Integrated solutions to advancing gender equality and reducing HIV infection in sub-Saharan Africa

March 18, 2022
ACHIEVE empowers adolescent girls and young women through its DREAMS implementation. Credit: Aidan Tarimo/Pact

During International Women’s Month, and every month, we are reminded of the importance of women’s empowerment and gender equality in fostering human development. Access to quality and inclusive education, health care, adequate work and freedom to make choices are fundamental human rights. This is why the Adolescents and Children HIV Incidence Reduction, Empowerment and Virus Elimination project, or ACHIEVE, is committed to empowering adolescent girls and young women (AGYW) so that they can own their future. 

ACHIEVE’s DREAMS implementation has been the cornerstone of its progress toward reaching epidemic control among AGYW. DREAMS, meaning Determined, Resilient, Empowered, AIDS-free, Mentored and Safe, is a PEPFAR initiative to prevent HIV infection and gender-based violence among AGYW and empower them through economic strengthening. 

ACHIEVE implements DREAMS in Namibia, Rwanda and South Sudan, and reached 53,000 AGYW last year. That number will likely double this year as ACHIEVE embarks on DREAMS work in a large part of Tanzania.

Activities are provided through Safe Spaces that are usually established in schools or health facilities. Services include pre-exposure prophylaxis (PrEP) and gender-based violence (GBV) response and prevention, and economic strengthening activities. ACHIEVE’s economic strengthening package equips AGYW with the skills and experience for successful personal and household economic growth, including training 7,702 AGYW on financial literacy and 2,235 AGYW on business and entrepreneurship skills, and establishing 438 WORTH savings groups for AGYW and their families. ACHIEVE also supported 658 AGYW in attending comprehensive vocational training and in some cases, distributed business start-up kits to kick-start their personal economic journey.

Last year, in Namibia ACHIEVE successfully reached the majority of its PEPFAR targets by serving 28,049 AGYW with standardized HIV-prevention interventions including enrolling AGYW on PrEP_NEW to prevent HIV infection. The team also focused on ensuring AGYW have access to GBV clinical care and implementing the Families Matter! Program for parents and caregivers of 9 to 19-year-olds, which promotes positive parenting practices and effective parent-child communication about sex-related issues and sexual risk reduction.

In Rwanda, 18,719 AGYW were served through ACHIEVE’s DREAMS services in 2021. One such service includes access to WORTH savings and loan groups, which provides caregivers and AGYW the support they need to provide necessities for their children and households. AGYW also received educational support in the form of school fees and school materials, as well as Technical and Vocational Educational Training (TVET) scholarships in four of its targeted districts. ACHIEVE’s DREAMS mentors were also instrumental in increasing demand for PrEP uptake among supported AGYW where 402 AGYW were initiated on PrEP and received PrEP adherence counselling and support.

In South Sudan, ACHIEVE continued to build on its strong DREAMS initiatives by focusing on delivering the primary life skills package for active DREAMS participants using the empowerment and livelihood for adolescents (ELA) curriculum. Additionally – and as part of the project’s layering strategy – AGYW continued to access secondary services through referrals as well as engaging in economic strengthening activities. In 2021, 459 AGYW completed training in short-term courses including juice, liquid soap, and sandal making, while an additional 70 completed long-term courses focused on beauty treatment and tailoring – opening the way for employment opportunities.

Supporting these activities are DREAMS Ambassadors, who are selected AGYW within ACHIEVE’s DREAMS program based on their leadership potential. These paid employees of the project provide mentorship and peer support to other AGYW, creating positive change and increasing the impact of the program. This has included protecting vulnerable AGYW from violence and early/unwanted pregnancies in Namibia, increasing AGYW’s access to PrEP in Rwanda, and improving financial literacy and vocational skills in South Sudan.

These are just a few examples of the progress ACHIEVE has made to prevent and respond to the barriers faced by AGYW in the countries it serves. Through innovative, community-based solutions, ACHIEVE remains committed to reducing gender inequalities and empowering women and girls. Because when women and girls thrive, the entire world thrives.