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Un
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id
1.
I
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HI
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em
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s
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ld
wid
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with
t
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[
1
]
,
[
2
]
.
B
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n
d
its
clin
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co
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s
eq
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s
,
HI
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GDP
Evaluation Warning : The document was created with Spire.PDF for Python.
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8
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A
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485
p
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ca
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s
co
r
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th
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p
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ten
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s
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4
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titu
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ased
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tio
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s
tr
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ar
e
in
cr
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s
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ly
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ized
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p
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n
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n
t
o
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k
f
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tl
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ale
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e
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[
4
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[
5
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ig
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s
,
wh
ile
a
s
tu
d
y
am
o
n
g
m
ig
r
an
t
r
o
ad
co
n
s
tr
u
ctio
n
wo
r
k
er
s
in
C
am
er
o
o
n
d
o
cu
m
en
ted
h
ig
h
lev
els
o
f
m
u
lti
p
le
s
eq
u
en
tial
p
ar
tn
er
s
h
ip
s
,
m
u
ltip
le
co
n
cu
r
r
en
t
p
ar
tn
er
s
h
ip
s
,
lo
w
c
o
n
s
is
ten
t
co
n
d
o
m
u
s
e,
a
n
d
lo
w
p
er
ce
iv
e
d
HI
V
r
is
k
.
T
h
ese
f
i
n
d
in
g
s
r
ein
f
o
r
ce
co
n
ce
r
n
s
th
at
m
o
b
ilit
y
,
f
r
a
g
m
en
ted
s
o
cial
n
e
two
r
k
s
,
an
d
lim
ited
ac
ce
s
s
to
h
ea
lth
in
f
o
r
m
atio
n
m
ay
in
c
r
ea
s
e
th
e
v
u
ln
er
a
b
ilit
y
o
f
co
n
s
tr
u
ctio
n
-
r
elate
d
o
cc
u
p
atio
n
s
to
HI
V
tr
an
s
m
is
s
io
n
[
6
]
,
[
7
]
.
T
a
k
en
to
g
et
h
er
,
th
ese
s
tu
d
ies
s
u
g
g
est
th
at
m
o
b
ilit
y
,
tem
p
o
r
a
r
y
em
p
lo
y
m
en
t,
lim
ited
ac
ce
s
s
to
h
ea
lth
i
n
f
o
r
m
atio
n
,
an
d
f
r
a
g
m
en
ted
s
o
cial
n
etwo
r
k
s
m
ay
in
cr
ea
s
e
HI
V
-
r
elate
d
v
u
ln
e
r
ab
ilit
y
am
o
n
g
co
n
s
tr
u
ctio
n
wo
r
k
er
s
.
Fo
r
ex
am
p
le,
in
T
a
n
za
n
ia,
m
o
r
e
th
an
5
0
%
o
f
co
n
s
tr
u
ctio
n
wo
r
k
e
r
s
r
ep
o
r
ted
v
iewin
g
m
u
ltip
le
s
ex
u
al
p
ar
tn
er
s
h
ip
s
as
n
o
r
m
ativ
e
[
5
]
,
[
6
]
.
Similar
ly
,
m
ig
r
an
t
wo
r
k
er
s
in
Ma
lay
s
ia
f
ac
e
s
o
c
io
ec
o
n
o
m
ic
v
u
ln
er
ab
ilit
ies
an
d
lim
ited
o
u
tr
ea
ch
s
er
v
ices,
cr
ea
tin
g
b
ar
r
ier
s
to
HI
V
p
r
ev
en
tio
n
an
d
ca
r
e
[
7
]
.
I
n
I
n
d
o
n
esia,
lab
o
r
f
o
r
ce
d
ata
in
d
icate
th
at
m
an
y
wo
r
k
er
s
r
e
m
ain
ac
tiv
e
b
ey
o
n
d
th
e
ag
e
o
f
5
0
,
an
d
i
n
f
o
r
m
al
e
m
p
lo
y
m
e
n
t c
o
n
tr
ib
u
tes to
u
n
d
er
r
ep
o
r
tin
g
in
o
f
f
icial
lab
o
r
s
tatis
tics
[
8
]
.
Alth
o
u
g
h
I
n
d
o
n
esia
h
as
estab
lis
h
ed
r
eg
u
lato
r
y
f
r
am
ewo
r
k
s
m
an
d
atin
g
wo
r
k
p
lace
HI
V
ed
u
ca
tio
n
,
non
-
d
is
cr
im
in
atio
n
p
o
licies,
an
d
ac
ce
s
s
to
v
o
lu
n
tar
y
c
o
u
n
s
elin
g
an
d
test
in
g
,
in
clu
d
in
g
th
e
Dec
r
ee
o
f
th
e
Min
is
ter
o
f
Ma
n
p
o
wer
an
d
T
r
an
s
m
ig
r
atio
n
n
u
m
b
er
6
8
/Me
n
/I
V/2
0
0
4
,
im
p
lem
en
tatio
n
r
e
m
ain
s
in
co
n
s
is
ten
t.
Po
licy
an
aly
s
es
s
u
g
g
est
th
at
d
esp
ite
r
eg
u
lato
r
y
r
e
q
u
ir
e
m
en
ts
,
co
n
s
tr
u
ctio
n
co
m
p
a
n
i
es
f
r
eq
u
en
tly
lack
s
tr
u
ctu
r
ed
an
d
s
u
s
tain
ab
le
HI
V
p
r
o
g
r
a
m
s
[
9
]
,
[
1
0
]
.
T
h
is
p
er
s
is
ten
t
p
o
licy
–
p
r
ac
tice
g
ap
h
ig
h
lig
h
ts
th
e
n
ee
d
f
o
r
in
ter
v
en
tio
n
s
th
at
m
o
v
e
b
ey
o
n
d
co
m
p
lian
ce
an
d
ac
tiv
el
y
en
g
ag
e
w
o
r
k
er
s
in
p
r
ev
e
n
tio
n
e
f
f
o
r
ts
.
I
n
I
n
d
o
n
esia,
em
p
ir
ical
ev
id
e
n
ce
also
s
u
p
p
o
r
ts
th
e
n
ee
d
f
o
r
wo
r
k
p
lace
-
b
ased
HI
V
p
r
ev
en
tio
n
in
th
e
co
n
s
tr
u
ctio
n
s
ec
to
r
.
A
s
tu
d
y
a
m
o
n
g
1
5
0
co
n
s
tr
u
ctio
n
la
b
o
r
e
r
s
in
Su
r
ab
a
y
a
r
e
p
o
r
te
d
th
at
5
0
%
o
f
wo
r
k
er
s
h
ad
n
ev
er
r
ec
eiv
e
d
HI
V/AI
D
S
-
r
e
lated
in
f
o
r
m
atio
n
an
d
4
8
%
h
ad
n
ev
e
r
u
s
ed
HI
V/AI
DS
s
er
v
ices,
in
d
icatin
g
p
er
s
is
ten
t
g
ap
s
in
i
n
f
o
r
m
atio
n
ex
p
o
s
u
r
e
a
n
d
s
er
v
ice
u
tili
za
tio
n
am
o
n
g
t
h
is
o
cc
u
p
atio
n
al
g
r
o
u
p
[
1
1
]
.
I
n
ad
d
itio
n
,
I
n
d
o
n
esian
liter
atu
r
e
h
as
id
en
tifie
d
co
n
s
tr
u
ctio
n
w
o
r
k
er
s
as
a
v
u
ln
e
r
ab
le
g
r
o
u
p
b
ec
au
s
e
m
an
y
ar
e
m
ale,
h
ig
h
ly
m
o
b
ile,
s
ep
a
r
a
ted
f
r
o
m
th
eir
f
am
ilies
,
an
d
em
p
lo
y
ed
in
wo
r
k
e
n
v
ir
o
n
m
en
ts
wh
er
e
HI
V
p
r
ev
en
tio
n
m
a
y
n
o
t
b
e
s
y
s
te
m
atica
lly
im
p
lem
en
ted
[
1
2
]
.
T
h
ese
f
in
d
i
n
g
s
s
u
p
p
o
r
t
th
e
n
ee
d
f
o
r
s
tr
u
ct
u
r
ed
,
wo
r
k
p
lace
-
b
ased
in
ter
v
e
n
tio
n
s
th
at
ca
n
im
p
r
o
v
e
HI
V
-
r
elate
d
k
n
o
wled
g
e
a
n
d
s
tr
en
g
th
en
in
ter
n
al
p
r
ev
en
tio
n
ca
p
ac
ity
with
in
co
n
s
tr
u
ctio
n
c
o
m
p
an
ies.
T
r
ain
in
g
-
of
-
T
r
ai
n
er
s
(
T
o
T
)
m
o
d
els
o
f
f
e
r
a
p
r
o
m
is
in
g
ap
p
r
o
ac
h
to
s
tr
en
g
t
h
en
in
g
wo
r
k
p
lace
HI
V
p
r
ev
en
tio
n
.
Pre
v
io
u
s
tr
ain
-
th
e
-
tr
ain
er
an
d
p
ee
r
-
ed
u
ca
tio
n
liter
atu
r
e
s
u
g
g
ests
th
at
tr
ai
n
in
g
s
elec
ted
lo
ca
l
f
ac
ilit
ato
r
s
ca
n
ex
ten
d
th
e
r
ea
ch
o
f
h
ea
lth
ed
u
ca
tio
n
,
s
tr
en
g
t
h
en
lo
ca
l
ca
p
ac
ity
,
an
d
s
u
p
p
o
r
t
th
e
s
u
s
tain
ab
ilit
y
o
f
h
ea
lth
p
r
o
m
o
tio
n
p
r
o
g
r
am
s
wh
en
ad
eq
u
ate
o
r
g
an
izatio
n
al
s
u
p
p
o
r
t
an
d
o
p
p
o
r
t
u
n
ities
f
o
r
r
ep
licatio
n
a
r
e
p
r
o
v
id
e
d
[
1
3
]
,
[
1
4
]
.
I
n
HI
V
p
r
ev
en
tio
n
,
tr
ain
-
t
h
e
-
tr
ain
er
a
n
d
p
ee
r
-
ed
u
ca
tio
n
ap
p
r
o
ac
h
es
h
av
e
b
ee
n
u
s
ed
t
o
d
ev
elo
p
p
ee
r
ed
u
ca
to
r
s
an
d
d
is
s
em
in
ate
p
r
ev
en
tio
n
m
ess
ag
es
with
in
co
m
m
u
n
ities
an
d
h
ea
lth
s
y
s
tem
s
[
1
5
]
,
[
1
6
]
.
T
o
T
s
tr
ateg
ies
ar
e
g
r
o
u
n
d
e
d
in
p
a
r
ticip
ato
r
y
lear
n
in
g
p
r
in
cip
les
a
n
d
em
p
o
w
er
m
en
t
th
e
o
r
y
an
d
em
p
h
asize
p
ee
r
-
led
k
n
o
wle
d
g
e
d
is
s
em
in
atio
n
,
s
h
ar
ed
r
esp
o
n
s
ib
ilit
y
,
an
d
in
ter
n
al
ca
p
ac
ity
b
u
ild
in
g
.
E
m
p
o
wer
m
e
n
t
-
b
ased
in
ter
v
en
tio
n
s
h
av
e
b
ee
n
ass
o
ciate
d
with
im
p
r
o
v
ed
h
ea
lth
b
e
h
av
io
r
s
a
n
d
r
ed
u
ce
d
s
tig
m
a,
wh
er
ea
s
T
o
T
ap
p
r
o
ac
h
es
h
av
e
d
em
o
n
s
tr
ated
ef
f
ec
tiv
en
ess
in
r
eso
u
r
ce
-
lim
ited
s
etti
n
g
s
b
y
f
ac
ilit
atin
g
s
u
s
tain
ab
le
k
n
o
wled
g
e
tr
a
n
s
f
e
r
[
1
7
]
-
[
1
9
]
.
T
h
is
r
atio
n
ale
is
f
u
r
th
er
s
u
p
p
o
r
ted
b
y
HI
V
im
p
l
em
en
tatio
n
r
esear
ch
s
h
o
win
g
th
at
s
tr
u
ctu
r
ed
tr
ain
i
n
g
f
o
r
la
y
HI
V
w
o
r
k
er
s
ca
n
in
cr
ea
s
e
p
r
ev
e
n
tio
n
k
n
o
wled
g
e,
r
ed
u
ce
s
tig
m
a,
an
d
p
r
o
m
o
te
p
r
e
v
en
tio
n
in
f
o
r
m
ati
o
n
d
i
f
f
u
s
io
n
th
r
o
u
g
h
p
ee
r
an
d
co
m
m
u
n
ity
n
etwo
r
k
s
.
I
n
C
h
i
n
a,
a
PrE
P
d
if
f
u
s
io
n
tr
ain
in
g
p
r
o
g
r
am
f
o
r
lay
HI
V
wo
r
k
er
s
in
cr
ea
s
ed
k
n
o
wled
g
e
s
co
r
es
b
y
6
5
%
f
r
o
m
p
r
e
-
to
p
o
s
t
-
tr
ain
in
g
,
an
d
4
3
%
o
f
p
ar
ticip
an
ts
r
ep
o
r
ted
i
n
teg
r
atin
g
PrE
P
ed
u
ca
tio
n
i
n
to
th
eir
r
o
u
tin
e
wo
r
k
af
ter
o
n
e
m
o
n
th
.
I
n
ad
d
itio
n
,
em
p
o
wer
m
en
t
-
f
o
cu
s
ed
HI
V
in
ter
v
en
tio
n
s
h
av
e
d
e
m
o
n
s
tr
a
ted
s
ig
n
if
ican
t
im
p
r
o
v
em
e
n
ts
in
em
p
o
wer
m
en
t
o
u
tco
m
es,
s
u
p
p
o
r
tin
g
th
e
in
c
lu
s
io
n
o
f
em
p
o
wer
m
en
t
p
r
in
cip
les
in
wo
r
k
p
lace
HI
V
ed
u
ca
tio
n
[
2
0
]
,
[
2
1
]
.
Ho
wev
er
,
th
e
r
ig
o
r
o
u
s
ev
alu
a
tio
n
o
f
T
o
T
-
b
ased
HI
V
in
ter
v
en
tio
n
s
with
in
co
n
s
tr
u
cti
o
n
w
o
r
k
p
lace
s
r
em
ai
n
s
lim
ited
.
I
n
p
a
r
ticu
lar
,
th
e
r
e
is
lim
ited
ev
id
en
ce
r
e
g
ar
d
i
n
g
k
n
o
wled
g
e
r
et
en
tio
n
,
p
e
r
ce
iv
ed
em
p
o
wer
m
en
t,
an
d
p
o
ten
tial g
en
d
er
d
if
f
er
en
ce
s
in
lear
n
in
g
o
u
tco
m
es.
T
h
is
s
tu
d
y
ad
a
p
ted
a
s
tr
u
c
tu
r
ed
T
o
T
-
b
ased
f
ac
ilit
ato
r
tr
ain
in
g
p
r
o
g
r
am
to
th
e
I
n
d
o
n
esian
co
n
s
tr
u
ctio
n
co
n
te
x
t.
B
y
em
p
o
wer
in
g
s
elec
ted
wo
r
k
er
s
to
s
er
v
e
as
p
ee
r
f
ac
ilit
ato
r
s
,
th
e
in
ter
v
en
tio
n
s
o
u
g
h
t
to
en
h
an
ce
in
ter
n
al
HI
V
p
r
ev
en
t
io
n
ca
p
ac
ity
an
d
p
r
o
m
o
te
s
u
s
tain
ed
o
r
g
a
n
izatio
n
al
en
g
a
g
em
en
t.
T
h
e
o
b
jectiv
es
o
f
th
is
s
tu
d
y
wer
e
to
ev
alu
at
e
th
e
ef
f
ec
tiv
e
n
ess
o
f
a
s
tr
u
c
tu
r
ed
T
o
T
-
b
ased
f
ac
ilit
ato
r
tr
ain
in
g
p
r
o
g
r
am
in
im
p
r
o
v
in
g
HI
V
-
r
elate
d
k
n
o
wled
g
e
an
d
p
er
ce
iv
e
d
r
ea
d
in
es
s
f
o
r
wo
r
k
p
lace
p
r
ev
e
n
tio
n
a
m
o
n
g
co
n
s
tr
u
ctio
n
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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Hea
lth
Sci
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Vo
l.
15
,
No
.
2
,
J
u
n
e
20
26
:
4
8
4
-
4
9
3
486
wo
r
k
er
s
in
I
n
d
o
n
esia,
ex
am
in
e
wh
eth
er
k
n
o
wled
g
e
g
ai
n
s
d
if
f
er
ac
r
o
s
s
g
en
d
er
a
n
d
s
o
cio
d
em
o
g
r
a
p
h
ic
s
u
b
g
r
o
u
p
s
,
an
d
co
llect
q
u
alitativ
e
f
ee
d
b
ac
k
to
i
n
f
o
r
m
r
ef
i
n
e
m
en
t
o
f
f
u
tu
r
e
wo
r
k
p
lace
em
p
o
wer
m
en
t
an
d
T
o
T
in
itiativ
e
s
.
W
e
h
y
p
o
th
esize
d
th
at
p
ar
ticip
an
ts
wo
u
ld
d
em
o
n
s
tr
ate
s
ig
n
if
ican
tl
y
h
i
g
h
er
p
o
s
t
-
tr
ain
in
g
k
n
o
wled
g
e
s
co
r
es
co
m
p
ar
ed
with
b
aselin
e
ass
ess
m
en
t.
De
s
p
ite
ex
is
tin
g
wo
r
k
p
lace
HI
V
p
o
licies
an
d
p
r
io
r
s
tu
d
ies
o
n
HI
V
v
u
ln
er
ab
ilit
y
am
o
n
g
co
n
s
tr
u
ctio
n
an
d
m
o
b
ile
wo
r
k
er
s
,
ev
id
en
ce
o
n
s
tr
u
ctu
r
ed
an
d
s
u
s
tain
ab
le
in
ter
v
en
tio
n
m
o
d
els
with
in
co
n
s
tr
u
ctio
n
wo
r
k
p
lace
s
r
em
ain
s
lim
ited
.
Mo
s
t
p
r
ev
io
u
s
s
tu
d
ies
h
av
e
f
o
cu
s
ed
o
n
r
is
k
p
r
o
f
iles
,
s
tig
m
a,
o
r
g
en
er
al
HI
V
ed
u
ca
tio
n
,
wh
er
ea
s
em
p
ir
ical
ev
alu
ati
o
n
s
o
f
T
o
T
ap
p
r
o
ac
h
es
in
o
cc
u
p
atio
n
al
c
o
n
s
tr
u
ctio
n
s
ettin
g
s
ar
e
s
till
s
ca
r
ce
[
9
]
,
[
2
2
]
-
[
2
5
]
.
T
o
ad
d
r
ess
th
is
g
a
p
,
th
is
s
tu
d
y
a
d
ap
ted
an
d
e
v
alu
ated
a
s
tr
u
ctu
r
ed
two
-
d
a
y
T
o
T
HI
V
p
r
ev
en
tio
n
p
r
o
g
r
a
m
in
a
n
I
n
d
o
n
esian
co
n
s
tr
u
ctio
n
co
m
p
a
n
y
.
T
h
e
p
r
o
g
r
am
was
d
esig
n
ed
to
b
u
ild
i
n
te
r
n
al
p
ee
r
-
f
ac
ilit
ato
r
ca
p
ac
ity
,
im
p
r
o
v
e
HI
V
-
r
elate
d
k
n
o
wled
g
e
,
an
d
s
tr
en
g
t
h
en
p
er
ce
iv
e
d
r
ea
d
in
ess
f
o
r
wo
r
k
p
lace
HI
V
p
r
ev
en
tio
n
.
T
h
e
s
tu
d
y
also
ex
p
lo
r
e
d
wh
e
th
er
k
n
o
wle
d
g
e
g
ain
s
d
if
f
er
ed
ac
r
o
s
s
s
ex
an
d
s
elec
ted
s
o
cio
d
em
o
g
r
ap
h
ic
ch
a
r
ac
ter
i
s
tics
an
d
co
llected
q
u
alitativ
e
f
ee
d
b
ac
k
to
in
f
o
r
m
f
u
tu
r
e
r
ef
in
em
e
n
t
o
f
wo
r
k
p
lace
-
b
ased
T
o
T
in
itiativ
es.
T
h
e
n
o
v
elty
o
f
th
is
s
tu
d
y
lies
in
ap
p
ly
in
g
an
d
em
p
ir
ically
e
v
alu
atin
g
a
wo
r
k
p
lace
-
b
ased
T
o
T
m
o
d
el
in
th
e
co
n
s
tr
u
ctio
n
s
ec
to
r
a
n
d
in
co
m
b
in
in
g
q
u
a
n
titativ
e
p
r
e
-
test
–
p
o
s
t
-
test
ass
es
s
m
en
t
with
q
u
alitativ
e
f
ee
d
b
ac
k
to
ex
am
in
e
b
o
th
lear
n
in
g
o
u
tc
o
m
es
an
d
p
er
ce
iv
ed
r
ea
d
in
ess
f
o
r
wo
r
k
p
lac
e
p
r
e
v
en
tio
n
.
T
h
e
f
o
llo
win
g
s
ec
tio
n
s
d
escr
ib
e
th
e
s
tu
d
y
d
esig
n
,
in
ter
v
e
n
tio
n
p
r
o
ce
d
u
r
es,
k
n
o
wled
g
e
ass
es
s
m
en
t,
q
u
an
titativ
e
an
d
q
u
alitativ
e
f
in
d
in
g
s
,
an
d
i
m
p
licatio
n
s
o
f
th
e
T
o
T
m
o
d
el
f
o
r
wo
r
k
p
lace
HI
V
p
r
ev
en
tio
n
.
2.
M
E
T
H
O
D
2
.
1
.
Study
des
ig
n
T
h
is
s
tu
d
y
e
m
p
lo
y
e
d
a
q
u
asi
-
ex
p
er
im
en
tal
s
in
g
le
-
g
r
o
u
p
p
r
e
-
test
an
d
p
o
s
t
-
test
d
esig
n
t
o
e
v
alu
ate
th
e
s
h
o
r
t
-
ter
m
e
f
f
ec
tiv
en
ess
o
f
a
s
tr
u
ctu
r
e
d
T
o
T
f
ac
ilit
ato
r
p
r
o
g
r
a
m
f
o
r
HI
V/AI
DS
p
r
ev
e
n
tio
n
a
m
o
n
g
co
n
s
tr
u
ctio
n
wo
r
k
er
s
.
A
co
n
t
r
o
l
g
r
o
u
p
was
ex
clu
d
ed
b
ec
a
u
s
e
o
f
o
p
er
atio
n
al
an
d
eth
ica
l
co
n
s
id
er
atio
n
s
,
as
with
h
o
ld
in
g
tr
ain
in
g
f
r
o
m
elig
ib
le
wo
r
k
er
s
was
n
o
t
f
ea
s
ib
l
e
with
in
th
e
o
r
g
an
izatio
n
al
co
n
tex
t.
Acc
o
r
d
in
g
l
y
,
th
e
d
esig
n
was
in
ten
d
ed
to
ass
es
s
s
h
o
r
t
-
ter
m
with
in
-
p
ar
ticip
an
t
ch
an
g
es
r
ath
er
th
a
n
to
estab
lis
h
d
ef
in
itiv
e
ca
u
s
al
ef
f
ec
ts
.
T
h
e
d
esig
n
al
lo
wed
f
o
r
th
e
ass
ess
m
en
t
o
f
ch
an
g
es
in
k
n
o
wled
g
e
an
d
p
er
ce
iv
ed
r
ea
d
i
n
ess
b
ef
o
r
e
a
n
d
im
m
e
d
iately
af
ter
t
h
e
in
ter
v
en
tio
n
.
2
.
2
.
Study
s
et
t
ing
a
nd
pa
rt
ic
ipa
nts
T
h
is
s
tu
d
y
was
co
n
d
u
cted
with
in
a
c
o
n
s
tr
u
ctio
n
co
m
p
a
n
y
i
n
I
n
d
o
n
esia
th
at
im
p
lem
en
ts
wo
r
k
p
lace
HI
V
p
r
ev
en
tio
n
in
itiativ
es.
P
u
r
p
o
s
iv
e
s
am
p
lin
g
was
u
s
e
d
to
r
ec
r
u
it
3
0
p
ar
ticip
an
ts
.
Par
ticip
an
ts
wer
e
id
en
tifie
d
in
co
llab
o
r
atio
n
wi
th
co
m
p
a
n
y
r
ep
r
esen
tativ
es
b
ased
o
n
t
h
eir
in
v
o
lv
em
e
n
t
in
wo
r
k
p
lace
h
ea
lth
p
r
o
m
o
tio
n
ac
tiv
ities
an
d
th
eir
p
o
ten
tial
r
o
le
as
p
ee
r
f
ac
ilit
ato
r
s
.
E
lig
ib
le
wo
r
k
er
s
wer
e
in
v
ited
to
p
ar
ticip
ate,
r
ec
eiv
ed
an
ex
p
la
n
atio
n
o
f
t
h
e
s
tu
d
y
o
b
jectiv
es
an
d
p
r
o
c
ed
u
r
es,
an
d
p
r
o
v
id
e
d
wr
itten
in
f
o
r
m
e
d
co
n
s
en
t
b
ef
o
r
e
d
ata
co
llectio
n
.
T
h
e
i
n
clu
s
io
n
cr
iter
ia
wer
e:
c
u
r
r
e
n
t
em
p
lo
y
m
en
t
at
th
e
s
tu
d
y
s
ite,
willin
g
n
ess
to
p
ar
ticip
ate
i
n
th
e
f
u
ll
two
-
d
a
y
tr
ain
in
g
,
an
d
co
m
p
letio
n
o
f
b
o
th
p
r
e
-
a
n
d
p
o
s
t
-
test
ass
es
s
m
en
ts
.
Par
ticip
an
ts
in
clu
d
ed
b
o
t
h
m
ale
an
d
f
em
a
le
wo
r
k
er
s
.
So
cio
d
em
o
g
r
ap
h
i
c
d
ata,
in
clu
d
in
g
ag
e,
s
ex
,
jo
b
r
o
le,
an
d
p
r
o
ject
u
n
it,
wer
e
co
llected
t
o
ch
ar
ac
t
er
ize
th
e
s
am
p
le
an
d
ex
p
lo
r
e
s
u
b
g
r
o
u
p
d
if
f
er
e
n
ce
s
.
2
.
3
.
Sa
m
ple size
T
h
e
s
am
p
le
s
ize
o
f
3
0
p
ar
ticip
an
ts
was
d
eter
m
in
ed
p
r
ag
m
a
tically
b
ased
o
n
th
e
n
u
m
b
er
o
f
wo
r
k
er
s
wh
o
wer
e
in
v
ited
an
d
v
o
lu
n
tar
ily
ag
r
ee
d
to
p
ar
ticip
ate
i
n
th
e
wo
r
k
p
lace
-
b
ased
f
ac
ilit
ato
r
tr
ain
in
g
.
T
h
is
f
ea
s
ib
ilit
y
-
b
ased
ju
s
tific
atio
n
was
co
n
s
id
er
ed
ap
p
r
o
p
r
iate
b
ec
au
s
e
th
e
s
tu
d
y
was
co
n
d
u
cted
i
n
a
r
ea
l
o
cc
u
p
atio
n
al
s
ettin
g
an
d
aim
ed
to
ass
ess
s
h
o
r
t
-
ter
m
with
in
-
p
ar
ticip
an
t
ch
an
g
es
in
H
I
V/AI
DS
k
n
o
wled
g
e
r
ath
er
th
an
to
p
r
o
v
id
e
d
e
f
in
itiv
e
ca
u
s
al
ev
id
en
ce
.
R
es
o
u
r
ce
-
o
r
f
ea
s
ib
ilit
y
-
b
ased
s
am
p
le
s
i
ze
ju
s
tific
atio
n
h
as
b
ee
n
r
ec
o
g
n
ized
as
an
a
cc
ep
ta
b
le
ap
p
r
o
ac
h
wh
en
f
ield
co
n
s
tr
ain
ts
d
eter
m
in
e
th
e
attain
ab
le
s
am
p
le
s
ize
[
2
6
]
.
I
n
a
d
d
itio
n
,
a
s
en
s
itiv
ity
p
o
w
er
ch
ec
k
in
d
icate
d
th
at
3
0
p
ai
r
ed
o
b
s
er
v
atio
n
s
wo
u
ld
b
e
s
u
f
f
icien
t
to
d
etec
t
a
m
o
d
er
ate
with
in
-
p
ar
ticip
a
n
t
ef
f
ec
t.
Ho
wev
er
,
b
ec
au
s
e
n
o
f
o
r
m
al
a
p
r
io
r
i
p
o
wer
an
aly
s
is
was
co
n
d
u
cted
,
th
e
f
in
d
in
g
s
s
h
o
u
ld
b
e
i
n
ter
p
r
eted
as p
r
elim
in
ar
y
ev
i
d
en
ce
o
f
ed
u
ca
tio
n
al
im
p
r
o
v
em
e
n
t.
2
.
4
.
I
nte
rv
ent
io
n
T
h
e
in
ter
v
e
n
tio
n
co
n
s
is
ted
o
f
a
s
tr
u
ctu
r
e
d
two
-
d
ay
T
o
T
-
b
a
s
ed
f
ac
ilit
ato
r
tr
ain
in
g
alig
n
e
d
with
th
e
HI
V/AI
DS
p
r
ev
en
tio
n
cu
r
r
ic
u
lu
m
o
f
th
e
I
n
d
o
n
esian
Min
is
tr
y
o
f
Ma
n
p
o
wer
.
T
h
e
tr
ai
n
in
g
in
clu
d
e
d
lectu
r
es,
in
ter
ac
tiv
e
d
is
cu
s
s
io
n
s
,
ca
s
e
s
tu
d
ies,
g
r
o
u
p
wo
r
k
s
h
o
p
s
,
an
d
s
ce
n
ar
i
o
-
b
ased
ex
er
cis
es.
T
h
e
tr
ain
in
g
was
d
eliv
er
ed
in
s
eq
u
en
tial
s
ess
io
n
s
co
n
s
is
tin
g
o
f
in
tr
o
d
u
ct
o
r
y
b
r
ief
in
g
,
p
r
e
-
test
,
in
ter
ac
tiv
e
l
ec
tu
r
es,
g
r
o
u
p
-
b
ased
ca
s
e
d
is
cu
s
s
io
n
,
f
ac
ilit
ato
r
p
r
a
ctice
,
ac
tio
n
p
lan
n
i
n
g
,
a
n
d
p
o
s
t
-
test
ev
alu
atio
n
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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t J Pu
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lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
E
mp
o
w
ermen
t
-
b
a
s
ed
To
T HI
V
in
terven
tio
n
a
mo
n
g
I
n
d
o
n
esia
n
co
n
s
tr
u
ctio
n
… (
A
n
is
fu
l La
ilil
Mu
n
a
w
a
r
o
h
)
487
Day
1
f
o
cu
s
ed
o
n
f
o
u
n
d
atio
n
a
l
k
n
o
wled
g
e
,
in
clu
d
in
g
n
atio
n
al
HI
V
p
o
licies,
m
o
d
es
o
f
tr
an
s
m
is
s
io
n
,
p
r
ev
en
tio
n
s
tr
ateg
ies,
wo
r
k
p
la
ce
r
ig
h
ts
an
d
r
esp
o
n
s
ib
ilit
ies,
an
d
s
tig
m
a
r
ed
u
ctio
n
.
Day
2
e
m
p
h
asized
ap
p
lied
lear
n
in
g
,
in
clu
d
i
n
g
p
r
o
g
r
am
p
lan
n
i
n
g
,
s
tan
d
ar
d
o
p
er
ati
n
g
p
r
o
ce
d
u
r
e
d
ev
el
o
p
m
en
t,
ca
s
e
an
al
y
s
is
,
an
d
s
im
u
latio
n
ex
er
cises
f
o
r
im
p
lem
en
tin
g
wo
r
k
p
lace
HI
V
p
r
o
g
r
am
s
.
T
h
e
tr
ain
in
g
aim
ed
to
eq
u
ip
s
elec
ted
wo
r
k
er
s
with
b
o
th
tech
n
ical
k
n
o
wled
g
e
a
n
d
f
ac
ilit
atio
n
s
k
ills
to
ca
s
ca
d
e
in
f
o
r
m
atio
n
to
th
eir
p
ee
r
s
with
in
th
eir
wo
r
k
p
lace
s
.
E
ac
h
s
ess
io
n
was
f
a
cil
itated
u
s
in
g
s
tan
d
ar
d
ized
tr
ain
in
g
m
ater
ials
,
g
u
id
e
d
d
is
cu
s
s
io
n
p
r
o
m
p
ts
,
an
d
p
r
ac
tical
ex
er
cises
alig
n
ed
with
wo
r
k
p
lace
HI
V
p
r
ev
en
tio
n
o
b
jectiv
es.
2
.
5
.
M
ea
s
ures a
nd
ins
t
rum
e
nts
H
I
V
-
r
e
la
t
e
d
k
n
o
w
l
ed
g
e
wa
s
a
s
s
e
s
s
e
d
i
m
m
e
d
ia
t
e
l
y
b
ef
o
r
e
a
n
d
af
t
er
t
h
e
tr
a
in
i
n
g
u
s
i
n
g
a
s
t
r
u
c
t
u
r
e
d
20
-
i
te
m
m
u
l
t
ip
l
e
-
ch
o
ic
e
q
u
e
s
t
i
o
n
n
a
i
r
e
c
o
v
e
r
in
g
H
I
V
tr
a
n
s
m
i
s
s
i
o
n
,
p
r
e
v
en
t
i
o
n
s
t
r
a
te
g
i
es
,
w
o
r
k
p
l
ac
e
p
o
l
i
cy
a
n
d
r
i
g
h
t
s
,
an
d
s
t
ig
m
a
r
e
d
u
ct
i
o
n
.
E
a
ch
c
o
r
r
ec
t
a
n
s
w
er
wa
s
a
s
s
i
g
n
e
d
f
i
v
e
p
o
i
n
t
s
,
a
n
d
t
o
t
a
l
s
c
o
r
e
s
w
e
r
e
c
o
n
v
e
r
t
ed
t
o
a
0
–
1
0
0
s
c
a
l
e
.
T
h
e
q
u
e
s
t
i
o
n
n
a
ir
e
w
a
s
d
ev
e
lo
p
ed
f
r
o
m
th
e
t
r
a
in
i
n
g
co
n
t
en
t
a
n
d
r
ev
i
e
w
e
d
b
y
o
c
c
u
p
a
t
io
n
a
l
h
ea
l
t
h
a
n
d
HI
V
p
r
e
v
en
t
i
o
n
e
x
p
e
r
t
s
f
o
r
co
n
t
e
n
t
r
e
le
v
an
c
e
,
c
l
ar
i
t
y
,
an
d
a
l
i
g
n
m
en
t
w
i
th
th
e
t
r
a
i
n
in
g
o
b
je
c
t
i
v
e
s
.
A
p
r
e
l
i
m
i
n
a
r
y
p
s
y
c
h
o
m
e
tr
i
c
a
s
s
e
s
s
m
en
t
s
h
o
we
d
c
o
r
r
e
c
t
ed
i
t
em
-
to
ta
l
c
o
r
r
e
l
a
t
io
n
s
o
f
0
.
9
1
an
d
0
.
7
2
f
o
r
p
r
e
-
t
e
s
t
an
d
p
o
s
t
-
t
e
s
t
s
c
o
r
e
s
,
r
e
s
p
e
c
t
i
v
e
l
y
,
i
n
d
i
c
a
t
i
n
g
a
c
c
ep
t
a
b
l
e
s
co
r
e
v
a
l
id
i
t
y
,
wh
i
l
e
C
r
o
n
b
a
c
h
’
s
a
lp
h
a
w
a
s
0
.
5
3
,
s
u
g
g
e
s
t
i
n
g
m
o
d
e
s
t
i
n
t
er
n
a
l
co
n
s
i
s
t
e
n
c
y
.
Op
e
n
-
e
n
d
ed
q
u
e
s
t
io
n
s
w
er
e
a
l
s
o
u
s
e
d
t
o
c
o
l
le
c
t
q
u
a
l
i
t
a
t
iv
e
f
e
e
d
b
a
ck
o
n
t
h
e
r
e
le
v
an
c
e
,
c
l
a
r
i
ty
,
ap
p
l
i
c
ab
i
l
i
t
y
,
an
d
ar
e
a
s
f
o
r
im
p
r
o
v
em
e
n
t
o
f
t
h
e
t
r
a
i
n
in
g
.
2
.
6
.
Da
t
a
c
o
llect
io
n
T
h
e
p
r
e
-
test
q
u
esti
o
n
n
air
es
wer
e
ad
m
in
is
ter
ed
im
m
ed
iately
b
ef
o
r
e
th
e
s
tar
t
o
f
th
e
t
r
ain
in
g
p
r
o
g
r
am
.
Po
s
t
-
test
q
u
esti
o
n
n
air
es
wer
e
ad
m
in
is
ter
ed
at
th
e
en
d
o
f
th
e
s
ec
o
n
d
tr
ain
in
g
d
ay
.
T
h
e
p
ar
t
icip
an
ts
co
m
p
leted
th
e
ass
ess
m
en
t
s
an
o
n
y
m
o
u
s
ly
u
s
in
g
co
d
e
d
id
en
tifie
r
s
to
en
ab
le
p
air
e
d
an
aly
s
is
wh
ile
m
ain
tain
in
g
co
n
f
id
en
tiality
.
Qu
alitativ
e
r
e
s
p
o
n
s
es
wer
e
co
llected
u
s
in
g
o
p
en
-
en
d
e
d
wr
itten
q
u
es
tio
n
s
at
th
e
en
d
o
f
th
e
in
ter
v
en
tio
n
.
2
.
7
.
St
a
t
is
t
ica
l a
na
ly
s
is
Data
wer
e
an
aly
ze
d
u
s
in
g
I
B
M
SP
SS
Stati
s
tics
f
o
r
W
in
d
o
ws,
v
er
s
io
n
2
6
.
0
.
Descr
ip
tiv
e
s
tatis
tic
s
wer
e
u
s
ed
to
s
u
m
m
ar
ize
th
e
ch
ar
ac
ter
is
tics
an
d
k
n
o
wled
g
e
s
co
r
es
o
f
th
e
p
ar
ticip
an
ts
.
T
h
e
n
o
r
m
al
ity
o
f
th
e
s
co
r
e
d
is
tr
ib
u
tio
n
s
was
ass
ess
ed
u
s
in
g
th
e
Sh
ap
ir
o
–
W
ilk
test
.
Pair
ed
-
s
am
p
le
t
-
test
s
wer
e
co
n
d
u
cted
to
ev
alu
ate
th
e
m
ea
n
d
if
f
e
r
en
ce
s
b
etwe
en
t
h
e
p
r
e
-
test
an
d
p
o
s
t
-
test
s
co
r
es.
Alth
o
u
g
h
p
o
s
t
-
test
s
co
r
es
d
ev
iated
f
r
o
m
n
o
r
m
ality
,
p
ar
am
etr
ic
te
s
tin
g
was
r
etain
ed
g
iv
e
n
th
e
r
o
b
u
s
tn
ess
o
f
p
air
e
d
t
-
test
s
in
s
am
p
les
ap
p
r
o
a
ch
in
g
n
=
3
0
.
A
s
en
s
itiv
ity
an
aly
s
is
u
s
in
g
th
e
W
ilco
x
o
n
s
ig
n
e
d
-
r
a
n
k
test
was
p
er
f
o
r
m
e
d
to
c
o
n
f
ir
m
th
e
co
n
s
is
ten
cy
o
f
th
e
r
esu
lts
.
T
h
e
e
f
f
ec
t
s
ize
f
o
r
p
ai
r
ed
d
ata
was
ca
lc
u
lated
u
s
in
g
C
o
h
e
n
’
s
d
z
b
y
d
iv
id
in
g
t
h
e
m
ea
n
d
if
f
er
en
ce
b
y
t
h
e
s
tan
d
ar
d
d
e
v
iatio
n
o
f
th
e
p
air
e
d
d
if
f
er
en
ce
s
co
r
es
[
2
7
]
.
C
o
h
en
’
s
d
b
a
s
ed
o
n
th
e
p
o
o
le
d
s
tan
d
ar
d
d
e
v
iatio
n
was
also
ca
lcu
lated
f
o
r
co
m
p
leten
ess
,
alth
o
u
g
h
C
o
h
en
’
s
d
z
was
co
n
s
id
er
ed
th
e
m
o
r
e
ap
p
r
o
p
r
iate
esti
m
ate
f
o
r
p
air
ed
d
ata.
T
h
e
9
5
%
co
n
f
id
e
n
c
e
in
ter
v
als
(
9
5
%
C
I
)
wer
e
c
alcu
lated
f
o
r
m
ea
n
d
if
f
er
en
ce
s
.
Statis
tical
s
ig
n
if
ican
ce
was
s
et
at
p
<
0
.
0
5
(
two
-
tailed
)
.
I
n
d
e
p
en
d
e
n
t
-
s
am
p
le
t
-
test
s
wer
e
co
n
d
u
cte
d
as
ex
p
lo
r
ato
r
y
s
u
b
g
r
o
u
p
an
aly
s
es
to
e
x
am
in
e
s
ex
-
b
ased
d
i
f
f
er
en
c
es
in
p
o
s
t
-
t
r
ain
in
g
k
n
o
wled
g
e
s
co
r
es.
3.
RE
SU
L
T
S AN
D
D
I
SCU
SS
I
O
N
3
.
1
.
P
re
-
a
nd
po
s
t
-
inte
rv
ent
i
o
n k
no
wledg
e
s
co
re
s
All
3
0
p
ar
ticip
an
ts
co
m
p
lete
d
b
o
th
th
e
p
r
e
-
a
n
d
p
o
s
t
-
test
ass
ess
m
en
ts
an
d
wer
e
in
clu
d
ed
in
th
e
an
aly
s
is
.
T
h
e
m
ea
n
k
n
o
wled
g
e
s
co
r
e
in
cr
ea
s
ed
f
r
o
m
6
0
.
0
0
(
SD
=
1
2
.
6
6
)
at
p
r
e
-
test
to
9
1
.
3
3
(
SD
=
7
.
6
5
)
at
p
o
s
t
-
test
,
with
a
m
ea
n
d
if
f
er
en
ce
o
f
3
1
.
3
3
p
o
i
n
ts
(
9
5
%
C
I
:
2
6
.
7
6
–
3
5
.
9
0
;
p
<
0
.
0
0
1
)
.
T
h
e
p
air
e
d
an
al
y
s
is
s
h
o
wed
a
C
o
h
e
n
’
s
d
z
o
f
2
.
5
6
.
C
h
an
g
es
i
n
k
n
o
wled
g
e
s
co
r
es
f
o
llo
win
g
f
ac
ilit
ato
r
tr
ai
n
in
g
as
s
h
w
o
n
in
T
ab
le
1
.
T
h
e
p
r
e
-
test
s
co
r
es we
r
e
n
o
r
m
ally
d
is
tr
ib
u
ted
(
Sh
ap
ir
o
–
W
ilk
p
=
0
.
6
4
4
)
,
wh
er
ea
s
th
e
p
o
s
t
-
test
s
co
r
es
d
ev
iated
f
r
o
m
n
o
r
m
ality
(
p
<
0
.
0
0
1
)
.
Giv
e
n
th
e
r
o
b
u
s
tn
ess
o
f
p
air
ed
-
s
am
p
le
t
-
te
s
ts
in
s
am
p
les
o
f
ap
p
r
o
x
im
ately
3
0
p
ar
ticip
an
t
s
an
d
th
e
ab
s
en
ce
o
f
ex
tr
e
m
e
o
u
tlier
s
,
p
ar
am
etr
ic
test
in
g
was
r
etain
ed
.
T
h
e
W
ilco
x
o
n
s
ig
n
ed
-
r
an
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eld
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ten
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esu
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u
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r
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t
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d
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r
r
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n
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etwe
en
p
r
e
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t
est
an
d
p
o
s
t
-
test
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r
es
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o
s
itiv
e
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u
t
n
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t
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tatis
tically
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ig
n
if
ican
t
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5
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,
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ly
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As
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p
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u
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g
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if
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test
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r
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M
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.
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SD =
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.
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th
an
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ale
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ticip
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ts
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M
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8
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SD
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.
7
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.
T
h
is
f
in
d
in
g
s
h
o
u
ld
b
e
in
ter
p
r
ete
d
ca
u
tio
u
s
ly
b
ec
au
s
e
th
e
s
u
b
g
r
o
u
p
an
aly
s
is
was
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
15
,
No
.
2
,
J
u
n
e
20
26
:
4
8
4
-
4
9
3
488
ex
p
lo
r
ato
r
y
an
d
th
e
s
am
p
le
s
ize
was
lim
ited
.
F
ig
u
r
e
1
p
r
e
s
en
ts
th
e
co
r
r
esp
o
n
d
in
g
v
is
u
al
ch
an
g
e
in
m
ea
n
s
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r
es,
s
h
o
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ar
k
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r
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p
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e
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o
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test
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o
llo
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th
e
T
o
T
-
b
ased
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ter
v
en
tio
n
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T
ab
le
1
.
C
h
an
g
es in
k
n
o
wled
g
e
s
co
r
es f
o
llo
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f
ac
ilit
ato
r
t
r
ain
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g
(
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M
e
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su
r
e
M
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n
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M
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a
n
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i
f
f
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9
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C
I
t
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d
f
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P
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s
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z
Pre
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t
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1
2
.
6
6
P
o
st
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t
e
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9
1
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3
3
7
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6
5
3
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3
3
2
6
.
7
6
–
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8
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9
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2
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6
N
o
t
e
s
:
V
a
l
u
e
s
a
r
e
p
r
e
s
e
n
t
e
d
a
s
t
h
e
m
e
a
n
a
n
d
s
t
a
n
d
a
r
d
d
e
v
i
a
t
i
o
n
(
S
D
)
.
T
h
e
m
e
a
n
d
i
f
f
e
r
e
n
c
e
r
e
p
r
e
s
e
n
t
s
p
o
s
t
-
t
e
s
t
m
i
n
u
s
p
r
e
-
t
e
s
t
s
c
o
r
e
s
.
P
-
v
a
l
u
e
s
w
e
r
e
o
b
t
a
i
n
e
d
u
s
i
n
g
p
a
i
r
e
d
-
s
a
m
p
l
e
t
-
t
e
s
t
s
.
T
h
e
e
f
f
e
c
t
s
i
z
e
(
C
o
h
e
n
’
s
d
z
)
w
a
s
c
a
l
c
u
l
a
t
e
d
u
s
i
n
g
t
h
e
s
t
a
n
d
a
r
d
d
e
v
i
a
t
i
o
n
o
f
t
h
e
p
a
i
r
e
d
d
i
f
f
e
r
e
n
c
e
s
c
o
r
e
s
.
C
I
=
c
o
n
f
i
d
e
n
c
e
i
n
t
e
r
v
a
l
.
N
o
t
e
:
B
a
r
s r
e
p
r
e
s
e
n
t
m
e
a
n
s
c
o
r
e
s;
e
r
r
o
r
b
a
r
s
i
n
d
i
c
a
t
e
s
t
a
n
d
a
r
d
d
e
v
i
a
t
i
o
n
s
Fig
u
r
e
1
.
Me
an
HI
V
-
r
elate
d
k
n
o
wled
g
e
s
co
r
es b
e
f
o
r
e
a
n
d
af
ter
th
e
T
o
T
in
te
r
v
en
tio
n
am
o
n
g
c
o
n
s
tr
u
ctio
n
wo
r
k
e
r
s
3
.
2
.
Q
ua
lit
a
t
iv
e
f
ee
db
a
ck
T
h
e
o
p
en
-
e
n
d
ed
r
esp
o
n
s
es
wer
e
an
aly
ze
d
u
s
in
g
th
em
atic
co
n
ten
t
an
aly
s
is
.
T
h
r
ee
p
r
im
a
r
y
th
em
es
em
er
g
ed
:
i
)
s
tr
u
ctu
r
ed
a
n
d
p
r
ac
tical
lear
n
in
g
d
esig
n
,
ii
)
em
p
o
wer
m
en
t
a
n
d
co
n
f
i
d
e
n
ce
b
u
ild
in
g
,
an
d
iii
)
p
r
o
g
r
am
e
n
h
an
c
em
en
t
r
e
co
m
m
en
d
atio
n
s
.
T
h
e
p
ar
ticip
an
ts
f
r
eq
u
e
n
tly
em
p
h
asized
th
e
clar
ity
o
f
t
h
e
p
r
esen
tatio
n
,
th
e
r
elev
an
ce
o
f
th
e
ca
s
e
s
tu
d
ies,
an
d
th
e
in
ter
ac
tiv
e
f
o
r
m
at
o
f
th
e
s
ess
io
n
s
.
Par
ticip
an
ts
in
d
icate
d
th
at
th
e
co
m
b
in
atio
n
o
f
th
eo
r
etica
l
ex
p
la
n
atio
n
,
ca
s
e
ex
am
p
les,
an
d
in
ter
ac
tiv
e
d
is
cu
s
s
io
n
h
elp
ed
th
em
u
n
d
e
r
s
tan
d
th
e
tr
ain
in
g
co
n
ten
t
m
o
r
e
clea
r
ly
.
R
esp
o
n
d
en
ts
also
d
escr
ib
ed
in
c
r
e
ased
co
n
f
id
en
ce
i
n
p
r
o
m
o
tin
g
HI
V
p
r
ev
e
n
tio
n
in
itiativ
es
with
in
th
eir
wo
r
k
p
la
ce
s
.
Sev
er
al
p
ar
ticip
an
ts
r
e
p
o
r
ted
f
ee
lin
g
“m
o
r
e
p
r
ep
ar
e
d
”
an
d
“
m
o
tiv
ated
t
o
ta
k
e
ac
tio
n
”
f
o
llo
win
g
t
h
e
tr
ain
in
g
.
C
r
o
s
s
-
d
ep
a
r
tm
en
t
al
in
ter
ac
tio
n
was
h
ig
h
lig
h
ted
as
a
m
ea
n
s
o
f
s
t
r
en
g
th
en
i
n
g
p
ee
r
s
u
p
p
o
r
t
n
et
wo
r
k
s
.
T
h
e
p
ar
ticip
a
n
ts
r
ec
o
m
m
en
d
ed
p
er
io
d
ic
r
ef
r
esh
er
co
u
r
s
es,
th
e
in
clu
s
io
n
o
f
ex
p
er
ien
tial
co
m
p
o
n
e
n
ts
s
u
ch
as
v
o
lu
n
tar
y
co
u
n
s
el
in
g
an
d
test
in
g
s
im
u
latio
n
s
,
an
d
th
e
e
x
ten
s
io
n
o
f
tr
ain
in
g
d
u
r
atio
n
to
allo
w
d
ee
p
er
d
is
cu
s
s
io
n
o
f
im
p
lem
en
t
atio
n
s
tr
ateg
ies.
3
.
3
.
Dis
cus
s
io
n
T
h
e
p
r
esen
t
s
tu
d
y
ad
d
r
ess
ed
th
e
lim
ited
av
ailab
ilit
y
o
f
s
tr
u
ctu
r
ed
an
d
s
u
s
tain
ab
le
wo
r
k
p
lace
HI
V
p
r
ev
en
tio
n
in
ter
v
en
tio
n
s
in
th
e
co
n
s
tr
u
ctio
n
s
ec
to
r
b
y
ev
alu
atin
g
a
T
o
T
m
o
d
el
d
esig
n
e
d
to
s
tr
en
g
th
en
in
ter
n
a
l
p
ee
r
-
f
ac
ilit
ato
r
ca
p
ac
ity
.
T
h
e
lar
g
e
with
in
-
p
ar
ticip
a
n
t e
f
f
ec
t
s
ize
s
u
g
g
ests
th
at
th
e
T
o
T
-
b
ased
in
ter
v
en
tio
n
was
ass
o
ciate
d
with
a
s
u
b
s
tan
tial
s
h
o
r
t
-
ter
m
in
cr
ea
s
e
in
HI
V
-
r
elate
d
k
n
o
wled
g
e
am
o
n
g
co
n
s
tr
u
ctio
n
wo
r
k
e
r
s
.
T
h
is
f
in
d
in
g
in
d
icate
s
th
at
s
t
r
u
ctu
r
ed
f
ac
ilit
ato
r
tr
ain
in
g
m
ay
b
e
ed
u
ca
tio
n
ally
m
ea
n
i
n
g
f
u
l
an
d
p
o
ten
tially
u
s
ef
u
l
f
o
r
s
tr
en
g
th
en
in
g
in
ter
n
al
wo
r
k
p
lace
HI
V
p
r
ev
en
tio
n
ca
p
ac
ity
.
Nev
er
th
eless
,
b
ec
au
s
e
th
i
s
s
tu
d
y
u
s
ed
a
s
in
g
le
-
g
r
o
u
p
p
r
e
-
test
–
p
o
s
t
-
test
d
esig
n
with
o
u
t
a
co
n
tr
o
l
g
r
o
u
p
,
th
e
f
in
d
in
g
s
s
h
o
u
l
d
b
e
in
ter
p
r
eted
as
p
r
elim
in
ar
y
ev
id
e
n
ce
o
f
e
d
u
ca
tio
n
al
im
p
r
o
v
em
e
n
t
r
ath
e
r
th
an
d
ef
in
itiv
e
ca
u
s
al
ev
id
e
n
ce
o
f
in
ter
v
en
tio
n
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
E
mp
o
w
ermen
t
-
b
a
s
ed
To
T HI
V
in
terven
tio
n
a
mo
n
g
I
n
d
o
n
esia
n
co
n
s
tr
u
ctio
n
… (
A
n
is
fu
l La
ilil
Mu
n
a
w
a
r
o
h
)
489
ef
f
ec
tiv
en
ess
.
T
h
is
in
ter
p
r
etatio
n
i
s
p
ar
ticu
lar
ly
r
elev
an
t
b
ec
au
s
e
em
p
ir
ical
ev
id
en
ce
o
n
HI
V
-
f
o
cu
s
ed
T
o
T
in
ter
v
en
tio
n
s
in
co
n
s
tr
u
ctio
n
s
ettin
g
s
r
em
ain
s
lim
ited
,
esp
ec
i
ally
in
o
cc
u
p
atio
n
al
co
n
te
x
ts
in
lo
w
-
an
d
m
id
d
le
-
in
co
m
e
co
u
n
tr
ies.
T
h
e
im
p
r
o
v
em
en
t
o
b
s
er
v
ed
in
th
is
s
tu
d
y
is
co
n
s
is
ten
t
with
p
r
ev
io
u
s
HI
V
tr
ain
in
g
ev
alu
atio
n
s
s
h
o
win
g
s
ig
n
if
ican
t
g
ai
n
s
in
k
n
o
wled
g
e
af
ter
s
tr
u
ctu
r
e
d
tr
ain
in
g
p
r
o
g
r
am
s
,
in
clu
d
i
n
g
tr
ain
-
t
h
e
-
tr
ain
er
ed
u
ca
tio
n
am
o
n
g
n
u
r
s
es
in
I
n
d
ia
an
d
p
r
e
–
p
o
s
t
tr
ain
in
g
a
m
o
n
g
HI
V
tr
ea
tm
e
n
t
ce
n
ter
s
ta
f
f
in
Pak
is
tan
[
2
8
]
,
[
2
9
]
.
E
v
id
en
ce
f
r
o
m
wo
r
k
p
la
ce
-
b
ased
HI
V
in
ter
v
e
n
tio
n
s
i
n
T
h
ailan
d
an
d
a
s
y
s
tem
atic
r
ev
iew
o
f
f
ac
to
r
y
-
wo
r
k
er
in
ter
v
en
tio
n
s
in
lo
w
-
an
d
m
id
d
le
-
in
co
m
e
c
o
u
n
tr
ies
f
u
r
th
er
s
u
p
p
o
r
ts
th
e
r
o
le
o
f
s
tr
u
ctu
r
ed
e
d
u
ca
tio
n
an
d
p
ee
r
-
r
elate
d
ap
p
r
o
ac
h
es
in
im
p
r
o
v
i
n
g
HI
V
k
n
o
wled
g
e
an
d
p
r
e
v
en
tio
n
-
r
elate
d
o
u
t
co
m
es
[
3
0
]
,
[
3
1
]
.
T
o
g
eth
er
,
th
ese
f
in
d
in
g
s
in
d
icate
th
at
T
o
T
-
b
ased
wo
r
k
p
l
ac
e
ed
u
ca
tio
n
m
ay
b
e
a
f
ea
s
ib
le
ap
p
r
o
ac
h
f
o
r
im
p
r
o
v
in
g
HI
V
-
r
elate
d
k
n
o
w
led
g
e
wh
ile
also
s
tr
en
g
th
e
n
i
n
g
in
te
r
n
al
p
r
ev
e
n
tio
n
ca
p
ac
ity
in
o
cc
u
p
atio
n
al
s
ettin
g
s
.
T
h
e
o
b
s
er
v
ed
k
n
o
wled
g
e
g
ain
m
ay
b
e
p
a
r
tly
e
x
p
lain
ed
b
y
t
h
e
in
ter
ac
tiv
e
an
d
m
u
ltimo
d
al
d
esig
n
o
f
th
e
in
ter
v
e
n
tio
n
.
T
r
ain
in
g
c
o
m
p
o
n
e
n
ts
s
u
ch
as
lectu
r
es,
d
i
s
cu
s
s
io
n
s
,
ca
s
e
-
b
ased
lear
n
in
g
,
g
r
o
u
p
wo
r
k
s
h
o
p
s
,
an
d
s
ce
n
ar
io
-
b
ased
ex
e
r
cises
m
ay
h
av
e
h
elp
e
d
p
ar
tici
p
an
ts
co
n
n
ec
t
HI
V
p
r
ev
en
tio
n
co
n
ce
p
ts
with
p
r
ac
tical
wo
r
k
p
lace
s
itu
atio
n
s
.
I
n
a
d
d
itio
n
,
th
e
T
o
T
ap
p
r
o
ac
h
em
p
h
asi
ze
d
p
ee
r
in
ter
ac
tio
n
an
d
f
ac
ilit
ato
r
d
ev
el
o
p
m
en
t.
T
h
is
is
r
elev
an
t
b
ec
a
u
s
e
T
o
T
is
in
ten
d
ed
n
o
t
o
n
ly
to
tr
an
s
f
e
r
k
n
o
wled
g
e
d
u
r
in
g
a
s
in
g
le
tr
ain
i
n
g
s
ess
io
n
,
b
u
t
also
to
b
u
ild
a
ca
d
r
e
o
f
in
te
r
n
al
ag
e
n
ts
wh
o
ca
n
d
is
s
em
in
ate
p
r
e
v
en
tio
n
m
ess
ag
es,
s
u
s
tain
lear
n
in
g
,
an
d
s
u
p
p
o
r
t o
r
g
an
izatio
n
al
ca
p
ac
it
y
f
o
r
w
o
r
k
p
lace
HI
V
p
r
e
v
en
ti
o
n
[
1
9
,
[
3
2
]
,
[
1
4
]
.
T
h
e
ex
p
lo
r
ato
r
y
s
ex
-
b
ased
d
i
f
f
er
en
ce
in
p
o
s
t
-
tr
ain
in
g
s
co
r
es,
with
f
em
ale
p
ar
ticip
an
ts
ac
h
iev
in
g
h
ig
h
er
m
ea
n
s
co
r
es
th
a
n
m
ale
p
ar
ticip
an
ts
,
s
h
o
u
ld
b
e
in
ter
p
r
eted
ca
u
tio
u
s
ly
.
B
ec
au
s
e
s
u
b
g
r
o
u
p
an
aly
s
is
was
n
o
t
th
e
p
r
im
ar
y
o
b
jectiv
e
o
f
th
is
s
tu
d
y
an
d
th
e
s
am
p
le
s
ize
was
r
elativ
ely
s
m
all,
th
is
f
in
d
i
n
g
s
h
o
u
ld
b
e
co
n
s
i
d
er
ed
h
y
p
o
th
esis
-
g
en
er
atin
g
r
ath
er
t
h
an
c
o
n
f
ir
m
a
to
r
y
.
T
h
is
in
ter
p
r
etatio
n
is
co
n
s
is
ten
t
with
m
eth
o
d
o
l
o
g
ical
g
u
id
an
ce
s
tatin
g
th
at
e
x
p
lo
r
ato
r
y
s
u
b
g
r
o
u
p
f
in
d
in
g
s
s
h
o
u
ld
b
e
in
ter
p
r
eted
ca
u
tio
u
s
ly
b
ec
au
s
e
th
ey
m
ay
b
e
in
f
lu
en
c
ed
b
y
ch
an
ce
v
a
r
iatio
n
a
n
d
s
elec
tio
n
b
ias
[
3
3
]
.
Gen
d
er
-
r
elate
d
d
if
f
er
en
ce
s
in
HI
V
k
n
o
wled
g
e
h
av
e
also
b
ee
n
r
e
p
o
r
ted
i
n
p
r
ev
io
u
s
liter
atu
r
e,
s
u
g
g
esti
n
g
th
at
g
en
d
e
r
m
ay
i
n
f
lu
en
ce
h
o
w
HI
V
in
f
o
r
m
atio
n
is
ac
ce
s
s
ed
,
u
n
d
er
s
to
o
d
,
an
d
tr
an
s
lated
in
to
p
r
ev
en
tio
n
-
r
elate
d
awa
r
e
n
ess
[
3
4
]
.
Ho
wev
er
,
t
h
e
o
b
s
er
v
ed
d
if
f
er
en
ce
in
th
is
s
tu
d
y
s
h
o
u
ld
n
o
t b
e
in
ter
p
r
eted
a
s
an
in
tr
in
s
ic
d
if
f
er
en
ce
in
lear
n
in
g
ab
ilit
y
; r
ath
er
,
it
m
ay
r
ef
lect
v
ar
iatio
n
s
in
en
g
ag
em
en
t,
p
r
i
o
r
e
x
p
o
s
u
r
e
to
h
ea
lth
in
f
o
r
m
atio
n
,
c
o
m
m
u
n
i
ca
tio
n
d
y
n
am
ics,
o
r
o
th
er
c
o
n
tex
tu
al
f
ac
to
r
s
th
at
wer
e
n
o
t
m
ea
s
u
r
ed
in
th
is
s
tu
d
y
.
Fu
t
u
r
e
s
tu
d
ies
with
lar
g
e
r
an
d
m
o
r
e
b
alan
ce
d
s
am
p
les
ar
e
n
ee
d
ed
to
ex
am
in
e
wh
eth
er
s
ex
-
o
r
g
e
n
d
er
-
r
esp
o
n
s
iv
e
ap
p
r
o
ac
h
es
m
ay
im
p
r
o
v
e
wo
r
k
p
lace
HI
V
ed
u
ca
tio
n
o
u
tco
m
es.
T
h
e
m
o
d
est
an
d
n
o
n
-
s
ig
n
if
ic
an
t
co
r
r
elatio
n
b
etwe
en
p
r
e
-
t
est
a
n
d
p
o
s
t
-
test
s
co
r
es
s
u
g
g
ests
th
at
b
aselin
e
k
n
o
wled
g
e
was
n
o
t
c
lear
ly
ass
o
ciate
d
with
p
o
s
t
-
tr
a
in
in
g
p
er
f
o
r
m
an
ce
.
Ho
wev
e
r
,
th
is
f
in
d
in
g
s
h
o
u
ld
b
e
in
ter
p
r
eted
with
ca
u
tio
n
b
ec
au
s
e
in
d
iv
id
u
al
f
ac
to
r
s
s
u
c
h
as
ed
u
ca
tio
n
al
b
ac
k
g
r
o
u
n
d
,
p
r
io
r
HI
V
-
r
elate
d
tr
ain
in
g
,
an
d
h
ea
lth
liter
ac
y
wer
e
n
o
t
ass
es
s
ed
in
d
etail
.
T
h
e
s
tr
u
ctu
r
ed
an
d
in
te
r
ac
tiv
e
d
esig
n
o
f
th
e
in
ter
v
en
tio
n
m
a
y
h
av
e
h
elp
e
d
p
ar
ticip
an
ts
with
v
ar
y
in
g
b
as
elin
e
k
n
o
wled
g
e
lev
els
en
g
ag
e
with
th
e
tr
ain
in
g
co
n
ten
t.
Fu
tu
r
e
s
tu
d
ies
s
h
o
u
ld
f
u
r
th
er
ex
a
m
in
e
h
o
w
in
d
iv
id
u
al
lear
n
in
g
ch
a
r
ac
ter
is
tics
in
f
lu
en
ce
k
n
o
wled
g
e
im
p
r
o
v
em
e
n
t a
f
ter
wo
r
k
p
lace
-
b
ased
HI
V
tr
ain
in
g
.
Qu
alitativ
e
f
ee
d
b
ac
k
c
o
m
p
le
m
en
ts
th
e
q
u
an
titativ
e
r
esu
lts
b
y
h
ig
h
lig
h
tin
g
p
ar
ticip
an
ts
’
p
er
ce
p
tio
n
s
o
f
clar
ity
,
r
elev
an
ce
,
an
d
in
c
r
ea
s
ed
co
n
f
id
e
n
ce
to
p
r
o
m
o
t
e
HI
V
p
r
ev
en
tio
n
with
in
th
e
ir
wo
r
k
p
lace
.
T
h
e
r
ec
u
r
r
in
g
th
em
es o
f
e
m
p
o
wer
m
en
t a
n
d
p
ee
r
n
etwo
r
k
in
g
s
u
g
g
est th
at
th
e
in
ter
v
en
tio
n
m
ay
h
av
e
in
f
lu
e
n
ce
d
n
o
t
o
n
ly
co
g
n
itiv
e
o
u
tco
m
es
b
u
t
also
p
er
ce
iv
ed
r
ea
d
in
ess
to
ac
t.
T
h
is
is
p
ar
ticu
lar
ly
im
p
o
r
t
an
t
in
o
cc
u
p
atio
n
al
en
v
ir
o
n
m
en
ts
,
wh
er
e
p
ee
r
n
o
r
m
s
an
d
in
f
o
r
m
al
lead
e
r
s
h
ip
s
tr
u
ctu
r
es
ca
n
s
tr
o
n
g
ly
in
f
lu
e
n
ce
h
ea
lth
-
r
elate
d
attitu
d
es
an
d
p
r
ac
tices
[
1
7
]
.
T
ak
en
to
g
eth
e
r
,
th
ese
f
in
d
i
n
g
s
s
u
g
g
est
th
at
th
e
in
ter
v
en
tio
n
m
ay
h
av
e
v
alu
e
n
o
t
o
n
ly
as
a
o
n
e
-
tim
e
ed
u
ca
tio
n
al
ac
tiv
ity
b
u
t
also
as
a
f
o
u
n
d
atio
n
f
o
r
lo
n
g
er
-
te
r
m
p
ee
r
d
if
f
u
s
io
n
o
f
HI
V
p
r
ev
en
tio
n
m
ess
ag
es
with
in
t
h
e
wo
r
k
p
lace
.
T
h
is
in
ter
p
r
etat
io
n
is
s
tr
en
g
th
en
ed
b
y
ev
id
e
n
ce
f
r
o
m
p
ee
r
-
b
ased
HI
V
in
ter
v
en
tio
n
s
s
h
o
win
g
t
h
at
s
u
ch
ap
p
r
o
ac
h
es
ca
n
im
p
r
o
v
e
n
o
t
o
n
ly
k
n
o
wled
g
e
b
u
t
also
s
elf
-
ef
f
icac
y
,
s
tig
m
a
-
r
elate
d
attitu
d
es,
an
d
p
r
ev
en
tio
n
-
o
r
ien
te
d
co
m
m
u
n
icatio
n
.
I
n
Ma
lawi,
a
p
ee
r
-
g
r
o
u
p
in
ter
v
e
n
tio
n
am
o
n
g
h
o
s
p
ital
wo
r
k
er
s
im
p
r
o
v
ed
HI
V
-
r
elate
d
k
n
o
wled
g
e,
attitu
d
es
to
war
d
test
in
g
an
d
co
n
d
o
m
s
,
an
d
s
elf
-
ef
f
icac
y
f
o
r
p
r
ev
e
n
tio
n
ac
tiv
i
ties
.
Similar
ly
,
a
m
eta
-
an
aly
s
is
o
f
p
ee
r
ed
u
ca
tio
n
in
te
r
v
en
t
io
n
s
in
d
ev
elo
p
in
g
co
u
n
tr
ies
f
o
u
n
d
th
at
p
ee
r
-
b
ased
p
r
o
g
r
am
s
wer
e
ass
o
ciate
d
w
ith
s
ig
n
if
ican
tly
in
cr
ea
s
ed
HI
V
k
n
o
wled
g
e
(
o
d
d
s
r
atio
[
OR
]
,
2
.
2
8
; 9
5
% c
o
n
f
id
e
n
ce
in
ter
v
al
[
C
I
]
,
1
.
8
8
–
2
.
7
5
)
a
n
d
im
p
r
o
v
ed
co
n
d
o
m
u
s
e
o
u
tc
o
m
es
[
3
5
]
,
[
3
6
]
.
Fro
m
a
p
u
b
lic
h
ea
lth
p
er
s
p
ec
tiv
e,
th
e
o
b
s
er
v
e
d
im
p
r
o
v
em
en
t
in
HI
V
-
r
elate
d
k
n
o
wled
g
e
s
u
g
g
ests
th
at
p
ee
r
-
f
ac
ilit
ato
r
tr
ain
in
g
m
ay
s
er
v
e
as
a
p
r
ac
tical
s
tr
ateg
y
f
o
r
s
tr
en
g
th
en
in
g
wo
r
k
p
l
ac
e
HI
V
p
r
ev
en
tio
n
c
ap
ac
ity
.
At
th
e
p
o
licy
lev
el,
th
e
f
in
d
i
n
g
s
s
u
p
p
o
r
t
t
h
e
in
te
g
r
atio
n
o
f
p
ee
r
-
f
ac
ilit
ato
r
tr
ain
i
n
g
in
t
o
wo
r
k
p
lace
HI
V
p
r
ev
en
tio
n
p
r
o
g
r
a
m
s
,
p
ar
ticu
lar
ly
in
p
r
o
ject
-
b
ased
in
d
u
s
tr
ies
wh
er
e
wo
r
k
er
s
ar
e
m
o
b
ile
an
d
wo
r
k
p
lace
h
ea
lth
p
r
o
m
o
tio
n
m
ay
b
e
d
if
f
icu
lt
to
s
u
s
tain
.
T
h
is
in
ter
p
r
et
atio
n
is
co
n
s
is
ten
t
with
in
ter
n
atio
n
al
wo
r
k
p
lace
HI
V/AI
DS
g
u
id
an
ce
,
w
h
ich
em
p
h
asizes
wo
r
k
p
lace
-
b
a
s
ed
p
r
ev
e
n
tio
n
e
d
u
ca
tio
n
,
n
o
n
-
d
is
cr
im
in
atio
n
,
co
n
f
id
en
tiality
,
ca
r
e
an
d
s
u
p
p
o
r
t,
a
n
d
t
h
e
in
te
g
r
atio
n
o
f
HI
V
p
r
ev
e
n
tio
n
in
to
wo
r
k
p
lace
h
ea
lt
h
p
r
o
g
r
a
m
s
[
3
7
]
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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2
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15
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No
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2
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J
u
n
e
20
26
:
4
8
4
-
4
9
3
490
R
ath
er
th
an
r
ely
in
g
s
o
lely
o
n
ex
ter
n
al
f
ac
ilit
ato
r
s
,
co
n
s
tr
u
ctio
n
co
m
p
a
n
ies
m
ay
b
en
e
f
it
f
r
o
m
d
ev
elo
p
in
g
in
ter
n
al
p
ee
r
ed
u
ca
t
o
r
s
wh
o
c
an
d
eliv
er
r
ep
ea
ted
,
co
n
tex
t
-
s
p
ec
if
ic
p
r
ev
en
tio
n
m
ess
ag
es
an
d
r
ein
f
o
r
ce
n
o
n
-
d
is
cr
im
in
atio
n
p
r
in
cip
les
in
d
aily
wo
r
k
s
ettin
g
s
.
T
h
er
ef
o
r
e,
in
teg
r
atin
g
T
o
T
-
b
ased
H
I
V
ed
u
ca
tio
n
in
to
b
r
o
ad
e
r
o
cc
u
p
atio
n
al
h
ea
lth
p
r
o
m
o
tio
n
ac
tiv
ities
m
ay
s
tr
en
g
t
h
en
b
o
t
h
f
ea
s
ib
ilit
y
an
d
s
u
s
tain
ab
ilit
y
.
Alth
o
u
g
h
th
e
T
o
T
-
b
ased
in
ter
v
en
tio
n
s
h
o
wed
p
r
o
m
is
in
g
s
h
o
r
t
-
ter
m
e
d
u
ca
tio
n
al
g
ain
s
,
tr
a
in
in
g
alo
n
e
m
ay
n
o
t
b
e
s
u
f
f
icien
t
to
p
r
o
d
u
ce
s
u
s
tain
ed
p
r
ev
en
tio
n
o
u
tco
m
es
u
n
less
it
is
em
b
e
d
d
ed
with
in
b
r
o
ad
er
o
r
g
an
izatio
n
al
s
u
p
p
o
r
t.
Pre
v
io
u
s
wo
r
k
p
lace
HI
V
in
te
r
v
en
tio
n
r
esear
c
h
s
u
g
g
ests
th
at
HI
V
p
r
e
v
en
tio
n
p
r
o
g
r
a
m
s
ar
e
m
o
r
e
lik
ely
t
o
b
e
ef
f
ec
tiv
e
wh
e
n
ed
u
ca
tio
n
i
s
ac
co
m
p
an
ied
b
y
wo
r
k
p
lace
p
o
licies,
ac
ce
s
s
to
p
r
ev
en
tio
n
r
eso
u
r
ce
s
,
b
e
h
av
io
r
al
ca
m
p
aig
n
s
,
m
an
a
g
em
en
t
c
o
m
m
itm
en
t,
a
n
d
r
ef
er
r
al
p
ath
way
s
to
HI
V
-
r
elate
d
s
er
v
ices
[
3
1
]
,
[
3
8
]
.
E
v
id
e
n
ce
f
r
o
m
T
h
ailan
d
,
f
o
r
e
x
am
p
le,
s
h
o
wed
th
at
wo
r
k
p
lace
HI
V
p
r
o
g
r
am
s
wer
e
m
o
r
e
ef
f
ec
tiv
e
wh
en
tr
ai
n
in
g
was
i
n
teg
r
ated
with
p
o
licy
an
d
s
er
v
ice
co
m
p
o
n
en
ts
[
3
1
]
.
T
h
er
ef
o
r
e,
th
e
T
o
T
m
o
d
el
s
h
o
u
ld
b
e
v
iewe
d
n
o
t
o
n
ly
as
a
s
h
o
r
t
-
ter
m
ed
u
ca
tio
n
al
ac
tiv
ity
b
u
t
also
as
o
n
e
co
m
p
o
n
en
t
o
f
a
b
r
o
a
d
e
r
wo
r
k
p
lace
HI
V
p
r
ev
en
tio
n
s
y
s
tem
.
T
h
is
s
tu
d
y
co
n
tr
ib
u
tes
to
wo
r
k
p
lace
h
ea
lth
p
r
o
m
o
tio
n
liter
atu
r
e
b
y
d
em
o
n
s
tr
atin
g
th
e
f
e
asib
ilit
y
o
f
ap
p
ly
in
g
a
s
tr
u
ct
u
r
ed
T
o
T
m
o
d
el
in
t
h
e
c
o
n
s
tr
u
ctio
n
s
ec
to
r
,
a
wo
r
k
f
o
r
ce
th
at
is
o
f
te
n
m
o
b
ile,
p
r
o
ject
-
b
ased
,
an
d
u
n
d
e
r
s
er
v
ed
b
y
s
u
s
tain
ed
h
ea
lth
ed
u
ca
tio
n
p
r
o
g
r
am
s
.
T
h
e
f
in
d
in
g
s
s
u
g
g
est
th
at
f
ac
ilit
ato
r
-
ce
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ter
ed
tr
ain
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g
m
ay
h
elp
c
o
n
s
tr
u
ctio
n
co
m
p
a
n
ies
d
ev
elo
p
in
ter
n
al
p
ee
r
ed
u
ca
to
r
s
wh
o
ca
n
s
u
p
p
o
r
t
r
e
p
ea
ted
HI
V
p
r
ev
en
tio
n
m
ess
ag
es,
s
tig
m
a
r
ed
u
ctio
n
,
an
d
lin
k
ag
e
to
wo
r
k
p
lace
o
r
co
m
m
u
n
ity
-
b
ased
HI
V
s
er
v
ices.
I
n
th
is
s
en
s
e,
th
e
s
tu
d
y
ex
ten
d
s
p
r
ev
io
u
s
ev
id
en
ce
o
n
wo
r
k
p
lace
HI
V
ed
u
ca
tio
n
b
y
s
h
o
win
g
h
o
w
a
T
o
T
ap
p
r
o
ac
h
ca
n
b
e
o
p
er
atio
n
alize
d
in
a
co
n
s
tr
u
ctio
n
wo
r
k
p
lace
co
n
tex
t.
T
h
e
p
o
te
n
tial
s
u
s
tain
ab
ilit
y
o
f
th
e
T
o
T
m
o
d
el
d
ep
en
d
s
o
n
wh
eth
er
tr
ain
ed
f
ac
ilit
ato
r
s
ar
e
s
u
p
p
o
r
te
d
af
ter
th
e
in
itial
tr
ain
in
g
.
C
o
n
c
ep
tu
al
an
d
ev
alu
ativ
e
liter
atu
r
e
o
n
T
o
T
em
p
h
asizes
th
at
ca
s
ca
d
e
ef
f
ec
ts
r
eq
u
ir
e
n
o
t
o
n
ly
h
ig
h
-
q
u
ality
in
itial
tr
ain
in
g
b
u
t
also
o
p
p
o
r
tu
n
ities
f
o
r
f
ac
ilit
ato
r
s
to
ap
p
ly
th
ei
r
s
k
ills
,
o
r
g
an
izatio
n
al
s
u
p
p
o
r
t,
r
ef
r
esh
er
t
r
ain
in
g
,
an
d
r
eso
u
r
ce
s
to
s
u
s
tain
lo
ca
l
tr
a
in
in
g
n
etwo
r
k
s
o
v
e
r
tim
e
[
1
4
]
,
[
1
9
]
.
Acc
o
r
d
in
g
ly
,
f
u
tu
r
e
im
p
lem
en
tatio
n
s
h
o
u
ld
co
n
s
id
er
in
te
g
r
atin
g
T
o
T
-
b
ase
d
HI
V
e
d
u
ca
tio
n
in
to
r
o
u
tin
e
o
cc
u
p
atio
n
al
h
ea
lth
an
d
s
af
ety
p
r
o
g
r
a
m
s
,
p
er
io
d
ic
r
ef
r
esh
er
s
ess
io
n
s
,
p
ee
r
c
o
u
n
s
elin
g
r
ef
er
r
al,
s
tig
m
a
r
ed
u
c
tio
n
ac
tiv
ities
,
an
d
lin
k
ag
e
to
v
o
lu
n
tar
y
co
u
n
s
elin
g
an
d
test
in
g
s
er
v
ices
[
2
2
]
.
Sev
er
al
lim
itatio
n
s
s
h
o
u
l
d
b
e
co
n
s
id
er
e
d
wh
e
n
i
n
ter
p
r
etin
g
th
ese
f
in
d
in
g
s
.
First,
th
e
s
in
g
le
-
g
r
o
u
p
p
r
e
-
test
–
p
o
s
t
-
test
d
esig
n
with
o
u
t
a
co
m
p
ar
is
o
n
g
r
o
u
p
li
m
its
ca
u
s
al
in
f
er
en
ce
;
th
er
ef
o
r
e,
th
e
o
b
s
er
v
ed
im
p
r
o
v
em
e
n
t
ca
n
n
o
t
b
e
attr
i
b
u
ted
ex
cl
u
s
iv
ely
to
th
e
i
n
t
er
v
en
tio
n
.
Seco
n
d
,
p
ar
ticip
a
n
ts
wer
e
r
ec
r
u
ited
p
u
r
p
o
s
iv
ely
an
d
n
o
m
i
n
ated
b
y
m
an
a
g
em
en
t,
wh
ich
m
a
y
h
av
e
in
tr
o
d
u
ce
d
s
elec
tio
n
b
ias
an
d
lim
ited
th
e
r
ep
r
esen
tativ
en
ess
o
f
th
e
s
am
p
le.
T
h
ir
d
,
k
n
o
wled
g
e
was
ass
ess
ed
im
m
ed
iately
af
ter
th
e
in
t
er
v
en
tio
n
u
s
in
g
th
e
sa
m
e
in
s
tr
u
m
en
t,
s
o
test
in
g
e
f
f
ec
ts
,
s
h
o
r
t
-
ter
m
r
ec
all,
a
n
d
th
e
ab
s
en
ce
o
f
lo
n
g
er
-
ter
m
k
n
o
wled
g
e
r
eten
tio
n
ass
es
s
m
en
t
s
h
o
u
ld
b
e
co
n
s
id
er
ed
.
Fo
u
r
th
,
t
h
e
s
tu
d
y
f
o
c
u
s
ed
m
ain
ly
o
n
im
m
e
d
iate
k
n
o
wled
g
e
g
ai
n
an
d
p
er
ce
iv
ed
r
ea
d
in
ess
,
r
at
h
er
t
h
an
b
e
h
av
io
r
al
ch
a
n
g
e,
s
tig
m
a
r
ed
u
ctio
n
,
u
p
tak
e
o
f
HI
V
-
r
elate
d
s
er
v
ices,
o
r
ac
tu
al
im
p
lem
en
tatio
n
o
f
w
o
r
k
p
lace
p
r
e
v
en
tio
n
ac
tiv
ities
.
Fifth
,
th
e
m
o
d
est
r
eliab
ilit
y
co
ef
f
icien
t
o
f
th
e
k
n
o
wled
g
e
ass
ess
m
en
t
s
u
g
g
ests
th
at
f
u
tu
r
e
s
tu
d
ies
s
h
o
u
ld
r
e
f
in
e
th
e
in
s
tr
u
m
en
t
b
y
ad
d
i
n
g
m
o
r
e
ite
m
s
,
test
in
g
d
im
en
s
io
n
ality
,
an
d
co
n
d
u
cti
n
g
m
o
r
e
co
m
p
r
eh
e
n
s
iv
e
p
s
y
ch
o
m
etr
ic
v
alid
atio
n
.
Fin
ally
,
th
e
r
elativ
ely
s
m
all
s
am
p
le
s
ize
an
d
f
o
cu
s
o
n
o
n
e
o
cc
u
p
atio
n
al
co
n
tex
t
lim
it
th
e
g
en
er
aliza
b
ilit
y
o
f
th
e
f
i
n
d
i
n
g
s
.
Fu
tu
r
e
s
tu
d
ies
u
s
in
g
co
n
tr
o
lled
d
esig
n
s
,
lar
g
er
s
am
p
les,
v
alid
ated
in
s
tr
u
m
en
ts
,
an
d
lo
n
g
itu
d
in
al
f
o
llo
w
-
u
p
ar
e
n
ee
d
ed
to
co
n
f
ir
m
th
e
ef
f
ec
tiv
e
n
ess
,
s
u
s
tain
ab
ilit
y
,
an
d
r
ea
l
-
wo
r
ld
im
p
ac
t
o
f
T
o
T
-
b
ased
HI
V
p
r
ev
e
n
tio
n
in
ter
v
en
tio
n
s
in
wo
r
k
p
lace
s
ettin
g
s
.
4.
CO
NCLU
SI
O
N
T
h
e
p
r
esen
t
s
tu
d
y
ad
d
r
ess
ed
th
e
lim
ited
av
ailab
ilit
y
o
f
f
ea
s
ib
le
an
d
s
u
s
tain
ab
le
wo
r
k
p
lace
HI
V
p
r
ev
en
tio
n
m
o
d
els
in
th
e
co
n
s
tr
u
ctio
n
s
ec
to
r
b
y
im
p
lem
en
t
in
g
a
s
tr
u
ctu
r
ed
T
o
T
in
te
r
v
en
tio
n
.
T
h
e
p
r
o
g
r
am
s
u
b
s
tan
tially
im
p
r
o
v
e
d
HI
V
-
r
elate
d
k
n
o
wled
g
e
am
o
n
g
co
n
s
tr
u
ctio
n
wo
r
k
er
s
an
d
s
tr
en
g
th
en
ed
p
er
ce
iv
e
d
r
ea
d
in
ess
to
s
u
p
p
o
r
t
wo
r
k
p
la
ce
p
r
ev
e
n
tio
n
ef
f
o
r
ts
.
T
h
ese
f
in
d
in
g
s
in
d
icate
th
at
a
wo
r
k
p
lace
-
b
ased
T
o
T
ap
p
r
o
ac
h
is
a
f
ea
s
ib
le
an
d
p
o
ten
tially
s
ca
lab
le
s
tr
ateg
y
f
o
r
s
tr
en
g
th
en
in
g
in
te
r
n
al
HI
V
p
r
e
v
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23.
RE
F
E
R
E
NC
E
S
[
1
]
S
.
P
a
y
a
g
a
l
a
a
n
d
A
.
P
o
z
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i
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k
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Th
e
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[
2
]
U
N
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[
3
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Y
.
C
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.
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Re
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4
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[
5
]
P
.
P
.
Ja
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,
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M
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-
S
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.
[6
]
G
.
J.
K
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k
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n
d
S
.
R
.
L
u
k
w
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l
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,
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V
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d
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s:
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g
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,
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.
[
7
]
N
.
M
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.
H
.
M
y
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,
M
.
M
.
C
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o
W
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n
,
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d
M
.
A
k
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r
,
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mo
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M
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g
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W
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k
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r
s
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M
a
l
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y
si
a
,
”
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c
h
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rs
I
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t
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t
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O
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.
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.
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v
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1
.
[
8
]
C
e
n
t
r
a
l
B
u
r
e
a
u
o
f
S
t
a
t
i
st
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c
s
,
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P
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o
f
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l
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A
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a
l
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t
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P
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2
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O
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]
.
A
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.
h
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.
[
9
]
S
.
S
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mers
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t
,
W
.
Jo
n
e
s,
C
.
E
v
a
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s,
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.
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a
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d
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.
B
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k
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,
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O
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-
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H
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k
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s:
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Evaluation Warning : The document was created with Spire.PDF for Python.