Sport activities as a vehicle for HIV/ AIDS prevention in Trinidad and Tobago: Organizer’s perspectives

Various sporting activities are being used as vehicles for HIV/AIDS education and prevention within the field of sport-for-development (SFD). Kicking AIDS Out! is one SFD program that aims to promote protective attitudes regarding HIV/AIDS amongst youth. This study explored organizers’ perspectives of the use of sporting activities in the Kicking AIDS Out! program in Trinidad and Tobago. Qualitative case study methodology was used to examine the case. Data was generated through semi-structured interviews with seven organizers who were Kicking AIDS Out! staff or volunteer members. Thematic analysis guided data analysis. Generated themes include: Sport to Draw, There’s Something for Everyone, the Emotional Wow, and Beyond Sports. These themes illuminate the idea that sport captivates and attracts youth, and illustrate the use of sport activities to promote engagement in the program as they are tailored to the skills and interests of youth. Sport activities may challenge values and beliefs regarding HIV/AIDS and may promote engagement in new roles, such as those as advocate or caregiver for individuals with HIV/AIDS, and engagement in healthy lifestyle behaviours, such as safe sexual encounters. The findings of this study offer an opportunity for HIV/AIDS prevention programs to consider their use of sporting activities in a manner that achieves these SFD characteristics. DOI : 10.14302/issn.2324-7339.jcrhap-13-200


Introduction
Second to sub-Saharan Africa, the Caribbean is the region most affected by HIV/AIDS 1 . In the last twenty years, Trinidad and Tobago experienced a 500% increase in HIV/AIDS cases 2 ; of which 45% were youth aged 15 -24 3 . To target this age group, evidence suggests that direct and continuous prevention programs are required 1 . Knowledge about HIV/AIDS is the first step to preventing transmission 4 , followed by resources and support 1 . It is also critical that prevention efforts are culturally appropriate, stage-specific, and grounded in behavioural theories to be effective 5 .
Engagement in sport improves self-esteem, problem-solving and social skills, physical and mental health, and academic performance 6,7,8,9 . Sport and physical activity can contribute to changing behaviour through transformation of attitudes 10 . As such, sport can be used to achieve international development goals such as combating HIV/AIDS 11 . In 2001, sport was formally recognized by the United Nations (UN) as a mechanism to address international development goals to eradicate HIV/AIDS 12 .
Sport-for-Development (SFD) refers to the use of physical activity (e.g. football, basketball, or netball games, and physical energizers) as a tool to achieve international development goals 13 . Traditional SFD programs add sport to non-sport curriculum to enhance the effectiveness of knowledge transmission and selfdevelopment 13,14 , which has been found to be more successful than curriculum-only based programs 8 . These programs have been shown to be effective in addressing social and health issues such as rebuilding relationships, social inclusion and integration, and HIV/ AIDS prevention 15,16,17,18,19 .
Literature on the use of SFD for HIV/AIDS education and prevention has largely focused on the effectiveness of SFD strategies in specific contexts 11,13,20,21,22,23,24 . For example, an SFD program in Tanzania that uses peer learning to transmit knowledge on HIV/ AIDS prevention, cognitions, and perceived behaviours was found to be effective 25 . Additionally, Baird et al. (2007) found that incorporating physical games into a program's curriculum was effective in promoting safer sex behaviours in Trinidad and Tobago. To date, studies have not explored how and why sports are the vehicle for education in HIV/AIDS programming. Therefore, the purpose of this study was to explore organizers' perspectives on sporting activities in one HIV/AIDS prevention program in Trinidad and Tobago.

Methodology
To understand the perspectives of program organizers in a SFD organization in Trinidad Table 1 for organizer characteristics). In presenting the data below, pseudonyms are used to maintain organizer anonymity.

Management, and staff positions in Management.
All data were generated through face-to-face semi-

Sport to Draw
Organizers expressed that program youth had been exposed to HIV/AIDS education prior to participating in Kicking AIDS Out!, through mediums such as billboards, commercials, and formal education.
As a result, they had not initially been interested in learning about HIV/AIDS, because they felt they had heard about it many times before. Monique described the attitudes youth have when initially invited to Kicking AIDS Out! : The majority of them they will come with the impression that 'oh gosh another HIV/ AIDS…' they wouldn't even say HIV they will just say '*tsk* Another AIDS talk boy…'

The Emotional Wow
Engaging in sports and physical games   She would not go because she was so scared she would get ill if she was there.
And subsequently she was exposed to the Kicking AIDS Out! program... And that helped her to understand the issues and she said that up to the time her grandfather died she was able to be there for him and help him, so it totally helped change her whole attitude and that's a very personal experience.

Discussion
The purpose of this study was to explore  Kicking AIDS Out! to gain insight into elements that may be lacking from the programs. Understanding program youths' experiences would inform program organizers of limitations in their programming to develop it further to access more youth.

Conclusion
Existing literature in the SFD field aims to primarily evaluate program impact on HIV/AIDS prevention. However, examining how and why engagement in sport activities achieves these outcomes is yet to be fully understood. The purpose of this study was to explore organizers' perspectives of the use of sport as an activity in a HIV/AIDS prevention program in Kicking AIDS Out!, to gain insight into elements that hinder engagement and transformational learning.