Process Evaluation of a Sport-Based HIV Testing and Linkage-to-Care Event among Youth in Zambia

Brief Summary

Background

Young people in Zambia face significant barriers to HIV testing and follow-up care, including stigma, fear, and limited knowledge of where to access services.

What Grassroot Soccer did

Grassroot Soccer Zambia held 72 one-day sport-based testing events across Lusaka over 18 months, combining soccer activities with HIV prevention messaging and on-site testing and providing immediate referrals to a pediatric HIV clinic for those who tested positive.

What the study found

Nearly 7,000 young people were tested across the events, with strong uptake overall. Of those who tested positive, the majority were successfully enrolled into HIV care, and very few were lost to follow-up six months later.

Why this matters

These findings suggest that sport-based testing events, paired with active follow-up support, can be an effective strategy for connecting young people to HIV care quickly and sustainably.

DETAILED SUMMARY

Importance

Youth in Zambia face substantial barriers to HIV testing and linkage to care, including lack of knowledge of testing sites, fear of finger pricks, stigma, and poor referral completion. Grassroot Soccer Zambia introduced the SKILLZ Voluntary Counseling and Testing Event (SVE) to increase youth testing, reduce barriers, and strengthen linkage to HIV care.

Objective

To evaluate whether SVEs increase HIV testing uptake among youth and improve linkage to pediatric HIV care, and to assess adherence and loss to follow-up among those enrolled.

Study details

Study design: Process evaluation; no control group.
Data collection tools: HIV testing registers; demographic data; referral tracking; enrollment and adherence data from pediatric HIV clinic; loss to follow-up at 6 months.
Participants: Mixed-gender youth under 20 years; Department of Health nurses; New Start counselors.
Implementation setting: SVEs conducted across Lusaka, Zambia (urban).
Study period: June 2010–November 2011.

Intervention

SKILLZ VCT Event (SVE): A one-day sport-based event combining HIV prevention messaging, soccer activities, community outreach, and on-site voluntary counseling and testing. Youth who test HIV positive receive an immediate referral to a pediatric HIV clinic.

Results

Sample: 6,859 youth tested for HIV at 72 SVEs over 18 months. Approximately 11,000 youth attended SVEs, indicating a 62% VCT uptake rate.
HIV positivity: 1.6% HIV prevalence (110 youth tested positive for HIV).
Linkage to care: 45 youth (40.9%) enrolled into pediatric HIV care.
Retention: Only 5 youth (11.1%) were lost to follow-up at 6 months.

Conclusions and implications

Results demonstrate that SVEs substantially increased youth HIV testing and dramatically improved linkage to care when accompanied by home visits.
The event-based model offers a promising, youth-friendly strategy to reduce stigma and connect newly diagnosed adolescents to treatment quickly.

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Citation

Year: 2012

Authors: Zales M, Kaufman Z

Zales M, Kaufman Z. A sport-based intervention to increase linkage to care [poster]. Presented at: XIX International AIDS Conference (AIDS 2012); 2012 Jul 22-27; Washington, DC.