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HIV Prevention Strategy among Adolescent Girls and Young Women

AFENET implemented a policy review meeting for the Determined Resilient Empowered AIDs – Free Mentored and Safe (DREAMS) Initiative. The meeting of stakeholders reviewed a draft Zero of the HIV prevention Strategy among Adolescents and Young Women from 2 – 5 July 2019 in Jinja, Uganda.

HIV infections have reduced by 47% since the peak in 1996 (2017, 1.8 million compared to 3.4 million in 1996), Despite the reduction in new infections among adults and children by 16% and 35% respectively, every week, around 7000 young women aged 15- 24 years become infected with HIV.

In Sub Saharan Africa, 3 in 4 new infections are among girls (15 – 19). In Uganda 1.3 million people are living with HIV. Women are disproportionately affected (7.6% compared to male 4.7%). Women and girls are mostly affected due to factors such as less education and fewer formal business skills.

With support from the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the Government of Uganda implemented DREAMS since 2015. Dreams is a package of evidence based biomedical, social and economic interventions offered to AGYW aged 10 – 24 years with the aim of reducing HIV Incidence. 

DREAMS Initiative was piloted in 10 high burden districts in the first two years, and due to the success of the initiative, five more districts were included.

Some of the issues identified that affect girls as well as boys in Uganda in the age group of 15 – 14 include: Bullying, Corporal punishment, sexual harassment and abuse (age 9 – 10) and Sexual harassment and abuse (age 11 – 12). Verbal, emotional and physical violence from peers greatly affects girls as well as boys. Over 70% of girls by the age of 9-10 in Uganda reported to have been sexually harassed or abused by teachers as well as peers.

According the Juliet Cheptoris, Project Coordinator, DREAMS – Violence of adolescent girls and boys exposes them to risks of HIV even at later stages of their lives. Due to low esteem, the youth are unable to speak up when being sexually violated. In cases of rape and defilement they have now power to negotiate for condom use. Due to cultural dominance of men against women, in the cases of an HIV positive man and a negative woman, the woman has no power to ask for protection in form of condoms.

Ms Cheptoris also emphasizes that the school setting ideally should be the comfort zone for young girls and boys however today the highest perpetuators are the teachers. The case is worse for youth who do not go to school. The exposure to sexual violence is recurrent and yet not documented.

The DREAMS initiative therefore aims to bring women and adolescents at the forefront of HIV Prevention in Uganda. The initiative is implemented by several partners who include other key officers from MOH from the departments of strategic information, RH, Child Health, Community Health, Mental Health, ACP (Ped and Adolescent care, nutrition, M&E, KP), and school Health. Also include Uganda AIDS Commission, UNFPA, UNAIDS, WHO, AFENET, and office of the First Lady of Uganda among others.