Peer champions from the DREAMS partnership visit adolescent girls and young women in their homes to hold small group or individual discussions on ways to prevent HIV and unplanned pregnancies.

Photo credit: USAID/Communication for Healthy Communities

The DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) partnership is an ambitious public-private partnership to reduce rates of HIV among adolescent girls and young women (AGYW) in the highest HIV burden countries. In 2015, 10 DREAMS countries in sub-Saharan Africa, including Kenya, Lesotho, Malawi, Mozambique, South Africa, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe, accounted for nearly half of all the new HIV infections that occurred among AGYW globally.

Girls and young women account for 74 percent of new HIV infections among adolescents in sub-Saharan Africa and nearly 1,000 AGYW are infected with HIV every day. Social isolation, poverty, discriminatory cultural norms, orphanhood, gender-based violence and inadequate schooling all contribute to girls’ vulnerability to HIV and a life not lived to its full potential. The DREAMS initiative goes beyond typical health initiatives to address these factors, working toward meeting the Sustainable Development Goal of ending AIDS by 2030.

DREAMS builds upon USAID’s decades of experience empowering young women and advancing gender equality across many sectors of global health, education and economic growth. The Agency partners with community, faith-based and non-governmental organizations to mobilize significant numbers of volunteers, allowing the Agency to address the structural inequalities having an impact on girls’ vulnerability to HIV. These organizations are uniquely positioned to work with these young women and their families where they live in ways that few other groups can.

Scaling-up impactful and evidence-based interventions across multiple sectors has allowed the Agency to accelerate efforts to control the HIV/AIDS epidemic. For the first time in 2017, data from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) shows significant declines in new HIV diagnoses among adolescent girls and young women. In the 10 African countries implementing PEPFAR’s DREAMS partnership, the majority of the highest HIV-burden communities or districts achieved greater than a 25 percent–40 percent decline in new HIV diagnoses among young women. Significantly, new diagnoses declined in nearly all DREAMS intervention districts.

As the leading implementer of the DREAMS package, the Agency supports:

• HIV testing and counseling
• Education subsidies
• Post-violence care for survivors of gender-based violence
• School-based HIV and violence prevention programs
• Pre-Exposure Prophylaxis (PrEP)
• Condom promotion and provision for AGYW and their partners
• Improved access to youth friendly sexual and reproductive health care and a full range of contraceptive methods
• Parenting/caregiver programs
• Community mobilization and norms change programs

Additional Resources

• See how a young woman named Maggie is empowered to keep her peers HIV-free
• Read more about USAID’s Gender Equality and Women’s Empowerment Programming