Mixed methods study of SKILLZ Health for HIV prevention and life skills among adolescent boys in South Africa

Brief Summary

Background

Adolescent boys in South Africa face significant HIV risks but are difficult to reach through health programs due to stigma and reluctance to engage with health services.

What Grassroot Soccer did

Grassroot Soccer implemented SKILLZ Health, a sport-based HIV prevention and life skills program delivered by local football association coaches, to 974 adolescent boys across Johannesburg and Cape Town, South Africa.

What the study found

Participants showed improvements across all measured areas, including HIV knowledge, communication about HIV with friends, and gender equitable attitudes. Older participants showed greater gains than younger participants.

Why this matters

Findings suggest that local football structures may be an under-utilized entry point for reaching adolescent boys with HIV prevention education, with potential for expanded partnership and scale.

DETAILED SUMMARY

Importance

Health communication with adolescent male populations on the topic of HIV is difficult given the fear of societal stigmatization and reluctance to utilize health services.
Grassroot Soccer’s SKILLZ program aids in providing adolescent South African boys with HIV education through a discovery-based sports intervention.

Objective

To assess the effectiveness of SKILLZ at improving knowledge of HIV risk factors and prevention strategies, gender equitable beliefs, and self-image among South African youth ages 15-19 years.

Study details

Study design: Mixed methods study; no control group.
Data collection tools: 17-item questionnaire pre- and post-intervention; Focus group discussions conducted with adolescent participants, coaches; In-depth interviews performed with GRS staff and LFA administrators.
Participants: Adolescent boys (n = 974) with a mean age of 13.8 years
Implementation setting: Alexandra and Soweto, Johannesburg, South Africa; Khayelitsha, Cape Town, South Africa
Study period: Pre-intervention: Sept. 2016 – Dec. 2016; post-intervention: Mar 2017 – May 2017

Intervention

Other (SKILLZ Health): A 7-session youth-centered HIV prevention and life skills program for South African adolescents and young adults administered by local football association (LFA) coaches.

Results

Quantitative: Significant improvement was observed across all 17 questionnaire items (Wilcoxon Signed Rank Test p<0.01). Greatest changes were in: communication about HIV with friends (53% increase), gender equitable decision-making (61% increase), and knowledge that drinking alcohol increases HIV risk (57% increase).
Qualitative: Findings suggest improvements in participants’ attitudes towards women and alcohol. There was interest in more support and training for LFA Coaches from Grassroot Soccer.

Conclusions and implications

Local football structures may be under-utilized in reaching adolescent boys. SKILLZ may be effective for producing short-term improvements in HIV and gender-related knowledge and attitudes.
Consider scaling the partnership between Grassroot Soccer and LFAs.

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Citation

Year: 2018

Authors: Malotana M, Denington J, Zwele S, Advani N, Lee D, Banciu R, Barkley C

Malotana M, Denington J, Zwele S, Advani N, Lee D, Banciu R, Barkley C. HIV prevention and SRH education on the football pitch: results from a mixed-methods evaluation of an HIV prevention programme delivered to adolescent boys by football coaches [poster]. Presented at: 22nd International AIDS Conference (AIDS 2018); 2018 Jul 23-27; Amsterdam, Netherlands.