Led by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), DREAMS is a public-private partnership to reduce HIV infections among adolescent girls and young women (AGYW) in sub-Saharan Africa. Through the DREAMS Innovation Challenge, managed by JSI Research & Training Institute, Inc., PEPFAR funded 46 grantees to implement programs across six focus areas. The goal: to meet the urgent and complex health and social needs of vulnerable AGYW.

Overarching Impact

Over two years (2016-2018), the DREAMS Innovation Challenge touched the lives of more than 160,000 AGYW between the ages of 10 and 24. Of the total beneficiaries, 143,700 females as well as 13,142 males were reached with evidence-based interventions encouraging them to adopt HIV-prevention behaviors and access services.

DREAMS reached 143,700 females with evidence based interventions in Uganda, Kenya, Malawi, Tanzania, Mozambique, Zambia, Zimbabwe, South Africa, and Lesotho

Through the DREAMS Innovation Challenge, 89,777 females and 10,448 males received HIV tests and results.

Moreover, 21,703 orphans and vulnerable children affected by HIV— and their family members— were supported with services to reduce their vulnerability to HIV.

Kawala Fauza replicating books and sandals in Mukono District

Photo: Sawa World

Focus Area 1: Strengthening Capacity for Service Delivery

Six grantees focused on strengthening the ability of grassroots organizations to deliver HIV prevention services to AGYW. Grantees in Mozambique, Kenya, South Africa, Tanzania, and Zimbabwe

“Before going to safe space [peer education sessions discussing HIV prevention and sexual and reproductive health], if my mum was saying something to me, I could have been very rebellious.” -Irene, age 22, beneficiary of ICS Africa, Kenya
Photo: Lambert Coleman/ Hans Lucas
143 organizations' HIV service delivery systems strengthened

Grantee Example
HIVSA’s project in South Africa set up Choma DREAMS Cafés— internet-enabled shipping containers repurposed as girl-friendly safe spaces offering HIV-prevention education, information, and empowerment— at 40 grassroots organizations and schools.

Actress Charlize Theron with girls from the Africa Outreach Project

Chelsea Handler and Charlize Theron visit a group of DREAMS Challenge beneficiaries. Photo: Charlize Theron Africa Outreach Project

Focus Area 2: Keeping Girls in Secondary School

19 grantees focused on ensuring girls’ transition and access to secondary school education and addressing underlying challenges to retention. School engagement has been associated with lower rates of HIV acquisition.Grantees in Uganda, Malawi, Zambia, Kenya, South Africa, Tanzania, Mozambique, eSwatini, Zimbabwe

“Now I know how to read very well, and I can understand things. [Even] if you don’t have any parents…it’s not the end of the world. Things will get better.” -Rachel, age 19, beneficiary of Hope worldwide Zambia
Photo: Lambert Coleman/ Hans Lucas

View her story: Aspiring to become a nurse: DREAMS Innovation Challenge empowers dropouts to return to high school in Zambia

103,118 female and 33,432 male learners were reached in secondary schools or equivalent

Grantee Example
In eSwatini, Tanzania, and Zimbabwe, World Education, Inc./Bantwana Initiative reached 6,784 in-school girls and out-of-school teen mothers with clubs and non-formal education and mentoring to build their protective and social assets to remain in school, help them pass national exams, teach them life skills, and provide them with early childhood stimulation techniques. They also identified and gave AGYW who were at risk of dropping out financial assistance and services to help them stay in school.

Portrait of a smiling girl from World Education, Inc./ Bantwana Initiative

Photo: World Education, Inc./ Bantwana Initative

34,224 girls got access to feminine hygiene products and services

Focus Area 3: Linking Men to Services

Four grantees pioneered new ways to link boys and young men to HIV testing and counseling, treatment, and voluntary medical male circumcision services.Grantees in Kenya, South Africa, Tanzania, Zambia

“I found people testing here, so I thought I should make a step about [learning] my own status. I now know my HIV status and different HIV-prevention methods.” -Ronald, age 22, beneficiary of Afya Mzuri, Zambia
Photo: Lambert Coleman/ Hans Lucas

View his story: Using cultural traditions in innovative ways to break the cycle of HIV transmission

805 males were linked to voluntary medical male circumcision services

Grantee Example
All participated in TackleAfrica’s program, which trained 40 football coaches to conduct HIV-prevention talks with their teams and provided opportunities for voluntary HIV testing services at practices and games.

Participants of TackleAfrica listen to their football coach.

Photo: TackleAfrica

10,448 males received HIV testing services 80% of the males demonstrated comprehensive knowledge of HIV and AIDS

Focus Area 4: Supporting Pre-Exposure Prophylaxis (PrEP)

Eight grantees focused on supporting education for and provision of PrEP by identifying AGYW appropriate for PrEP initiation and supporting their adherence. PrEP is a daily medication regimen proven to dramatically reduce the risk of HIV infection.Grantees in Kenya, Lesotho, Malawi, Mozambique, Uganda

“I know I am at risk. You never know when HIV knocks at your door.” -Florence, age 23, peer educator with Bar Hostess Empowerment & Support Programme, Kenya
Photo: Lambert Coleman/ Hans Lucas

View her story: Increasing PrEP uptake through peer educators

9,742 AGYW and 192 ABYM newly enrolled in PrEP

Grantee Example
Bar Hostess Empowerment & Support Programme in Kenya reached 20,353 AGYW with PrEP information via community mobilization activities. Of the 4,957 who enrolled, 60% actively continued PrEP for at least three months.

Hands holding PrEP medication

Photo: Lambert Coleman/ Hans Lucas

Focus Area 5: Bridge to Employment

Six grantees focused on providing a post-secondary school bridge to employment for young women (ages 19–24) to decrease their risk of transactional sex and HIV transmission.Grantees in Kenya, Mozambique, South Africa, Tanzania, Zimbabwe

“At the training [to become a motor vehicle mechanic], there were only three girls. The rest were men, which made it challenging. The men believed that we weren’t good enough. Therefore, I decided to show them that I can do better than them. Now that I have experience with lots of different cars, I am confident that I will always find a job.” -Ann, age 24, beneficiary of the African Centre for Women, Information, and Communications Technology’s DREAMS Innovation Challenge project, Nairobi, Kenya
Photo: Lambert Coleman/ Hans Lucas

View her story: Empowering young women in Kenya to be economically independent and HIV-free

31,070 AGYW completed workforce development training 16,813 AGYW placed in new or better paying jobs

Grantee Example
Through Save the Children’s project, 3,222 AGYW built transferable life skills (e.g., positive identity, HIV prevention); entrepreneurial and employability skills (e.g., communication, job searching); and hard skills (e.g., carpentry, farming, welding). 2,090 (65% of those trained) obtained new or better paying jobs.

Portrait of a girl doing woodwork

Photo: Save the Children

Focus Area 6: Applying Data to Increase Impact

Four grantees focused on increasing the availability and use of data to inform policies to prevent HIV transmission among AGYW and increase program efficacy. Grantees in Kenya, South Africa, Uganda

“When I found out my HIV status, I was surprised and very upset…A few months later, I was introduced to Premise and joined its WhatsApp group and found other people my age who were facing the same struggles. The project encourages us to be more confident. Because of DREAMS, I have no stigma in my life.” -Evelyne, age 21, beneficiary of Premise Data Corporation, Kenya
Photo: Lambert Coleman/ Hans Lucas
108,166 AGYW reached with improved data platforms 365 entities supported with improved data for decision making

Grantee Example
AidData at College of William & Mary partnered with Zambia’s National HIV/AIDS/STI/TB Council to upgrade its national management information system. The system now provides government and implementing partners with information to help them allocate resources and deliver HIV-prevention and treatment services to vulnerable AGYW.

Group photo of College of William and Mary's NACMIS launch event

Photo: College of William and Mary

Legacy of DREAMS Innovation Challenge

Heightened commitment to equitable gender norms

74% of participants view GBV as less acceptable 60% of participants agreed there should be equal access to resources and opportunities

Improved ability to mobilize resources for sustainability

52% at the start to 95% at the end of project At least 95% of active grantees by the end of the project had up-to-date resource mobilization plans in place, compared to 52% at the beginning of the project.[i]
37% of grantees had no prior experience with PEPFAR funding 70% of grantees secured continued funding
Photo: Lambert Coleman/Hans Lucas

Improved organizational development and strong institutional systems

Finance systems and tools in place went from 60% to 100% of grantees All grantees assessed [ii] now have finance manuals, internal controls, and other systems for auditable financial management (compared to 60% when the project began).
All grantees assessed now have human resource (HR) manuals complete with job descriptions to systematize management procedure (compared to 68% with HR manuals and 48% with job descriptions at the start of the project). HR systems and tools in place went from 68% to 100% of grantees
AGYW engagement strategy in place went from 20% to 68% of grantees 68% of grantees assessed now have an AGYW engagement strategy (compared to 20% at the start of the project).
96% of grantees assessed have a gender policy now (compared to 16% at the start of the project). Gender policy in place went from 16% to 96% of grantees

Learn More

Note: JSI served as Funds Manager for 46 DREAMS Innovation Challenge grantees that were funded by PEPFAR, administering the awards, monitoring and supporting implementation and grants management, and providing capacity building and technical support.

Header photo: World Vision

[i] Four grantees were terminated, and two additional grantees did not report on this indicator.
[ii] JSI’s organizational capacity assessment measured institutional functioning for 25 organizations considered at greatest need of capacity strengthening at the beginning of the project, and the results listed here reflect that group.

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