Using the power of soccer to fight HIV/AIDS

Not one, not two, not three but a whole menu of biomedical services flavored with football  is what the community members of Mukuru Kwa Reuben slum and the participating teams bumped themselves into during the 2 days Kick ‘N’ Test football tournament held at Mukuru community stadium, all courtesy of VAP and its estinguished partners. For the very first time in the history of Kick ‘N’ Test tournaments, Mukuru community were the first beneficiaries of the newly rich infused tournament packed with services ranging from: hiv testing, distribution of condoms, and introduction and referral of voluntary medical male circumcision, both surgical and non-surgical services through prepex and oral self-testing pilot project which was taken a notch higher with the surveys available through electronic data collection. A total of 32 teams comprised of both boys and girls had to showcase their football and health prowess on the heavily dusted field of Mukuru Kwa Reuben which was divided into 4 playing sections. At some point the referees would be forced to stop some matches briefly to allow the playing teams to dust off the gathered dust on the their uniforms in order to avoid confusion and reidentify their original team colours. Despite being in a social and amenity deprived area on the peripheral of Nairobi characterized by dense population with majority of the inhabitants being squatters, mukuru slum prides itself by being the hub of the finest emerging and promising youthful footballers whom majority of them play in the big football clubs of Kenya’s organized football Kenya federation’s premier league.

Scramble for off the field points

Being one of its kind to ever happen in the soil of Mukuru kwa Reuben, the tournament which is traditionally coiled with the aspects of winning on and off the field through HIV testing also attracted the presence of team fans and community members residing in mukuru kwa Reuben ready to participate in the health services provided by the event and get a taste of its flavor where teams were not only getting points for winning or drawing matches, but also for participating in the Skillz Kenya activities, and visiting VCT tents to know their HIV status. Both fans and community members donated their extra off the field points to their respective teams that would eventually add up to their on field points with some members and youth benefiting from the easily available condoms.

Condom Vendors and Make The Cut Interventions

As an additional incentive to promote health and create easy access of condoms to the residents and the youth of Mukuru Kwa Reuben, VAP condom vendors had a booming business of distributing condoms through make shift tents and hawking around the playing fields. The condoms were distributed to the youth and community members over 17 years of age and a total of over 3,600 condoms were distributed within a span of 2 hours rendering VAP to run out of condoms during day one of the tournament. The distribution exercise was led by VAP’s ‘Mr Condom’ who also gave out his mobile number to be reached out incase of condom need. “Thanks for bringing free condoms close to us, now i have enough to use when am in need.” Said 21 years old Vincent,a resident at Mukuru Kwa Reuben.Additionally, for the first time, Make The Cut intervention was conducted at the tournament with a number of men and adolescent boys getting voluntary medical male circumcision referrals for both surgical and non-surgical. The referred participants were taught about the importance of VMMC uptake informed about the reduction of risk of female-to-male HIV transmission by 60% .The participants were referred to attend EDARP clinics, VAP’s partnering health service providers for both HIV testing and VMMC services. “Am glad to have received information aboutVMMC and HIV reduction rate, and am looking forward to the non-surgical circumcision. “Said John a 20 year old players from Barcelona FC.

Oral Self-Testing Electronic Data Capture

Participants filling in the oral self-testing surveys through the electronic tablets. The anonymous surveys written in English, Swahili and sheng were entered into Redcap (Research Electronic Data Capture) a firewall encrypted secure database, and analyzed electronically by the electronic tablets. The anonymous data was explored to determine self-reported proportions of study measures of interest, and explored group differences by sociodemographic and behavioral variables of interest e.g assessing the proportion of individuals attending Kick N Test football tournament who tested for HIV. The specific aims of the study included: estimating the proportion of HIV positive individuals who would be interested in a group approach to improving treatment access and adherence. Assessing proportion of individuals who are aware of HIV self-testing, and assess perceptions about self-testing for HIV. Assessing the importance of specific barriers to HIV testing, and accessing HIV treatment. Estimating the proportion of those who know themselves to be HIV positive and those who have been on treatment in the past, or were currently on treatment. Through offline app on password-protected tablets,the electronic surveys were automatically saved to the tablets and uploaded into Research Electronic Data Capture (REDCap) database once a secure internet was obtained for the purposes of accurate data analyzation.The study was aimed at helping determine effective strategies to improve continued HIV testing in the Mukuru Kwa Reuben slum population and improve retention on ART for those testing positive. With the result of this study, VAP aims to integrate distribution of oral self-testing kits to its HIV program participants as an additional innovative way of scaling up HIV testing.

Tournament's Parting Shot

Know your HIV status, know more about HIV, Circumcise and condomize, and two symbols of hiv ribbon with balls at the Centre, performed by VAP coaches were the words and signs behind the football tournament taken to the Mukuru Kwa Reuben and played by the 32 teams of both boys and girls. With the mission accomplished at Mukuru, VAP is looking forward to integrating and strengthening Make The Cut interventions in its HIV programming as well as distribution of condoms and oral self- testing kits.