Content uploaded by Clemens Ley
Author content
All content in this area was uploaded by Clemens Ley on Dec 05, 2014
Content may be subject to copyright.
This article was downloaded by: [Vienna University Library]
On: 10 July 2013, At: 01:10
Publisher: Routledge
Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered
office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK
International Journal of Health
Promotion and Education
Publication details, including instructions for authors and
subscription information:
http://www.tandfonline.com/loi/rhpe20
Perceptions of university athletes
engaged in soccer, rugby and netball
towards people living with HIV
C. Ley
a
, A.C. Lembethe
b
& J. Chiware
b
a
Institut für Sportwissenschaft, Universität Wien , Vienna , Austria
b
Department of Sport, Recreation and Exercise Science, University
of the Western Cape , Cape Town , South Africa
Published online: 10 Jul 2013.
To cite this article: International Journal of Health Promotion and Education (2013): Perceptions
of university athletes engaged in soccer, rugby and netball towards people living with HIV,
International Journal of Health Promotion and Education
To link to this article: http://dx.doi.org/10.1080/14635240.2013.795044
PLEASE SCROLL DOWN FOR ARTICLE
Taylor & Francis makes every effort to ensure the accuracy of all the information (the
“Content”) contained in the publications on our platform. However, Taylor & Francis,
our agents, and our licensors make no representations or warranties whatsoever as to
the accuracy, completeness, or suitability for any purpose of the Content. Any opinions
and views expressed in this publication are the opinions and views of the authors,
and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content
should not be relied upon and should be independently verified with primary sources
of information. Taylor and Francis shall not be liable for any losses, actions, claims,
proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or
howsoever caused arising directly or indirectly in connection with, in relation to or arising
out of the use of the Content.
This article may be used for research, teaching, and private study purposes. Any
substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing,
systematic supply, or distribution in any form to anyone is expressly forbidden. Terms &
Conditions of access and use can be found at http://www.tandfonline.com/page/terms-
and-conditions
Perceptions of university athletes engaged in soccer, rugby and netball
towards people living with HIV
C. Ley
a
*, A.C. Lembethe
b
and J. Chiware
b
a
Institut fu
¨
r Sportwissenschaft, Universita
¨
t Wien, Vienna, Austria;
b
Department of Sport, Recreation
and Exercise Science, University of the Western Cape, Cape Town, South Africa
This article explores knowledge and perceptions of university athletes towards people
living with HIV. Data were collected by using a questionnaire with athletes involved
in soccer, netball and rugby at a South African tertiary institution. Knowledge about
HIV and ways of transmission was relatively high. The risk of HIV transmission in
sport was considered as moderate (51.7%), low (33.3%) and high (15%). Participants
were equally divided about athletes’ obligation to be tested. A great majority agreed
that they could play with someone who was HIV-positive. However, 23.7% were
unsure whether they would stay away from a player with HIV in the field of sport and
8.5% admitted that they would rather stay away. Although most of the participants
(83.6%) stated willingness to be tested, 60.7% admitted to have tested regularly. Most
of the participants stated that they would try to support a teammate living with HIV,
whereas 11.7% perceived that their team had a negative attitude towards athletes with
HIV. Few would disclose to their team if they tested HIV-positive, and 8.2% stated
that their team attended a HIV-education programme. In conclusion, although
knowledge was relatively high, risk perceptions, fears and attitudes towards testing
need to be addressed in the sport-specific context. Sport teams and trainers should be
capacitated to provide a supportive environment and to facilitate peer education.
More research is needed on mediator effects, such as group cohesion, support and
communication in the sport teams, and on social –cultural perceptions related to body
and physical interaction, which comes into play using games and sports in HIV
education.
Keywords: HIV education; prevention; stigma; sport; tertiary institution
Introduction
‘The convening power of sport can be effectively used to tackle stigma and discrimination,
and to reach out to the most vulnerable population’ (Koss and Alexandrova 2005, S3).
Various authors argue that sport and games are effective tools that can be used to educate
people about HIV and to dispel myths that surround HIV. Sport could serve in an advocacy
role for HIV prevention (Koss and Alexandrova 2005; Sowell 2005; Grassrootsoccer -
USAID - CARE 2007; Tobisch and Preti 2010). Breakthrough Sport Academy, Grassroots
Soccer, Mathare Youth Sports Association, Sport in Action, Edusport and Kicking-Aids-
Out are examples of organisations that aim to create HIV awareness and education through
sport and recreational games. However, the overwhelming positive affirmations about the
impact of sport and games in HIV prevention are not backed by research or rigorous
evaluation (Campbell, Williams, and Gilgen 2002; Benotsch et al. 2004; Gallant and
Maticka-Tyndale 2004; Durantini et al. 2006; Clem and Borchers 2007; Ward 2008; Maro,
Roberts, and Sørensen 2009; Maticka-Tyndale and Barnett 2010; Tobisch and Preti 2010;
q 2013 Institute of Health Promotion and Education
*Corresponding author. Email: clemensley@gmail.com
International Journal of Health Promotion and Education, 2013
Vol. 00, No. 0, 1–10, http://dx.doi.org/10.1080/14635240.2013.795044
Downloaded by [Vienna University Library] at 01:10 10 July 2013
Coalter 2010; Delva et al. 2010; Lindsey and Banda 2011; Inman et al. 2011; Jeanes 2011;
Sanders, Phillips, and Vanreusel 2012; Kaufman et al. 2012). There is a lack of research on
the use of sport and games in HIV prevention and education, and on the possible mediator
effects. For example, it is important to understand communication in and through sport,
games, body, physical movement and so on, in the specific cultural context; for instance,
traditional games might be used in a culture-specific educational and behavioural
approach in HIV programmes (Ogoye-Ndegwa 2005; Ward 2008; Ndlovu 2010).
At the same time, negative perceptions and fear of transmission of HIV in the field of
sport might create doubt about the use of this tool. The announcement by Ervin Magic
Johnson about his HIV-positive status in 1991 and soon after, by Arthur Ashe, Creg
Lorganis and Tommy Morrison, all renowned athletes, shocked the sporting fraternity and
may have led to the view that one could easily contract HIV in sport (Feller and Flanigan
1997). In fact, a survey has shown that the majority of athletes believe that a risk of
transmission does exist in sport participation (Reddy and Coopoo 2005). Conversely,
various authors argue that there is no confirmed case of HIV being transmitted in sports
(Sankaran, Volkwein, and Bonsall 1999; Volkwein and Bonsall 1999; Kordi and Wallace
2004, 2009; Mu
¨
ller-Rath et al. 2004; Clem and Borchers 2007). It is argued that HIV
infection might be much more likely to be the result of off-field behaviour than contracting
HIV through sport. Sport-related habits, such as intramuscular injection of anabolic
steroids, may constitute an HIV risk behaviour associated with athletes when sharing
needles (Feller and Flanigan 1997; Kordi and Wallace 2004). At the same time, sport and
physical exercise have been shown to be beneficial for people living with HIV (O’Brien
et al. 2004, 2010; Rojas, Schlicht, and Hautzinger 2004; Ley and Rato Barrio 2012) and
everybody has the right to play and to practise sport; nobody should be excluded based on
their HIV status (Volkwein and Bonsall 1999).
The topic is relevant in the context of HIV and particularly in South Africa, as the
population group most affected by HIV is the youth between 18 and 25 years old, and this
age group has the highest number of individuals participating in sports (Reddy and
Coopoo 2005). At the same time misconceptions and stigma are high in the South African
context (Kalichman and Simbayi 2004). This study responds to the need to investigate the
knowledge and perceptions of university students (Balogun et al. 2011; Brown et al. 2012)
and to understand how university athletes may perceive and interact with others who are
affected by HIV. There is a need to draw the attention of athletes to thinking more
critically about the issue of HIV in the sporting fraternity and sharing their thoughts and
perceptions with regard to the issue of HIV in sport.
Methods
Study objectives
This exploratory study was aimed at analysing HIV-related knowledge and perceptions of
university students involved in sport. Based on the literature review and unstructured
observation at the tertiary institution, it was hypothesised that university athletes
participating in sports have negative perceptions towards people with HIV participating in
the same sport, as well as fear and a lack of knowledge. The research questions included:
What perceptions and knowledge do the athletes have about HIV in general? Is there a
general consensus about the risk of transmission of HIV in sport and (compulsory) testing
in the sport setting? To what degree do they fear playing sport with people with HIV?
What perceptions do they have regarding their team dealing with HIV and support among
the athletes?
2 C. Ley et al.
Downloaded by [Vienna University Library] at 01:10 10 July 2013
Study procedures
This study was conducted at a higher education institution in the Western Province (South
Africa). For this explorative study, the sport codes netball, rugby and soccer were included
owing to their popularity among male and female students with a population of 240
athletes at this institution, and the body contact which occurs in these sports. After
obtaining ethical clearance from the university study committee, further permission was
sought from the relevant authorities at the sports administration. The teams were
approached through the trainers, asking for permission and availability of the sport teams
to take part in the study. The questionnaire was administrated in the team setting at the
same time to all available team members; however, each athlete could individually and
anonymously consent or not without the others to be aware of his/her decision, in order to
avoid group bias. In total, 61 athletes consented to participate in the study, and filled out
the questionnaire. One did not consent and returned the questionnaire blank.
Measures
Based on the literature review, a questionnaire was designed to capture HIV-related
knowledge and perceptions of the university athletes. The questionnaire contained
32 questions divided into three parts: demographic data, knowledge and perceptions.
The questions about facts and knowledge were mainly multiple-choice questions, whereas
for the questions about perceptions a 5-point Likert scale was used to respond to
affirmations, ranging from 1, strongly disagree to 5, strongly agree. The questionnaire was
piloted and the language was adapted. It was self-administrated and anonymous.
Data analysis
The data were introduced in a database, checked and analysed with the support of the
statistics program SPSS v.19. Descriptive analysis was used as well as multi-variable
analysis (t-test and ANOVA). When data were not normally distributed, the equivalent
non-parametric test was used.
Results
Description of the sample
The results showed a participation of 56.7% males and 43.3% females. The age ranged
from 18 to 28 years old (mean ¼ 21.75; SD ¼ 2.528). As expected, participants who
spoke isi Xhosa and Afrikaans at home were the majority in this study with 51.7% and
23.3%, respectively, followed by English spoken at home of 16.7% of the participants.
Soccer players were represented by 47.5% of the participants, whereas rugby and netball
were each represented by 26.2% of the participants. Most athletes were studying for a
Bachelor of Commerce in Accounting (26.1%), followed by an Education (21.7%) and a
Sport Science (13%) degree. Second (41.1%) and third (30.4%) year students had the
highest participation in this sample; whereas first year (14.3%), fourth year/Honours
(12.5%) and Master degree students (1.8%) were less represented.
HIV-related knowledge
In this sample, knowledge about HIV transmission was relatively high, although on
average 10–15% of responses were incorrect. For example, 14% of the participants stated
International Journal of Health Promotion and Education 3
Downloaded by [Vienna University Library] at 01:10 10 July 2013
that semen or vaginal fluids do not contain enough HIV for transmission; 86.8% agreed
that HIV can be transmitted through sexual intercourse with someone who is HIV-infected
without condomising and 9.8% opposed that affirmation.
Although 27.1% were unsure, 50.8% of the study participants stated that they could
reduce their risks of contracting HIV by having a mutual relationship with an uninfected
person; 22% disagreed with that affirmation. At the same time, 85.2% agreed that having
more than one sexual partner increased one’s chances of contracting HIV; 11.5%
disagreed and 3.3% were not sure.
Almost all participants (98.4%) agreed that one cannot tell whether someone is HIV-
positive; one participant (1.6%) agreed that you can tell it as they look tired and ill.
Perceptions about HIV transmission and sport
Half of the study participants considered the risk of HIV transmission in sport as
moderate (51.7%), one-third regarded it as low (33.3%) and 15% thought that there was a
high risk.
Furthermore, 91.8% disagreed that someone who is HIV-positive can infect other
players during sport through normal body contact without blood contact; nevertheless,
four participants agreed with this statement (6.5%). More controversy was expressed
regarding the affirmation that athletes must be tested before they participate in sport. The
same percentage of participants agreed (41%) and disagreed (39.4%) with this affirmation;
19.7% stated that they were not sure about it.
However, only 11.9% would exclude people with HIV from participation in sport.
The majority (76.3%) disagreed that athletes who are HIV-positive should not participate
in sport. The majority (91.8%) approved that athletes with HIV could play sport like
anyone else. Accordingly, most study participants (83.6%) agreed that they could play
sport with someone who was HIV-positive; four (6.5%) disagreed. Nevertheless,
although 67.8% disagreed, the rest of the participants were more hesitant regarding the
declaration that they would stay away from a player with HIV in the field of sport,
23.7% were not sure and five participants (8.5%) admitted that they would rather
stay away.
HIV prevention and responsibility
A large proportion (86.6%) admitted that it was their own responsibility to protect
themselves and other players from HIV; five participants (8.3%) disagreed. Three
participants (4.9%) disagreed that it is important to know one’s HIV status to plan for
one’s future. The rest agreed.
HIV testing
Although most (83.6%) of the study participants said that they would be willing to take a
HIV test (9.8% disagreed, 6.6% were not sure), 60.7% stated to have tested for HIV
regularly (18% disagreed, 21.3% were not sure).
Most participants expressed the need that everybody should be tested, and disagreed
that only people with symptoms should test for HIV (82%), 11.4% agreed with this
affirmation. As already mentioned, half of the participants indicated that athletes must be
tested before they participate in sport.
4 C. Ley et al.
Downloaded by [Vienna University Library] at 01:10 10 July 2013
Disclosure and support
Regarding the question ‘if someone in your team tells you that he or she is HIV-positive,
what will be your reaction?’, the participants responded in 93.4% of the cases that they
would try to support him or her; three participants (4.9%) would tell everyone in the team,
and one (1.6%) would do nothing, but would avoid him or her.
Ten per cent of the participants stated that they could not talk freely about HIV with
their teammates, whereas 26.7% were not sure about it, and 63.3% agreed that they could
talk freely about it with their teammates. Coherent with these data, 11.7% of the
participants thought that their team had a negative attitude towards athletes with HIV; 55%
disagreed.
Regarding the question ‘If you would test positive, to whom would you tell your
status?’ (multiple responses possible), the participants prioritised their own family
(78.7%), followed by the best friend (34.4%). Ten participants (16.4%) would disclose
their status to the sport team, whereas 11.5% would prefer not to tell it to anybody; 24.6%
said that they would disclose to anybody and would live openly with the status (Table 1).
In case of the female participants, the sport teams seemed to be more important (see
Table 1).
Although a high number of the participants (37.7%) were not sure, only five
participants (8.2%) agreed that their team attended a HIV-education programme; 54.1%
stated that the team did not attend a HIV-education programme.
Differences according to gender
Analysing the data according to the gender of the participants, using a t-test of independent
samples, two significant differences were found. Male and female participants differed in
opinion regarding the affirmation I would stay away from a player with HIV in the field of
sport (n ¼ 58; t ¼ 2.9; df ¼ 56; p ¼ 0.005) and the affirmation Athletes with HIV can play
sport like anyone else (n ¼ 60; t ¼ –2.1; df ¼ 46; p ¼ 0.044). Female participants
expressed stronger disagreement that they would stay away from a player with HIV in the
Table 1. Analysis of disclosure according to gender (multiple responses possible).
Gender
A. If you would test positive, you would tell your status:
Male
(n ¼ 34)
Female
(n ¼ 26)
Total
(n ¼ 60)
To nobody 4 3 7
% within Gender 11.8 11.5 11.7
% within question A. 57.1 42.9 100
To your family 28 19 47
% within Gender 82.4 73.1 78.3
% within question A. 59.6 40 100
To your best friend 10 10 20
% within Gender 29.4 38.5 33.3
% within question A. 50 50 100
To your sport team 3 7 10
% within Gender 8.8 26.9 16.7
% within question A. 30 70 100
To anybody and live openly with the status 6 8 14
% within Gender 17.6 30.8 23.3
% within question A. 42.9 57.1 100
International Journal of Health Promotion and Education 5
Downloaded by [Vienna University Library] at 01:10 10 July 2013
field of sport, and stronger agreement that athletes with HIV could play sport like anyone
else.
Regarding the question to whom they would disclose their status if they tested positive
(multiple responses were possible), the data indicated that as a tendency (x
2
: p ¼ 0.062;
Cramer’s V ¼ 0.241), the female athletes were more open to disclose their status to their
sport teams; most male athletes indicated that they would stick to tell their families (see
Table 1).
Differences according to the sport code
Three affirmations were valued significantly differently according to the participants’
involvement in the different sport codes (Table 2). The results from the analysis of
variance (ANOVA) indicate that the netball players, who participated in this survey,
expressed more willingness to take a HIV test than did rugby and soccer players. In fact,
they also indicated more strongly that they were tested regularly for HIV (Table 2).
Rugby players seemed to be more likely to stay away from people with HIV than
netball and soccer players. However, a limitation of this study is that in this sample the
rugby players were mostly males, and the above results indicated that men were more
likely than women to stay away from HIV athelete. For that reason, rugby players were
compared with soccer players in the sample of only males, using a t-test for independent
samples. Soccer athletes showed a significant (n ¼ 31; t ¼ 4.348; df ¼ 29; p ¼ 0.0001)
stronger disagreement (M ¼ 1.56; SD ¼ 0.814) that they would stay away from a HIV
athlete in the field of sport than did the rugby athletes (M ¼ 3.07; SD ¼ 1.100).
No significant differences were found regarding the perception of risk of HIV
transmission in sport according to the different sport codes (Table 3).
Discussion
Similar to other studies (Lance 2001; Van Wyk 2006; Brown et al. 2012; Melwa and
Oduntan 2012), knowledge about HIV and transmission was relatively high in this sample;
however, this might not be a surprising result, considering the sample consisting of
Table 2. Analysis of differences among the sport codes (ANOVA).
N Mean SD Fp
I would be willing to take a HIV test
Netball 16 4.81 0.544 3.169 0.049
Rugby 16 3.88 1.628
Soccer 29 4.21 0.902
Total 61 4.28 1.113
I would stay away from a player with HIV in the field of sport
Netball 16 1.38 0.719 16.089 0.0001
Rugby 15 3.07 1.100
Soccer 28 1.61 0.916
Total 59 1.92 1.134
I have tested for HIV regularly
Netball 16 4.50 0.632 6.754 0.002
Rugby 16 3.44 1.632
Soccer 29 3.21 1.048
Total 61 3.61 1.255
6 C. Ley et al.
Downloaded by [Vienna University Library] at 01:10 10 July 2013
university students, and the HIV information campaigns reaching out in South Africa
(Benotsch et al. 2004). However, in several questions, various participants stated that they
were not sure. This can be seen as a lack of awareness and knowledge, or else confusion
(Van Wyk 2006; Melwa and Oduntan 2012). The acquisition of knowledge is definitely
not enough, as HIV information alone does not guarantee changes in perceptions and
behaviours (Van Wyk 2006). Participants seemed to have received information on HIV,
but the results also showed that teams did not take part in HIV education.
Dissonant responses were found concerning the willingness to be tested and the
statement of having been tested. Most of the study participants admitted that they would be
willing to take a HIV test, whereas only two-thirds indicated having tested regularly for
HIV. The willingness to be tested is essential; however, it does not lead inherently and
automatically to actual testing.
Although the risk of HIV transmission in sport might not be zero, most authors agree
that there is a low risk (Sankaran, Volkwein, and Bonsall 1999; Volkwein and Bonsall
1999; Mu
¨
ller-Rath et al. 2004; Reddy and Coopoo 2005; Clem and Borchers 2007). One-
third of the participants of this particular study agreed that there is a low risk. The rest of
the participants regarded the risk as moderate (51.7%) or even high (15%). Nevertheless,
the majority of the participants indicated that they would play sport with a player who was
HIV-positive, although 23.7% were not sure and 8.5% admitted that they would rather stay
away from that player. In addition, participants were divided into equal proportions about
compulsory HIV testing for sport athletes. Around 40% of the participants agreed that
athletes must be tested before they participated in sport. These results indicate a moderate
fear of HIV transmission in sport.
Compulsory testing is controversially discussed in the literature (cf. Volkwein and
Bonsall 1999), especially regarding combat sports (Mu
¨
ller-Rath et al. 2004; Kordi and
Wallace 2009); at the same time, fear and personal perceptions of HIV transmission risks
seem to clash with human rights arguments and a willingness to support. The majority of
the participants stated that people with HIV should not be excluded from sport and that
they should be able to participate like anybody else. Most participants responded that they
would try to support a teammate who was HIV-positive; whereas 11.7% of the participants
thought that their team had a negative attitude towards athletes living with HIV. The sport
team was not the environment where the athletes would choose to disclose their status.
Table 3. Analysis of risk perceptions according to the sport codes (frequencies).
The risk of HIV transmission in sport is
Sport code High Moderate Low Total
Netball 2 9 4 15
% within sport code 13.3 60.0 26.7 100.0
% within the risk 22.2 29.0 20.0 25.0
Rugby 4 7 5 16
% within sport code 25.0 43.8 31.2 100.0
% within the risk 44.4 22.6 25.0 26.7
Soccer 3 15 11 29
% within sport code 10.3 51.7 37.9 100.0
% within the risk 33.3 48.4 55.0 48.3
Total 9 31 20 60
% within sport code 15.0 51.7 33.3 100.0
International Journal of Health Promotion and Education 7
Downloaded by [Vienna University Library] at 01:10 10 July 2013
Two limitations of this study were the limited sample size and the unequal gender
distribution among the sport codes. In addition, the study explored HIV-related knowledge
and perceptions only in the sport codes soccer, netball and rugby. As some differences
were found among the sport codes, it would be of great interest to extend the study to other
sport codes. The study used a self-reported questionnaire, whereas actual behaviour and
practices were not observed.
Conclusions
There is a need to run HIV-education programmes with sport teams that reach further than
information provision and knowledge acquisition. Peer education could be a valuable
approach in sport teams, using the role of team leaders and coaches.
Although knowledge might be high in this sample, risk perceptions and attitudes
towards testing challenged a supportive environment. HIV, gender and sport specific
questions should be considered and should be discussed in sport teams. In the sport setting,
the body and body interaction play a major role, but have scarcely been analysed from a
behavioural perspective, in a culture-specific context, or in relation to HIV and stigma.
Social-cultural and HIV-related perceptions of the body and physical movement influence
also the use of sport and games as educational tools.
A close collaboration among the sport teams and HIV-education programmes on
campus is desirable. The sport teams could be prepared to be a supportive group, and be
sensitive to issues around HIV, where disclosure could take place if wanted, fears could be
discussed and mutual support facilitated. Working on team processes, such as group
cohesion and communication among the athletes, could add important resources to
individual processes in HIV education. More research is needed on evaluating such
mediator effects.
References
Balogun, J., T. Abiona, M. Lukobo-Durrell, A. Adefuye, S. Amosun, J. Frantz, and Y. Yakut. 2011.
“Readability and Test–Retest Reliability of a Psychometric Instrument Designed to Assess
HIV/AIDS Attitudes, Beliefs, Behaviours and Sources of HIV Prevention Information of Young
Adults.” Health Education Journal 70 (2): 141 –159.
Benotsch, E. G., L. Y. Stevenson, C. A. Sitzler, J. A. Kelly, G. Makhaye, E. D. Mathey, A. M.
Somlai, et al. 2004. “HIV Prevention in Africa: Programs and Populations Served by Non-
Governmental Organizations.” Journal of Community Health 29 (4): 319 –336.
Brown, C. W., J. T. Shepperson, H. Gopalan, and S. El-Amin. 2012. “HIV: Facts, Fiction, and the
Impact on Behavior of Students at an Historically Black College/University.” International
Journal of Health Promotion and Education 50 (2): 61 –67.
Campbell, C., B. Williams, and D. Gilgen. 2002. “Is Social Capital a Useful Conceptual Tool for
Exploring Community Level Influences on HIV Infection? An Exploratory Case Study From
South Africa.” AIDS Care 14 (1): 41 – 54.
Clem, K. L., and J. R. Borchers. 2007. “HIV and the Athlete.” Clinics in Sports Medicine 26 (3):
413–424.
Coalter, F. 2010. “The Politics of Sport-for-Development: Limited Focus Programmes and Broad
Gauge Problems?” International Review for the Sociology of Sport 45 (3): 295– 314.
Delva, W., K. Michielsen, B. Meulders, S. Groeninck, E. Wasonga, P. Ajwang, M. Temmerman, and
B. Vanreusel. 2010. “HIV Prevention Through Sport: The Case of the Mathare Youth Sport
Association in Kenya.” AIDS Care 22 (8): 1012 –1020.
Durantini, M. R., A. L. Mitchell, A. N. Earl, J. C. Gillette, and D. Albarracon. 2006.
“Conceptualizing the Influence of Social Agents of Behavior Change: A Meta-Analysis of the
Effectiveness of HIV-Prevention Interventionists for Different Groups.” Psychological Bulletin
132 (2): 212–248.
8 C. Ley et al.
Downloaded by [Vienna University Library] at 01:10 10 July 2013
Feller, A., and T. P. Flanigan. 1997. “HIV-Infected Competitive Athletes: What Are the Risks? What
Precautions Should Be Taken?” Journal of General Internal Medicine 12 (4): 243– 246.
Gallant, M., and E. Maticka-Tyndale. 2004. “School-based HIV Prevention Programmes for African
Youth.” Social Science & Medicine 58 (7): 1337 –1351.
Grassrootsoccer - USAID - CARE. 2007. “Resiliency Coach’s Guide. For a Sport-Based HIV/AIDS
Prevention and Youth Life Skills Intervention.” http://www.sportanddev.org
Inman, D. D., K. M. Van Bakergem, A. C. Larosa, and D. R. Garr. 2011. “Evidence-based Health
Promotion Programs for Schools and Communities.” American Journal of Preventive Medicine
40 (2): 207–219.
Jeanes, R. 2011. “Educating Through Sport? Examining HIV/AIDS Education and Sport-for-
Development Through the Perspectives of Zambian Young People.” Sport, Education and
Society 1–19.
Kalichman, S. C., and L. Simbayi. 2004. “Traditional Beliefs About the Cause of AIDS and AIDS-
related Stigma in South Africa.” AIDS Care 16 (5): 572 –580.
Kaufman, Z. A., R. L. Welsch, J. D. Erickson, S. Craig, L. V. Adams, and D. A. Ross. 2012.
“Effectiveness of a Sports-based HIV Prevention Intervention in the Dominican Republic:
A Quasi-experimental Study.” AIDS Care 24 (3): 377 – 385.
Kordi, R., and W. A. Wallace. 2004. “Blood Borne Infections in Sport: Risks of Transmission,
Methods of Prevention, and Recommendations for Hepatitis B vaccination *Commentary.”
British Journal of Sports Medicine 38 (6): 678 –684.
Kordi, R., and W. A. Wallace. 2009. “Blood-Borne Infections in Combat Sports.” In Combat Sports
Medicine, edited by R. Kordi, R. R. Wroble, N. Maffulli, and W. A. Wallace, 109–120. London,
UK: Springer.
Koss, J. O., and A. Alexandrova. 2005. “Essay: HIV/AIDS Prevention and Peace Through Sport.”
The Lancet 366 (Supplement 1): S3– S4.
Lance, L. 2001. “HIV/AIDS Perceptions and Knowledge of Heterosexual College Students Within
the Context of Sexual Activity Suggestions for the Future.” College Student Journal 35 (3):
179– 196.
Ley, C., and M. Rato Barrio. 2012. “A Narrative Review of Research on the Effects of Physical
Activity on People Living with HIV and Opportunities for Health Promotion in Disadvantaged
Settings.” African Journal of AIDS Research 11 (2): 123 –133.
Lindsey, I., and D. Banda. 2011. “Sport and the Fight Against HIV/AIDS in Zambia: A “partnership
approach”?” International Review for the Sociology of Sport 46 (1): 90 –107.
Maro, C. N., G. C. Roberts, and M. Sørensen. 2009. “Using Sport to Promote HIV/AIDS Education
for At-risk Youths: An Intervention Using Peer Coaches in Football.” Scandinavian Journal Of
Medicine & Science In Sports 19 (1): 129 –141.
Maticka-Tyndale, E., and J. P. Barnett. 2010. “Peer-led Interventions to Reduce HIV Risk of Youth:
A Review.” Evaluation and Program Planning 33 (2): 98 –112.
Melwa, I. T., and O. A. Oduntan. 2012. “Knowledge About HIV and AIDS Among Young South
Africans in the Capricorn District, Limpopo Province.” Health Education Journal 71 (2):
189– 194.
Mu
¨
ller-Rath, R., T. Mumme, O. Miltner, and E. Skobel. 2004. “Wettkampfkarate und die Gefahr
einer HIV-Infektion – U
¨
bersicht, Risikoanalyse und Strategien zur Risikominimierung
[Competitive Karate and the Risk of HIV Infection– Review, Risk Analysis and Risk
Minimizing Strategies].” Sportverletzung Sportschaden: Organ Der Gesellschaft Fu
¨
r
Orthopa
¨
disch-Traumatologische Sportmedizin 18 (1): 37–40.
Ndlovu, C. M. 2010. “A Cultural Response: The Exploration of Traditional Dance and Games as an
HIV/AIDS Intervention. A Zimbabwean Case Study.” Master of Arts. WITS School of Arts,
Johannesburg, South Africa.
O’Brien, K., S. Nixon, R. Glazier, and A.-M. Tynan. 2004. “Progressive Resistive Exercise
Interventions for Adults Living with HIV/AIDS.” Cochrane Database of Systematic Reviews 4
(CD004248).
O’Brien, K., S. Nixon, A.-M. Tynan, and R. Glazier. 2010. “Aerobic Exercise Interventions for
Adults Living with HIV/AIDS.” Cochrane Database of Systematic Reviews 8 (CD001796).
Ogoye-Ndegwa, C. 2005. “Modelling a Traditional Game as an Agent in HIV/AIDS Behaviour-
change Education and Communication.” African Journal of AIDS Research 4 (2): 91– 98.
Reddy, S., and Y. Coopoo. 2005. “Attitudes Towards the Risk of HIV Transmission in Sport.” South
African Journal of Sports Medicine 17 (1): 11 –18.
International Journal of Health Promotion and Education 9
Downloaded by [Vienna University Library] at 01:10 10 July 2013
Rojas, R., W. Schlicht, and M. Hautzinger. 2004. “Auswirkungen der Compliance auf den
Psychophysischen Effekt Einer Sportintervention bei HIV-1 Positiven/The Influence of
Compliance on Psychophysiological Effects of an Exercise-intervention in HIV-1-positive
Persons.” Zeitschrift fu
¨
r Sportpsychologie/German Journal of Sport Psychology 11 (1): 2 –9.
Sanders, B., J. Phillips, and B. Vanreusel. 2012. “Opportunities and Challenges Facing NGOs Using
Sport as a Vehicle for Development in Post-apartheid South Africa.” Sport, Education and
Society 1–17.
Sankaran, G., K. A. E. Volkwein, and D. R. Bonsall. 1999. HIV AIDS in Sport: Impact, Issues, and
Challenges. Champaign, IL: Human Kinetics.
Sowell, R. L. 2005. “What Does Sport Have to Do With AIDS?” Journal of the Association of Nurses
in AIDS care 16 (4): 1– 2.
Tobisch, C., and D. Preti. 2010. The Role of Football in HIV Prevention in Africa. Brussel; Biel:
Koning Boudewijnstichting; Swiss Academy for Development.
Van Wyk, C. 2006. “HIV/AIDS Perceptions, Attitudes and Awareness of Undergraduate Students.”
The Journal for Transdisciplinary Research in Southern Africa 2 (1): 165– 180.
Volkwein, K. A. E., and D. R. Bonsall. 1999. “Transmission of HIV in Sport.” In HIV AIDS in Sport:
Impact, Issues, and Challenges, edited by G. Sankaran, K. A. E. Volkwein, and D. R. Bonsall,
1– 8. Champaign, IL: Human Kinetics.
Ward, S. A. 2008. “African-centered Dance: An Intervention Tool in HIV/AIDS Prevention.”
JOPERD: The Journal of Physical Education, Recreation & Dance 79 (7): 4– 5.
10 C. Ley et al.
Downloaded by [Vienna University Library] at 01:10 10 July 2013
