Adolescent girls and young women are at higher risk of HIV infection for a range of biological and socio-economic reasons, including poverty, gender inequality, and limited access to youth-friendly health services. In Uganda, HIV prevalence among young people aged 15-24 was estimated at 4.2 percent for women compared to 2.4 percent for men, according to a 2013 UNAIDS Report.
USAID’s Strengthening Decentralization for Sustainability Program is addressing this challenge by coordinating the DREAMS (Determined, Resilient, Empowered, AIDS-Free, Mentored, and Safe) Initiative in three northern Uganda districts: Gulu, Lira, and Oyam. The aim is to significantly reduce new HIV infections among adolescent girls and young women by 25 percent in year one and 40 percent in year two.
To reach this objective, USAID’s Strengthening Decentralization for Sustainability Program, is working closely with partner community-based organizations to train girls and young women to reduce HIV in their communities. Since February 2016, the program has identified over 8,800 adolescent girls and young women in 240 peer groups.
Susan, age 24, is one of 10 DREAMS Ambassadors in the Gulu district. The single mother of one says that joining DREAMS has made her more determined to stamp out HIV in her community.
“I am confident and assertive. I can now negotiate for condom use with my partner,” says Susan, following a five-day training session in the Stepping Stones curriculum conducted by The AIDS Support Organization, a local organization supported by USAID’s Strengthening Decentralization for Sustainability Program.
The Stepping Stones training package offers the girls tools, or “stepping stones,” they require to overcome socio-economic inequalities, including knowledge on how to curb gender-based violence, and prevent the spread of HIV in their communities.
As a DREAMS Ambassador, Susan was trained as a peer educator. She now oversees a group of 24 high-risk, out-of-school girls and young women. In less than three months of working with the peer group, Sharon is proud of the behavior change so far.
“When I started with this group, only seven out of 24 girls knew their HIV status. Today, all the 24 girls know their status. They are all using condoms; 17 of the girls are using Family Planning to prevent pregnancy, and most have convinced their partners to go for voluntary medical male circumcision (VMMC),” says Susan confidently.
Girls and young women who test positive are immediately referred to care and treatment centers with DREAMS support. Susan is hopeful that, with DREAMS’ economic empowerment trainings, these girls and young women will also overcome the financial challenges they are still faced with.
USAID’s Strengthening Decentralization for Sustainability Program aims to improve the results and sustainability of decentralized service delivery, with an initial emphasis on HIV/AIDS services at local government levels in Uganda through four objectives: (1) Strengthening coordination of activities at the district and sub-county level; (2) Improving district management of resources and programs; (3) Providing financial support through grants to local governments for better service delivery; and (4) Establishing and supporting innovative approaches to sustain social sector service delivery. The program is made possible due to the support of the American people through USAID and implemented by Cardno Emerging Markets USA, Ltd. along with international and local partners.