In Zambia, adolescents and young girls aged 15-24 bear a disproportionate burden of HIV and unwanted pregnancy. The need to improve their health and ensure they have control over their reproductive futures calls for creative solutions.
Integrating sports and sexual health could be an innovative and effective approach for promoting HIV and pregnancy prevention. A recent study led by Assistant Professor Lila Sheira, PhD, MPH, evaluated whether a peer-led, sports-based program in Zambia impacted girls’ and young women’s sexual and reproductive empowerment.
Over 2,000 young women participated in the SKILLZ program across urban districts in Lusaka. They had 12 peer-led after-school sessions that included comprehensive sexual and reproductive health information and soccer classes, taught by peer coaches. They had a community graduation within a month of completing the session, with HIV testing and contraception available at the event via a mobile clinic. There were also optional “teen club” meetings focused on sexual health, empowerment, and well-being. Trained coaches distributed HIV self-test kits and contraception.
To understand how well the SKILLZ program worked, the study used the Sexual and Reproductive Health Empowerment scale for adolescent girls and young women developed by one of the study co-authors and UCSF Professor, Dr. Ushma Upadhyay. The scale was developed with input from young people and captures their diverse experiences and needs at this stage of their lives.
The study found that the program moderately improved sexual and reproductive empowerment, a step on the way toward increased HIV testing and contraceptive use. The program had the biggest effect in areas like comfort talking with a partner, sexual safety, and sexual pleasure, which were covered in the curriculum. The effects were even more pronounced among young women who were sexually active.
Given that adolescence is a critical period for sexual and gender education, empowerment interventions at schools might support other sexual health behaviors that will impact young people’s lives in the future.
