At a glance
This story highlights the impact of HIV among adolescent girls and young women. CDC, with support from PEPFAR, is implementing the DREAMS program to build an AIDS-free future for girls and young women.
Background
About DREAMS
"Every great dream begins with a dreamer," said Harriet Tubman, an American abolitionist and political activist.
So is the case of the DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) program. CDC, with support from the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), has been supporting this initiative across 15 countries since 2015.
The ultimate goal of the DREAMS program is an AIDS-free future for girls and women aged 10 to 24. The program is comprised of a comprehensive, multi-sectoral package of core interventions. These interventions aim to address key factors that make adolescent girls and young women (AGYW) particularly vulnerable to HIV. The program also strives to increase AGYW's knowledge, decision-making power, and access to health services and support networks.
AGYW living with HIV
Despite substantial declines in new HIV infections globally, the HIV epidemic disproportionately impacts AGYW in many countries. For example, in sub-Saharan Africa, 67 percent of new HIV infections in young people occur in AGYW. Additionally, AGYW are up to 14 times more likely to be at risk for HIV than their male counterparts.
In Uganda, AGYW aged 10-24 years have more than three times the HIV prevalence compared to boys of the same age. Even more concerning is that the rate of NEW infections remains twice as high among AGYW than their male counterparts.
Uganda implements DREAMS in four rural regions. There was also a recent expansion to Kampala, Wakiso, and Mbarara Districts to respond to the high incidence of HIV among AGYW in these urban centers.
CDC's impact
As a leading PEPFAR-implementing agency in Uganda, CDC supports 15 of the 24 DREAMS districts. Leveraging decades of expertise in youth and community focused HIV programs, the CDC in Uganda delivers tailored services to AGYW.
Through the DREAMS program, CDC works with many key figures to help AGYW reach their fullest potential, including:
- Comprehensive regional partners.
- District and local leadership.
- Faith-based and non-governmental organizations.
- Their families.
- Community leaders.
DREAMS layers multiple interventions so that AGYW are surrounded with critical support to prevent HIV and other health and socio-economic risks.
Janet's story
Janet is one of the DREAMS beneficiaries in Mityana District. This district is supported by Mildmay Uganda, a CDC-DREAMS implementing partner. Born into a family of eight siblings, Janet’s family struggled with domestic violence, divorce, and poverty.
Janet was forced to leave school and had no financial support. Due to this, she started selling sex for money at 13 years old. During these encounters she did not have the ability to negotiate condom use. Without this protection, Janet assumed she had HIV and contemplated suicide.
Janet was enrolled in DREAMS and offered an HIV test. Although she was scared, the result came back negative. Overall, the health knowledge and skills she built in the program signaled a turning point in her life.
"I can now afford necessities. I can't go back to my old life on the streets," Janet says.
“I have learnt a lot about HIV/AIDS and how I can protect myself. I did not know about using condoms. I could not tell any man to put on a condom. Today, DREAMS has empowered me to make right healthy choices and negotiate for safe sex,” she adds.
An inspiration
Janet’s life has completely changed. Her inspiring story has impacted many girls in her community. She now speaks to other AGYW about how to make healthy choices. She is a role model to both girls and boys and is seen as a mentor by many in her community. This is a value she attributes to DREAMS.