HIV Testing Uptake Among Adolescents and Adults in Southern Africa via SKILLZ Tournaments

Brief Summary

Background

HIV testing rates in southern Africa in the mid 2000s were low, particularly among males and young people. Low testing makes it harder for those living with HIV to access treatment.

What Grassroot Soccer did

Over four years, Grassroot Soccer ran voluntary HIV counseling and testing tournaments across five countries: South Africa, Lesotho, Zambia, Malawi, and Namibia. Grassroot Soccer combined HIV prevention education with on-site testing and immediate referrals for those who tested positive.

What the study found

Based on routine monitoring data, more than 16,000 people were tested across the tournaments, the majority for the first time. Over 800 individuals who tested positive were connected to care, and participants reported feeling less fear of stigma compared to clinic settings.

Why this matters

Sport-based testing events show promise as an effective way to reach adolescents and males who might not otherwise seek HIV testing, helping connect more people to the care they need.

DETAILED SUMMARY

Importance

Access rates for voluntary counseling and testing (VCT) of HIV in southern Africa remains low with 34% of females and 15% of males reporting uptake of services. Increasing uptake is critical to ensuring that individuals can receive proper treatment in a timely manner.

Objective

To evaluate Grassroot Soccer’s VCT soccer tournament model ability to promote de-stigmatization of seeking HIV access and uptake of VCT services over 4 years in 5 countries in Sub-Saharan Africa.

Study details

Study design: Program evaluation using routine monitoring data
Data collection tools: HIV testing data
Participants: Approximately 16,137 individuals tested across all tournaments. 52% of participants were male and approximately half were adolescents aged 15–24 years.
Implementation setting: Community settings across five countries: South Africa, Lesotho, Zambia, Malawi, and Namibia.
Study period: 2006-2010

Intervention

SKILLZ VCT Tournaments: Combined HIV prevention education with counseling, testing, and treatment services using rapid diagnostic tests at every event and providing immediate referrals for those who test positive.

Results

Over a 4 year-period, 16,137 individuals received testing through the VCT tournament model. Of those tested, 820 individuals tested positive and were referred to a treatment partner for further care.
The majority of attendees were accessing VCT for the first time.
Tournaments in Zambia (where counselors provided testing) tested 2.6 times more individuals than tournaments held in South Africa (where counselors were not permitted to perform tests until May 2010), and half-day events in Malawi tested more individuals, on average, than full-day events in South Africa and Namibia.
Tournament attendees in Zambia reported a preference for the VCT setting over local clinics, noting they felt a reduced fear of stigma and greater sense of support.

Conclusions and Implications

VCT soccer tournaments can provide an effective means of increasing VCT uptake in southern African settings, particularly for adolescents and males.
Further evaluation is needed to assess changes in participants’ attitudes and attrition rates.

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Citation

Year: 2013

Authors: Kaufman Z, Friedrich P, Dunberger A, Bell S

Kaufman Z, Friedrich P, Dunberger A, Bell S. VCT soccer tournaments: linking sport, prevention, testing and treatment [poster]. Presented at: 18th International AIDS Conference (AIDS 2010); 2010 Jul 18-23; Vienna, Austria.