Impact in Tanzania: Young Women Find New Pathways to Empowerment

Preventing HIV Among Africa’s Growing Youth Population: Successes and Challenges
Photo Credit: CDC/DGHT 2015

Nadia’s Story

Her husband walked out of the health clinic in Tanzania’s Shinyanga Region as soon as the blood was drawn – which is how, at just 19, Nadia found herself alone, pregnant, and awaiting her HIV test results. “The clinician provided me with results that showed I was HIV positive. At first, I cried a lot, but they counseled me, and I started antiretroviral therapy (ART). The hospital staff reassured me that through proper adherence to my HIV medication, I could prevent my unborn baby from getting HIV.” It was also then that her clinician introduced her to the DREAMS program ambassador stationed at the facility. DREAMS – Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe lives – is a first of its kind program that weaves together proven interventions—from clinical to educational—aimed at helping girls stay HIV-free.

Being with her fellow girls was comforting, and Nadia felt hope take root. “Through the DREAMS champions, I realized that I was facing gender-based violence from my husband and should take steps against it,” she said. “I opted to return to my parents’ house and stay far from my husband. This gave me peace of mind, resulting in proper adherence to ART medication.” Months later, thanks to treatment and this support, Naida gave birth to a healthy baby boy, free from HIV.

DREAMS: Bringing Hope to Those Who Need It Most

In eastern and southern Africa, HIV remains a leading cause of death for teen girls, and the root causes of this disproportionate burden are as unique as they are complex. CDC’s Division of Global HIV & TB (DGHT) understands to be effective, the whole individual must be treated, and issues of poverty, access to education, violence, and other gender inequities must be tackled in tandem.

DREAMS and its related programs aim to empower young women and girls by expanding access to education and economic training. Through this effort, PEPFAR and its implementing agencies aim to drive down HIV infections among girls ages 15-24 in high-burden geographic areas.

Throughout Tanzania, DREAMS and its suite of layered prevention programs – programs like Families Matter! — are saving lives and transforming families one woman at a time—women just like Selina.

Selina’s Story

Preventing HIV Among Africa’s Growing Youth Population: Successes and Challenges
Selina, a Families Matter! participant in Mwanza City Tanzania.

As a single mother and sole breadwinner for a family of five, Selina works hard to provide for and protect her family. Still, she is all too aware of the many things that could happen to an impressionable teenager like her daughter. So, when 17-year-old Ester began attending DREAMS, she was elated. Selina also started attending the Families Matter! program for caregivers. Each session of Families Matter! helps caregivers foster a healthy environment for adolescent girls and young women to discuss challenges and ultimately understand their sexual and reproductive rights.

Over seven weeks, Selina participated in sessions ranging from addressing gender-based violence to HIV awareness, its mode of transmission, and the benefits of being tested and knowing one’s HIV status. During one of these sessions, the strange symptoms that she and Ester were experiencing – skin rash, body aches, and fever – began to make sense.

Armed with her new knowledge, Selina gathered the courage to approach a facilitator and seek HIV testing for herself and her daughter. A home visit was arranged where both mother and daughter were found to be HIV positive and started immediately on treatment.

Restoring Hope

Today, thanks to the DREAMS initiative and investments from a financial community group, Nadia successfully runs a vegetable garden. She now sells her produce at the market – earning enough to comfortably care for her family. “Never had I thought I would become a healthy and independent woman. I am thankful to DREAMS champions for restoring my hope of living. I am now a strong and healthy woman, taking good care of my child.”

Nadia is one of the 65 young women who are members of the DREAMS club, and according to the local champions, Agnes and Zainab, membership continues to grow. In fact, from March to June 2022, Agnes and Zainab have provided 78 adolescent girls and young women (AGYW) with Pre-Exposure Prophylaxis (PrEP) services, connected all AGYW visiting the health facility to HIV screening and testing, provided family planning education, and linked those with partners in need of voluntary medical male circumcision to service providers.

An hour away in Northern Tanzania, Selina says the CDC-supported program has transformed her life. “The Families Matter! Program empowered me to make the decision to know my HIV status and that of my daughter. Through the sessions, I found the courage to undergo an HIV test and start treatment.” With support from implementing partners ICAP and the FIKIA+ project, Families Matter! has provided sessions to another 760 parents, like Selina, in the first three quarters of 2022.

“Nadia, Selina, and Ester’s stories are stories of hope and courage to beat impossible odds,” said Jane Kitalile, public health specialist for DREAMS at CDC-Tanzania. “With the help of CDC, adolescent girls, young women, and their families are empowered to make informed choices for their health and financial future — the impact of which will be felt for generations to come.”

Stories of hope are not unique to just Tanzania. For nearly 10 years, CDC, through PEPFAR, has implemented the DREAMS program in 13 countries and empowered countless girls and young women. While progress has been made in keeping girls safe, empowered, and free from HIV – the fight is far from over. The data – and the young women around the world – tell us clearly that we must continue to sustain our efforts and do even more.