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 ages 12–16. Female community leaders—“coaches”—deliver ten 2-hour sessions bi-weekly. Attendance and HCT data were collected at 38 programmes across 5 GRS sites during 24 months in 2011–2012. 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 1,953 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.

Introduction:Grassroot Soccer (GRS) developed 2 brief and scalable voluntary medical male circumcision (VMMC) promotion interventions for males in Bulawayo, Zimbabwe, consisting of a 60-minute interactive, soccer-themed educational session with follow-up behavioral and logistical reinforcement. Both interventions were led by circumcised male community leaders (“coaches”) ages 18–30. “Make The Cut” (MTC) targeted adult males on soccer teams and “Make The Cut+” targeted boys in secondary schools. We conducted a process evaluation of MTC and Make The Cut+ to investigate perceptions of program impact, intervention components, and program delivery; participants' understandings of intervention content; and factors related to uptake.Methods:We conducted 17 interviews and 2 focus group discussions with coaches and 29 interviews with circumcised (n = 13) and uncircumcised participants (n = 16).Results:Findings demonstrate high program acceptability, highlighting the coach–participant relationship as a key factor associated with uptake. Specifically, participants valued the coaches' openness to discuss their personal experiences with VMMC and the accompaniment by their coaches to the VMMC clinic.Conclusions:Should the coach quality remain consistent at scale, MTC offers an effective approach toward generating VMMC demand among males.

Grassroot Soccer (GRS) is exploring the effectiveness of a twoway SMS campaign delivered through a single-sex, soccer-based HIV prevention programme. The campaign aims to enhance reproductive health and rights outcomes among at-risk adolescent South African girls ages 11-14. To test and refine the SMS campaign prior to piloting, GRS employed a participatory process in building a prototype of an Unstructured Supplementary Service Data (USSD) line using Open Data Kit (ODK), an open-source application for building, collecting, and managing data on Android-enabled phones and tablets. The USSD prototype was delivered to 72 female participants and coaches in July 2013. All participants also completed a 10-item questionnaire on ODK. Focus group discussions were conducted with coaches (N=1 group) and parents (N=1 group). Results demonstrate that 55% of participants reported owning a mobile phone; a majority reported being "very interested" in the USSD prototype (68%) and "very comfortable" interacting with the USSD prototype (62%). Findings suggest that two-way SMSs could offer an acceptable service for reaching at-risk adolescent girls in South Africa with health-related messaging, particularly on sensitive issues. Results will inform delivery of a USSD line in a programmatic pilot and assessment to be carried out in six primary schools (approximately 600 participants) in Soweto, separated between control and intervention groups, beginning in September 2013.

BackgroundThe nature and structure of the school environment has the potential to shape children's health and well being. Few studies have explored the importance of school-level factors in explaining a child's likelihood of experiencing violence from school staff, particularly in low-resource settings such as Uganda.MethodsTo quantify to what extent a student's risk of violence is determined by school-level factors we fitted multilevel logistic regression models to investigate associations and present between-school variance partition coefficients. School structural factors, academic and supportive environment are explored.Results53% of students reported physical violence from staff. Only 6% of variation in students' experience of violence was due to differences between schools and half the variation was explained by the school-level factors modelled. Schools with a higher proportion of girls are associated with increased odds of physical violence from staff. Students in schools with a high level of student perceptions of school connectedness have a 36% reduced odds of experiencing physical violence from staff, but no other school-level factor was significantly associated.ConclusionOur findings suggest that physical violence by school staff is widespread across different types of schools in this setting, but interventions that improve students' school connectedness should be considered.