Pilot study of Generation SKILLZ among Adolescents in South Africa

Brief Summary

Background

South Africa faces one of the world's most severe HIV epidemics, and adolescents remain at significant risk. Sport-based HIV prevention programs are growing, but evidence for their effectiveness is limited.

What Grassroot Soccer did

Grassroot Soccer implemented Generation SKILLZ , which is an eleven-session sport-based HIV prevention program, across secondary schools in Soweto, Mtubatuba, and Khayelitsha, South Africa. The program reached over 600 mixed-gender students with an average age of about 16 years.

What the study found

Participants showed meaningful improvements in HIV-related knowledge, attitudes, and communication following the program, with particularly strong gains in understanding key risk factors and prevention methods.

Why this matters

These findings provide encouraging early evidence that Generation SKILLZ can positively influence adolescents' HIV-related knowledge and attitudes, supporting its potential as a school-based prevention tool in high-burden settings.

DETAILED SUMMARY

Importance

South Africa has one of the world’s most severe HIV epidemics, with 5.6 million infected and about 390,000 new infections per year. There are many upcoming sports-based interventions but not a lot of evidence for the effectiveness of these interventions.

Objective

To assess whether Generation SKILLZ improves sexual risk behaviors and reduces HIV/HSV-2 incidence among adolescents attending secondary schools in Soweto, Mtubatuba, and Khayelitsha, South Africa.

Study details

Study design: Pre and post intervention pilot study (no control group)
Data collection tools: Pre and post questionnaires
Participants: 612 secondary school participants (mixed gender (54% female), mean age of 15.7 years)
Implementation setting: Secondary schools in Soweto, Mtubatuba and Khayelitsha, South Africa
Study period: Pre and post intervention assessments conducted between February to September 2011 (questionnaires administered immediately before and after intervention)

Intervention

Generation Skillz: An eleven-session sport-based HIV prevention intervention delivered in secondary schools in South Africa, primarily focusing on age-disparate sex, multiple partnerships, gender-based violence, and male circumcision.

Results

612 total participants
Strong evidence of positive effects on knowledge (t=27.2, p<0.001), reported attitudes (t=12.9, p<0.001), and reported communication (t=11.4, p<0.001)
Significant pre/post changes observed on 19 of the 20 indicators (p<0.005).
Overall, the mean number of favorable responses increased from 11.46 (SD=3.18) to 15.08 (SD=3.51) from pre- to post-intervention (t=28.3, p<0.001).
The strongest effects were observed in knowledge of older partners (RR=2.05, 95% CI=1.77-2.37), alcohol and drugs (RR=1.77, 95% CI=1.53-2.05), and acute infection (RR=2.74, 95% CI=2.30-3.26) as risk factors for HIV, as well as knowledge of male circumcision as an HIV prevention method (RR=1.75, 95% CI=1.50-2.05).

Conclusions and Implications

Findings demonstrate encouraging evidence that Generation SKILLZ produces a short-term positive effect on participants’ knowledge, attitudes and communication related to HIV. Findings will inform a randomized controlled trial (the GOAL trial).

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Citation

Year: 2012

Authors: Kaufman ZA, Braunschweig EN, DeCelles J, Nkosi Z, Delany-Moretlwe S, Ross DA

Kaufman ZA, Braunschweig EN, DeCelles J, Nkosi Z, Delany-Moretlwe S, Ross DA. GOAL Trial: pilot results of a sport-based HIV prevention intervention to inform a cluster-randomized trial in South African schools [poster]. Presented at: XIX International AIDS Conference; 2012 Jul 22-27; Washington, DC, USA.