"PEPFAR gives confidence"

PEPFAR Kenya gives hope and confidence through....

mentoring adolescent girls to be determined, resilient, empowered, AIDS-free, mentored, and safe

As PEPFAR marks 20 years of impact and hope in Kenya, we celebrate the fact that nearly nine hundred thousand adolescent girls and young women (AGYW) have been reached with age-appropriate, multilayered, comprehensive HIV and violence prevention interventions. The DREAMS program is aimed at equipping AGYW to be Determined, Resilient, Empowered, AIDS-free, Mentored and Safe, and the program uses a safe space mentor-led model to deliver multiple behavioral, biomedical and structural interventions.

PEPFAR Kenya actively began implementation of the DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) program in 2016, covering five high HIV burden counties initially: Mombasa, Nairobi, Kisumu, Siaya, Homa-Bay. In 2018, the Government of Kenya conducted a county-level analysis and used HIV incidence data to guide scale-up of HIV and violence prevention interventions that were deemed most effective, and their findings and recommendations led to the expansion of DREAMS to Kiambu and Migori counties in 2019. DREAMS was also a catalyst for roll out of PrEP in Kenya, and there have been marked reductions in new HIV infections among AGYW in the seven DREAMS counties.

The program goes beyond public health interventions by equipping AGYW with enabling economic strengthening interventions, helping them pursue their dreams with trainings in financial literacy, entrepreneurship, and saving, and the added support of funding for schooling and vocational training programs.

Implementation of PEPFAR’s DREAMS program started at a time when the youth bulge in East Africa was at about 75%, and adolescent girls and young women (AGYW) aged 15–24 years were at considerably greater risk of contracting HIV than their male peers – accounting for nearly one in four of all new HIV infections in the region in 2019. Continued high HIV incidence among AGYW meant a worrying increase in the triple threat – high teen pregnancies, new HIV infections, and increased gender-based violence – due to multiple vulnerabilities associated with social and structural factors, such as the ones experienced by Lorine Hill, now 19 years old. 

As Lorine recounts: “My life before DREAMS was complicated, in that my dad died when I was only seven years old, and my mom went through a deep depression and was unable to care for us. Eventually I went to stay with my maternal uncle, but life was not easy because the only thing he could do was to pay my school fees; I had to take care of myself, at the age of 10. A young man who was working at a stripping hotel took me and told me, ‘I'll be paying you if you take drugs and drug people so that you may take money from them.’ I had no option because I needed the money. I did the work until one of my aunts saw me and took me away from there, but when I reached Class 8, my mummy said now I was a big girl, and I could take care of myself. The only plan I had was to go back to Nairobi and start stripping, because I thought that was the only thing that could help me at that time.”

PEPFAR’s Kenya DREAMS program targets 10-24-year-old adolescent girls and young women (AGYW) like Lorine, and uses a ‘safe space’ model for service delivery, anchored on strengthening social networks such as relationships with peers and adults who can offer emotional support, information, and material assistance. When Lorine joined Form 1, some DREAMS mentors came to her school and told them that DREAMS offers many kinds of support to vulnerable AGYW, including support for education costs and informational programs about sexual and reproductive health and rights. “Under the DREAMS My Health My Choice program,” Lorine recalls, “I was taught about love, money, and sex, and DREAMS also helped pay my school fees.”

Delivered as a core package, the DREAMS program includes interventions that: (1) empower adolescent girls and young women and reduce their risk, (2) strengthen the families of AGYW, (3) mobilize communities for change, and (4) reduce the risk of men who are likely to be male sexual partners of AGYW.  Specifically, these interventions include HIV testing services, post-violence care intervention and services, voluntary contraceptive method access, condom promotion and provision, a family/caregiver program, education support, and comprehensive economic strengthening support – any/all of which are offered to AGYW based on their individual needs.

Lorine represents the remarkable progress PEPFAR has made through DREAMS, and the nearly nine hundred thousand Kenyan adolescent girls and young women reached with a comprehensive package of HIV prevention, risk reduction, health promotion, and empowerment interventions. “I am thankful for the DREAMS program,” Lorine reflects, “because they have helped me become the person I am today; I am this girl who can help someone emotionally, mentally, and also physically, because I now know how to save my money, and I know how to protect myself from unwanted pregnancy and diseases…

“I want to thank the DREAMS program for everything that they have done in my life. My thanks goes to LVCT Health, through the sponsorship of CDC and PEPFAR, for introducing the DREAMS program in my area… This has helped me, Lorine Hill, become a courageous young woman who can now stand in front of people and actually teach someone about life.” Lorine is currently a student at Kisii National Polytechnic undertaking a Diploma in Fashion and Design, and doing an apprenticeship at a clothing design shop in Kisumu. “My life changed after DREAMS,” Lorine concludes; “Now I am this girl who is working, and I have a future. I want my life as a fashion designer to be nice - to be called the biggest fashion designer in this country; my thanks goes to PEPFAR for bringing out this organization that nurtures young girls and helps us pursue our dreams.” DREAMS is changing lives.