offer of voluntary HIV testing to pregnant women.
                Randomised controlled trial involving four combinations of written and verbal communication, followed by the direct offer of a test. The control group received no information and no direct offer of a test, although testing was available on request.
                Hospital antenatal clinic covering most of the population of the city of Edinburgh.
                3024 pregnant women booking at the clinic over a 10 month period.
                Uptake of HIV testing and women's knowledge, satisfaction, and anxiety.
                Uptake rates were 6% for those in the control group and 35% for those directly offered the test. Neither the style of leaflet nor the length of discussion had an effect on uptake. Significant independent predictors of uptake were a direct test offer; the midwife seen; and being unmarried, previously tested, and younger age. Knowledge of the specific benefits of testing increased with the amount of information given, but neither satisfaction nor anxiety was affected by the type of offer.
                The universal offer of HIV testing is not intrusive and is acceptable to pregnant women. A policy of offering the HIV test to all women resulted in higher uptake and did not increase anxiety or dissatisfaction. Uptake depends more on the midwife than the method of offering the test. Low uptake rates and inadequate detection of HIV infection point to the need to assess a more routine approach to testing.


Title 3:
Using message framing to motivate HIV testing among low-income, ethnic minority women.
Abstract 3:
This study compared the effectiveness of 4 videotaped educational programs designed to motivate HIV testing among low-income, ethnic minority women. Four hundred eighty women were assigned randomly to watch one of 2 gain-framed or 2 loss-framed videos. Consistent with prospect theory, participants' perceptions of the certainty of the outcome of an HIV test moderated the effects of framing on self-reported testing behavior 6 months after video exposure. Among participants who reported being certain of the test's outcome, those who saw a gain-framed video reported a higher rate of testing than those who saw a loss-framed message. Among women who perceived the outcome of HIV testing as relatively uncertain, gain- and loss-framed videos led to similar rates of self-reported testing, with some advantage for the loss-framed message.


Title 4:
The "Grim Reaper" campaign.
Abstract 4:
nan


Title 5:
Evaluation of the Quebec Public Information Campaign and Human Immunodeficiency Virus (HIV) Antibody Screening Program directed to persons transfused between 1978 and 1985.
Abstract 5:
This study aimed to determine the number and characteristics of the blood recipients tested for HIV infection as a result of the provincial HIV antibody screening program (directed to persons transfused between 1978 and 1985 and their contacts) and to estimate the rate of HIV seroprevalence among them. All physicians in the province of Quebec were provided with a special prescription form for HIV testing of eligible patients. Over a six-month period, a total of 6,348 special prescription forms were used. The HIV seroprevalence was 0.13% (95% confidence interval: 0.04% to 0.2%). We estimated an increase of 16.5% (12,061 tests) in the number of HIV tests related to the program. These results were consistent with those found by similar programs elsewhere in Canada but less than expected. Multiple strategies, including direct notification of transfusion recipients, particularly pediatric patients, are probably necessary to reach infected blood recipients still unaware of their infection.


Title 6:
HIV testing in Glasgow Genito-Urinary Medicine Clinics 1985-1987.
Abstract 6:
Between 1 March 1985 and 28 February 1987, 1659 patients attending Glasgow Genito-Urinary Medicine (GUM) Clinics were tested for antibodies to human immunodeficiency virus (HIV). Forty (2.4%) were positive. Thirty-seven of these were homosexual (36/37) or bisexual (1/37) males. The overall prevalence of antibodies to HIV in this group was 3.9% (37/940) and showed no significant increase over the two year period. Following the extensive media campaign in October 1986, the total numbers tested each month rose from an average of around 50, to 144 in December 1986. There was a further rise to 220 in March 1987 coinciding with AIDS week in March 1987. Since then the numbers have again declined. Before the October campaign, 70% of these tested (692/990) were homo/bisexual males. After the campaign the number of heterosexual males and females rose sharply, accounting for 68% of these tested.


Title 7:
Epidemiological observations in the AIDS clinic at the Hadassah University Hospital in Jerusalem.
Abstract 7:
Of the first 395 attendees at the AIDS clinic in Jerusalem, 32% were homo/bisexuals, 4% i.v. drug abusers (IVDAs), 24% persons with minimal risk for AIDS and 38% were persons having no risk. Human immunodeficiency virus (HIV) antibody rates were 7% for homosexuals, 29% for IVDAs, 1% for persons with minimal risk and 0% for persons at no risk. Israeli homosexuals had a significantly greater risk for HIV infection (9 of 35) if they had sexual contact with non-Israelis as compared with homosexuals who had contact with local partners only (0/91, P less than 0.001). The mean number of attendees per month increased by 431% during the 4 months following the first prime-time television program on AIDS. The largest mean increases occurred among persons at no risk (1 to 27.2), those with minimal risk (2.5 to 16.5), and among women (1.25 to 20.0). This report indicates that HIV infection among Israeli homosexuals has not yet reached U.S. proportions. It also shows that the TV program raised anxiety concerning AIDS among the general public, and probably encouraged the public to use HIV testing as part of a general health screening program.


Title 8:
Can targeted HIV testing campaigns alter health-seeking behaviour?
Abstract 8:
This paper describes the evaluation of 'gimme 5 minutes' a multimedia HIV testing campaign aimed at gay and bisexual men in London particularly targeting those of Black and South European Origin and those under the age of 25 years old using peer images. The text linked a summary of the key issues of a pre-test discussion with detailed information on how to access testing at a specified testing centre (campaign clinic). The number and demographics of men who reported sex with men (MSM) testing at the campaign clinic were monitored and compared with those testing at two other central London clinics. There was a 4.5-fold rise (p < 0.001) in MSM testing at the campaign clinic. Increases were proportionately greater in the sub-populations targeted with peer images: South European origin, 14-fold rise (p < 0.001), Black origin, 6.5-fold rise (p = 0.003), and MSM under 25 years old, 9.5-fold rise (p < 0.001). There were no significant changes in the number of MSM testing for HIV at the two other central London clinics studied. The results suggest that including detailed information about accessing testing services may be a vital ingredient in the success of media campaigns focusing on HIV testing.


Title 9:
Is a general women's health promotion program as effective as an HIV-intensive prevention program in reducing HIV risk among Hispanic women?
Abstract 9:
This study aimed to assess whether participants in an HIV-intensive prevention program and participants in a general women's health promotion program reported greater HIV risk-reduction than participants in a wait-list control group immediately following program participation and at three-month follow-up.
                The authors studied 162 Hispanic women ages 18 to 35 years, most of them immigrants. Three-fourths of the sample (74%) reported earning less than $800 a month, 29% did not have a high school degree, and 90% had children. Data were gathered through surveys at baseline, at intervention completion, and at three-month follow-up. Information was collected on sociodemographics, HIV risk factors, and risk behaviors. Crude and adjusted (for demographics and dose) logistic regression analyses were used to assess program effects on participants' risk reduction.
                Crude logistic regression analyses reveal that both programs resulted in increased condom use at post-test and follow-up. Only participants in the HIV-intensive prevention program reported increased safer sex negotiation at post-test and follow-up, however, and only participants in the women's health promotion program reported increased HIV testing at post-test.
                Both interventions increased condom use. The HIV-intensive prevention program appeared to be more effective in promoting safer sex negotiation, and the women's health promotion program appeared more effective in promoting HIV testing. The findings suggest that both approaches may be viable ways to package HIV prevention for short-term behavior change in this population.
Mass media interventions have immediate and overall effects in promotion of HIV testing. No long-term effects were seen. There was no significant impact of detecting seropositive status after mass media intervention for promoting HIV testing, and this finding was limited to a small number of studies. Further research is required to identify possible effects on seropositivity status after mass media intervention for promotion of HIV testing among high-risk groups in epidemic countries. Additional research is needed to identify the effectiveness of different types of mass media interventions, the cost effectiveness of the interventions, and characteristics of messages.