DREAMS in Tanzania: A Path to Hope

At a glance

In Tanzania, two young women experience the U.S. President's Emergency Plan for AIDS Relief's (PEPFAR) DREAMS education and empowerment program for adolescent girls and young women.

The struggle for change

Joana grew up in poverty and experienced homelessness along with her mother and siblings. Hoping to provide for her family, she found herself employed by an abusive supervisor. Determined to change her circumstances, Joana moved to a different town with hopes of finding opportunities but ended up living in a brothel, engaging in high-risk sexual behaviors.

Flora endured a toxic home environment filled with neglect from her mother, leading her to run away and drop out of school. In search of a relief, Flora made the difficult decision to get married at 19 years old. Relief was not to be had as her husband became abusive, disregarding her well-being and forcing unwanted sexual encounters - leading to her contracting HIV.

Despite their challenging circumstances, both Joana and Flora refused to let their past define their future. They were determined to create better lives for themselves.

About DREAMS

Both Joana and Flora's paths grew parallel after discovering DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe lives) – a first-of-its-kind program that weaves together proven interventions—from clinical to educational—aimed at helping girls stay HIV-free.

DREAMS provides education on sexual health and evidence-based HIV prevention services, like access to oral pre-exposure prophylaxis (PrEP) and economic empowerment opportunities. Through this effort, PEPFAR and its implementing agencies, including CDC, work to reach vulnerable girls who are at risk of acquiring HIV and contribute to lowering HIV infections among girls aged 15-24 years in high-burden regions. For a decade, CDC, through PEPFAR, has supported DREAMS in 13 countries and contributed towards 1 million adolescent girls and young women successfully receiving a complete package of comprehensive HIV prevention services in 2023.

About oral PrEP‎

Oral PrEP is a highly effective medication that is taken before exposure to prevent HIV infection. When taken consistently, PrEP reduces the risk of getting HIV by 99 percent.

Joana’s newfound joy

A young woman in a pink shirt smiles at the camera.
Joana at her market booth where she sells handmade items.
SOURCE:

Hosea

For Joana, connecting with her DREAMS mentor was a turning point. After testing negative for HIV, Joana fully embraced the DREAMS programs. She began using PrEP to ensure she continued to test negative for HIV and joined the economic empowerment group. It was in this group that Joana received valuable handicraft skills training from the Small Industries Development Organization. With newfound knowledge and determination, Joana started creating handmade products such as batik clothing items, cultural bags, and bracelets and honed her tailoring skills. Her talents shone as she began selling these products and earning a stable income - freeing herself from engaging in unsafe behavior. Joana's success is an inspiration for others on how resilience and support can lead to lifesaving transformation.

We need to be open and raise our voices about the violence we face. I believe we all have dreams and goals to achieve by learning and trying new things in our lives. I am grateful that the DREAMS program has changed my life.
-Joana

Flora’s future

A young woman in a pink shirt speaks at a table with another woman.
Flora speaks with a DREAMS mentor.
SOURCE:

Singwa

With guidance from a DREAMS mentor, Flora came to terms with her HIV diagnosis while understanding that she could still lead a happy and fulfilling life while managing her health. The program initiated her on antiretroviral treatment (ART1) and provided her new husband with PrEP. The support has had a deep impact in alleviating concerns about HIV transmission.

I was worried. I was thinking that I was going to lose my spouse, and I didn't know the fate of my life and this coming child. I thank God for the presence of ART, and I am also very grateful for PrEP in keeping my husband HIV-free. After the explanation provided by DREAMS, I knew that we still have a chance to be together, and we will continue to give birth to children who are safe from HIV.
-Flora

The impact of DREAMS on Joana and Flora's lives is profound and not unique to Tanzania. CDC, through DREAMS, has supported nearly 300 adolescent girls and young women in initiating PrEP services since October 2020. Through the comprehensive support provided by DREAMS and the right HIV prevention, girls and young women are learning just how bright the future can be.


Resources

image of the Tanzania flag
HIV and TB Overview: Tanzania
A summary of CDC's HIV and TB programs, services, and partnerships in Tanzania.
16 Days of Activism Against Gender-Based Violence
Ending Gender-Based Violence
Starting November 25, CDC affirms our commitment to prevent and respond to gender-based violence.
two young women standing at a fruit stall in Mozambique.
When DREAMS Become Reality in Mozambique
Each year DREAMS reaches more than 200,000 adolescent girls and young women in Mozambique
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Content Source:
Global Health Center
  1. Antiretroviral therapy (ART) is a highly effective medication taken by a person living with HIV. When taken consistently and an undetectable viral load is maintained, there is zero risk of transmitting HIV to their sexual partners.