DREAMS: Partnership to Reduce HIV/AIDS in Adolescent Girls and Young Women

Sexual and Reproductive Health Field Trainee Prudence Chimanda practices the procedure for testing for HIV in Zambia
Sexual and Reproductive Health Field Trainee Prudence Chimanda, age 22, practices the procedure for testing for HIV at the Stage 2 Clinic in Samfya, Zambia.
Photo credit: Adriane Ohanesian/VSO.


The DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) Initiative is an ambitious $385 million partnership to reduce HIV infection among adolescent girls and young women (AGYW) in HIV priority areas within Kenya, Lesotho, Malawi, Mozambique, South Africa, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe. The 10 DREAMS countries, all in sub-Saharan Africa, accounted for nearly half of the new HIV infections that occurred among AGYW globally in 2014.

Girls and young women account for over 70 percent of new HIV infections among adolescents in sub-Saharan Africa, and nearly 1,000 AGYW are infected with HIV every day. Social isolation, economic disadvantage, discriminatory cultural norms, orphanhood, gender-based violence, and school drop-out all contribute to girls’ vulnerability to HIV. The DREAMS initiative goes beyond health to address these factors – a key to reaching the Sustainable Development Goal of ending AIDS by 2030.

The DREAMS Innovation Challenge [PDF, 1.7MB] seeks solutions to strengthening capacity for service delivery, keeping girls in secondary school, linking men to services, supporting pre-exposure prophylaxis, providing a bridge to employment, applying data to increase impact and offering sustainable solutions that may be scaled or replicated, and deploying solutions rapidly.

DREAMS builds upon the U.S. Agency for International Development’s (USAID’s) decades of experience empowering young women and advancing gender equality across the sectors of global health, education, and economic growth. USAID partners with community, faith-based, and non-governmental organizations whose credibility within communities and capacity to mobilize significant numbers of volunteers allow USAID to address the structural inequalities impacting girls’ vulnerability to HIV.

Scaling up evidence-based interventions across multiple sectors will allow USAID to accelerate efforts to achieve an AIDS-free generation. By the end of 2017, DREAMS will achieve a 40 percent reduction in HIV incidence among women and girls ages 15–24 in the hardest-hit areas of the 10 DREAMS countries.

As the leading implementer of the DREAMS package, USAID will support:

  • HIV testing and counseling for nearly 528,000 AGYW
  • Education subsidies for almost 88,000 AGYW
  • Post-violence care for more than 113,000 AGYW survivors of gender-based violence
  • School-based HIV and violence prevention programs for approximately 684,000  AGYW
  • Pre-exposure prophylaxis for more than 10,500 AGYW
  • Condom promotion and provision for almost 1.7 million  AGYW and their partners
  • Improved access to youth friendly sexual and reproductive health services and the full range of contraceptive methods
  • Parenting/caregiver programs for more than 281,000 people

DREAMS is supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the Bill & Melinda Gates Foundation, Girl Effect, Johnson & Johnson, Gilead Sciences, and ViiV Healthcare.

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