Using Soccer to Build Confidence and Increase HCT Uptake Among Adolescent Girls: A Mixed-methods Study of an HIV Prevention Program in South Africa

HIV prevalence is eight times higher in young South African women compared to men. Grassroot Soccer (GRS) developed SKILLZ Street (SS), a single-sex intervention using soccer to improve self-efficacy, HIV-related knowledge and HIV counselling and testing (HCT) uptake among girls aged 12-16 years. Female community leaders – ‘coaches’ – deliver 10 two-hour sessions bi-weekly. Attendance and HCT data were collected at 38 programmes across five GRS sites during 24 months in 2011-2012. A total of 514 participants completed a 16-item pre/post questionnaire. Focus group discussions (FGDs) were conducted with participants (n = 11 groups) and coaches (n = 5 groups), and coded for analysis using NVivo. Of 1953 participants offered HCT, 68.5% tested. Overall, significant pre/post improvement was observed (p < 0.001). FGDs suggest participants: valued coach-participant relationship; improved self-efficacy, HIV-related knowledge, communication and changed perception of soccer as a male-only sport; and increased awareness of testing's importance. Results suggest SS helps at-risk girls access HCT and HIV-related knowledge while promoting self-confidence.