ACHIEVE project promotes violence prevention in HIV care

Through committed and collective action, the world is closer to meeting the UN 95-95-95 goals to achieve sustained HIV epidemic control. Despite this progress, adolescent girls and young women (AGYW) remain disproportionately vulnerable to and at risk for HIV infection. In sub-Saharan Africa, women and girls account for more than 60% of all new HIV infections. Among the drivers increasing their risk of acquiring HIV is gender-based violence (GBV), which is fueled by gender inequality and inhibits AGYW from accessing critical HIV and sexual and reproductive health services.

Since 2019, the USAID-funded global Adolescents and Children HIV Incidence Reduction, Empowerment and Virus Elimination (ACHIEVE) project has implemented innovative, community-based approaches to address the causes and consequences of violence against children (VAC) and GBV among its targeted populations – orphans and vulnerable children (OVC) and AGYW. Its integrated activities aim to safeguard these individuals and their caregivers from the structural and social factors that increase their risk of GBV. The project’s approaches have included comprehensive gender-focused violence prevention programs and intensive economic strengthening pathways to improve wellbeing, safety, financial independence and HIV outcomes for the individuals it serves. 

No Means No 
In Nigeria, GBV remains a pressing issue, particularly among vulnerable children and adolescents. Recognizing the urgent need for intervention, ACHIEVE has actively worked since 2020 to strengthen the capacity of four local partners implementing the USAID-funded Integrated Child Health and Social Services Award (ICHSSA) program to ensure that OVC and their households have improved access to GBV prevention and response services. A significant focus of this effort is the "No Means No" (NMN) program, an intervention that has proven to reduce rates of sexual assault among 42% of the participants who received training through the program. The curriculum, delivered by trained community-based instructors, aims to end the cycle of violence by teaching boys and girls, aged 10-19, mental, verbal and physical skills and strategies to prevent sexual violence and to safely intervene when anticipating or witnessing violence.

In 2024, ACHIEVE coordinated the certification of staff from all four ICHSSA implementing partners to become lead trainers of NMN. Subsequently, the lead trainers prepared 280 instructors to implement the NMN curriculum for 74,399 boys and girls in 17 states across Nigeria. Additionally, the project has trained 56 Government of Nigeria stakeholders from the Federal and State Ministries of Women Affairs from 27 states on the NMN curriculum to effectively supervise NMN activities. 

DREAMS
ACHIEVE’s DREAMS activities have been a driving force in its progress toward reaching epidemic control among AGYW in Namibia, Rwanda, South Africa, South Sudan and Tanzania. The initiative employs targeted interventions that include evidence-based violence prevention programming to change social norms that may exacerbate the levels of sexual violence targeted at AGYW. Critical to this approach are IES opportunities such as wage employment and entrepreneurship, designed to reduce AGYW’s engagement in transactional sex and relationships for financial stability, which can lead to GBV. 

In 2024, ACHIEVE reached 64,809 AGYW in Rwanda, South Africa, South Sudan and Tanzania through the DREAMS primary life skills package and IES interventions. Through these activities, 62,104 AGYW participated in skills building activities such as financial literacy and marketable business skills, 15,572 AGYW received business start-up support, and 829 gained access to wage employment, internships or income generating opportunities.  

Coaching Boys Into Men 
Since 2020, ACHIEVE has implemented the violence prevention program, CBIM, in Botswana, Kenya, Lesotho, Malawi, Rwanda, Tanzania, Uganda, Zambia and Zimbabwe. The program’s aim is to increase discipline, cooperation and integrity among adolescent boys and young men through sports to mitigate violence against children, particularly girls, ultimately reducing the risk of HIV infection among adolescent girls who have experienced or are at risk of experiencing violence. Led by athletic coaches, who are trained to serve as mentors, the young athletes are taught the importance of developing healthy masculinity and respectful, nonviolent relationships, thus increasing positive attitudes that promote gender equity. 

In 2024, ACHIEVE implemented the CBIM program in 451 Tanzanian primary schools and reached more than 29,000 boys aged 10-14. Key outcomes of the initiative included an increase in ABYM’s ability to recognize abuse and to intervene when they witnessed peers engage in harmful or abusive behavior. The initiative also reinforced teachers’ knowledge of topics and practice focused on instilling characteristics of leadership among ABYM. Ultimately, CBIM has proven to be a promising practice that creates an enabling environment dedicated to equality, health and safe growth for young women and boys. 

Looking Ahead
Through these targeted approaches implemented in close collaboration with national governments, local partners and civil society organizations, ACHIEVE has made significant progress to sustain gender equality and GBV prevention and response interventions within HIV services and systems. Recognizing that sustained HIV epidemic control can only be achieved by addressing the social determinants that make vulnerable populations susceptible to HIV, ACHIEVE ensures that its HIV/GBV interventions are evidence-based and community-led, as well as survivor-centered, accessible to, and respectful of the individuals it serves. 

With the continuation of these efforts, ACHIEVE will reach more individuals in the coming year with its GBV prevention interventions and post-violence clinical care services, so that OVC and AGYW can live in an environment free from harm or violence.