Girls and young women account for 67 percent of new HIV infections among adolescents in sub-Saharan Africa.

Through the DREAMS Innovation Challenge, which is funded by PEPFAR and managed by JSI,[1] the Bar Hostess Empowerment & Support Programme (BHESP) helps vulnerable adolescent girls and young women (AGYW) in Kenya to protect themselves from HIV infection, including through pre-exposure prophylaxis (PrEP). PrEP is a daily dose of antiretroviral medication and is demonstrated to be up to 99 percent effective (depending on risk and adherence) for preventing HIV infection. Best of all, girls can self-administer it.[2]

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Peer educators Florence and Beryl at a clinic in Kenya.

As a local nongovernmental organization, BHESP trains young women from Nairobi’s vast informal settlements to serve as peer educators; develops youth-oriented public awareness campaigns; provides HIV testing and counseling at its youth-friendly drop-in clinics; and educates AGYW about PrEP.

Florence and Beryl are peer educators with BHESP. They hold weekly support groups to help young women understand their risk of HIV infection and get tested, and encourage those who are negative to consider PrEP to stay that way.

Vivian has been taking PrEP for a year and is one of BHESP’s 15 PrEP champions. These young women are mentored to be ambassadors in their communities. They help BHESP create demand for PrEP by discussing their experiences with other eligible AGYW.

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Vivian, Ian, and their 3-year-old son.

Vivian’s partner Ian says that, “At first, I had some objections (to PrEP). I did not know much about it, but now I am in support of it. It guarantees the safety of the child and of both parents.”

Mercy, another member of the support group, started using PrEP after meeting a BHESP peer educator. At first, she was not interested. The first weeks of PrEP use often come with side effects, that can deter prospective and new users. As Mercy recalls, “I did not want to take PrEP. My friend who took it had some difficulties, including nausea. Then I realized it would keep me HIV-free: I have an HIV-positive aunt, and I saw how she suffered. So I changed my mind.” “Now,” Mercy continues, “I recommend PrEP to some of my friends who are at risk, and one of them is taking it.”

Mercy’s sister Norah also came around to PrEP after initial reluctance. She had heard rumors that PrEP infected people with HIV, instead of protecting them from it. When she saw that Mercy was fine, Norah started taking PrEP, too.

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In just two years, with support from DREAMS IC, BHESP has reached 5,469 adolescent girls and young women with PrEP services and raised awareness of HIV transmission risk and PrEP among 18,525 young people.

[1] As Funds Manager for 45 DREAMS IC grantees, JSI administers awards, monitors and supports implementation and grant management, and builds grantees’ organizational and technical capacity.

[2] https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001323.

Photo credit: Lambert Coleman / Hans Lucas

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