Gender-specific HIV and substance abuse prevention strategies for South African men: study protocol for a randomized controlled trial

Mary Jane Rotheram-Borus, Mark Tomlinson, Andile Mayekiso, Jason Bantjes, Danielle M Harris, Jacqueline Stewart, Robert E Weiss, Mary Jane Rotheram-Borus, Mark Tomlinson, Andile Mayekiso, Jason Bantjes, Danielle M Harris, Jacqueline Stewart, Robert E Weiss

Abstract

Background: Young men in South Africa face concurrent epidemics of HIV, drug and alcohol abuse, and unemployment. Standard HIV prevention programs, located in healthcare settings and/or using counseling models, fail to engage men. Soccer and vocational training are examined as contexts to deliver male-specific, HIV prevention programs.

Methods: Young men (n = 1200) are randomly assigned by neighborhood to one of three conditions: 1) soccer league (n = 400; eight neighborhoods); 2) soccer league plus vocational training (n = 400; eight neighborhoods); or 3) a control condition (n = 400; eight neighborhoods). Soccer practices and games occur three times per week and vocational training is delivered by Silulo Ulutho Technologies and Zenzele Training and Development. At baseline, 6 months, 12 months, and 24 months, the relative efficacy of these strategies to increase the number of significant outcomes (NSO) among 15 outcomes which occur (1) or not (0) are summed and compared using binomial logistic regressions. The summary primary outcome reflects recent HIV testing, substance abuse, employment, sexual risk, violence, arrests, and mental health status.

Discussion: The failure of men to utilize HIV prevention programs highlights the need for gender-specific intervention strategies. However, men in groups can provoke and encourage greater risk-taking among themselves. The current protocol evaluates a male-specific strategy to influence men's risk for HIV, as well as to improve their ability to contribute to family income and daily routines. Both interventions are expected to significantly benefit men compared with the control condition.

Trial registration: ClinicalTrials.gov registration, NCT02358226 . Registered 24 November 2014.

Keywords: Alcohol abuse; Drug abuse; Gender-specific interventions; HIV prevention for men; HIV prevention strategies; HIV testing; Men’s HIV risk; Soccer; Social determinants of HIV.

Conflict of interest statement

The study has been approved by the Institutional Review Boards (IRB) of the University of California, Los Angeles (IRB 14–001587) and Stellenbosch University (N14/08/116). Informed consent will be obtained from all participants prior to participation in the study.

Not applicable.

The authors declare that they have no competing interests.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Relationships among contextual/background factors, mediating/moderating influences, intermediate outcomes, and primary and secondary outcomes. ARV antiretroviral, AUDIT Alcohol Use Disorders Identification Test, RDT rapid diagnostic tests, ZAR South African Rand
Fig. 2
Fig. 2
Schedule of enrolment, interventions, and assessments
Fig. 3
Fig. 3
Design of the cluster randomized controlled trial
Fig. 4
Fig. 4
Model reflecting the training program implemented with coaches to deliver the HIV preventive intervention

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