Impact of a multilevel HIV prevention programme on adolescent girls and young women’s empowerment for risk reduction: A mixed methods evaluation in Kenya
Outcomes: Human Immunodeficiency Virus, Sexual and Reproductive Health
View SourceKey Social Norms Take-aways The study shows that gender norms are central to HIV risk and to the DREAMS theory of change, particularly norms around male authority, female submissiveness, stigma toward girls’ sexual and reproductive health (SRH) service use, and acceptance of violence. While DREAMS contributed to changes in girls’ confidence, aspirations, and peer support, broader social norms at community and institutional levels remained largely unchanged, continuing to constrain girls’ ability to act on these shifts.
Objectives The study aimed to assess whether the DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, Safe) Partnership promotes empowerment among adolescent girls and young women (AGYW) in Kenya, and how addressing structural drivers, including gender norms, supports HIV risk reduction.
Methods The study used a mixed-methods design combining longitudinal cohort data (2017/18–2022) with qualitative research. Gender norms were not directly measured through a dedicated scale, but were incorporated into the analytical framework (Kabeer’s model) as part of institutional structures shaping empowerment. Quantitative measures focused on related outcomes (self-efficacy and social support), while qualitative methods explicitly examined prevailing gender norms, expectations, and sanctions affecting AGYW.
Intervention Details DREAMS is a multilevel HIV prevention program designed to address structural drivers of HIV risk, including gender norms, through social asset building, mentorship, economic support, and community engagement. Its theory of change emphasizes strengthening girls’ resources and agency while also aiming to shift normative and institutional environments.
Results DREAMS improved social support and self-efficacy and enabled girls to act in ways that challenged restrictive expectations, such as refusing unsafe sex and avoiding transactional relationships. However, norms stigmatizing girls’ SRH service use, reinforcing male dominance, and tolerating violence persisted, and some program elements unintentionally reinforced these norms. Limited engagement of men and communities further constrained broader normative change.
Conclusions DREAMS strengthened key precursors to empowerment but did not substantially shift the wider gender norms embedded in social and institutional systems. The findings highlight that addressing gender norms requires deeper engagement beyond girls themselves, including communities, men, and structural conditions that sustain inequality.
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