Adolescence is a time when gender disparities between boys and girls become more pronounced. While many boys stay focused on school, girls often have more responsibilities at home. These responsibilities limit girls’ opportunities for maintaining
social networks, and social isolation can contribute to increasing the risk of dropping out of school, marrying early, and being in situations that leave them vulnerable to pregnancy and HIV infection. Young people with the fewest risk factors and the
most social assets (usually boys) receive the largest share of available services rather than those who are more vulnerable (usually girls). Investing in adolescent girls, especially those ages 10 to 14, is crucial for alleviating poverty, achieving universal
primary education, promoting gender equity, and addressing other factors that put girls at risk of negative health outcomes. At their most recent annual meeting, the Interagency Youth Working Group focused on protecting and empowering adolescent girls. Sports programming was among the innovative approaches highlighted. This brief summarizes the discussion.
Sports as an intervention
For more than a decade, reproductive health experts have discussed whether sports can help build social networks for girls in developing countries, allowing
them to challenge gender norms that contribute to their vulnerability.1 In addition to promoting gender equity, sports can enhance physical and mental well-being; promote social integration for girls; provide girls with adult mentors; and encourage
the development of new skills, knowledge, and self-confidence. Participation in organized physical activity can also give girls access to public spaces, such as parks and sports fields. Although men and boys are usually free to visit these venues, women
and girls are often physically or psychologically intimidated or excluded outright.
Many HIV prevention programs are beginning to incorporate sports as a platform for disseminating HIV prevention messages and for teaching life skills
that help adolescents change their knowledge, attitudes, and behaviors regarding HIV. More than ever, international policies support the participation of girls in sports programs, and sports advocates are incorporating more health and development
goals into their agendas. Most of the research on sports programs for adolescent
girls has come from the United States and other Western countries. More scientific evidence on the social and health benefits of sports—including reproductive
health benefits—is emerging from developing countries. Now appears to be an opportune time to invest more in the evaluation of these programs.
Changes in knowledge and attitudes
A few published studies have shown that sports can have a positive effect on the knowledge and attitudes of both adolescent boys and adolescent
girls, with promising results. A recent evaluation of an eight-month AIDS
education intervention program called EMIMA, which used peers as soccer coaches and sources of HIV/AIDS education for at-risk adolescents in
Tanzania, found that the program was effective in improving knowledge and attitudes about HIV and safe sexual practices. Nine hundred fifty adolescents ages 12 to 15 were
included in the study, 764 of whom were involved in EMIMA and the rest of whom received either standard HIV education in school or no HIV education
(the control groups). Questionnaires before and after the intervention revealed that when compared with adolescents in the control groups, the adolescents who participated in EMIMA were significantly more likely to believe
that they had control over condom use, abstinence, and engaging in exclusive sexual relationships to prevent HIV. They also had significantly higher levels
of knowledge about HIV and had more positive attitudes about condom use. A school-based pilot project in Zimbabwe showed that professional soccer players can be effective role models and HIV educators. Using an interactive game-based approach, soccer players taught an HIV curriculum (developed specifically for the
study) to about 150 seventh-grade girls and boys over a two-week period. When compared with a control group of students who received traditional school-based HIV education, the students in the intervention group were significantly more likely to
believe that condoms can effectively prevent HIV and to know where they could find HIV prevention services. They were also significantly more likely to report having social support and to report that they would not avoid a classmate who had HIV. Five months after the intervention, the adolescents in the control group had reached the same level of knowledge as the adolescents in the intervention group on all of these measures. This suggests that the adolescents in the intervention group were likely sharing what they had learned with their peers.
Effects on behaviors
Additional research is beginning to show that participation in sports may have a positive effect on sexual behaviors, in addition to knowledge and attitudes. In a study published in 2002, scientists investigated the relationship between sexual health and
membership in voluntary community organizations such as churches, youth groups, and sports clubs in South Africa. The study included a survey of more than 1,000 men and women ages 13 to 60 living in a small mining community near Johannesburg. Although the results were mixed depending on sex, age, and type of community organization, the
scientists found that young women ages 15 to 24 were significantly less likely to be infected with HIV if they belonged to a sports club than if they did not. This did not hold true for young men of the same age (although young men ages 20 to 29 were significantly less likely to be infected if they were in a sports club).
The results also showed that young women who were members of a sports club were significantly more likely to use condoms with casual partners and nonmembers, when compared with young women who were not involved in a sports club. This finding is difficult to interpret, however, because the authors did not report the ages of these women. More recently, the International Centre for Reproductive Health and its partners published the results of a cross-sectional survey assessing
relationships between sexual behavior and membership
in the HIV/AIDS Prevention and Awareness.
Project of the Mathare Youth Sport Association (MYSA). MYSA is a large-scale community-based organization that reaches more than 15,000 boys
and girls, ages 8 to 18, in the urban slums of Nairobi. Sports programming is the largest component of the organization, of which the girls’ football leagues are among the largest of their kind. The evaluation included 454 MYSA members and 318 nonmembers ages 12 to 24. Results showed that MYSA members were significantly more likely to report condom use with their current or last partners (for example, 23 percent reported always using condoms with their partner, while 17 percent did not), although rates of use were low in both groups. No significant differences were found between members and nonmembers in terms of other sexual behaviors, attitudes about risk-avoiding behaviors, and intentions for future behaviors. Results were
not stratified by sex, so it is difficult to determine if the program had any unique effects on girls.