Key Social Norms Take-aways The DREAMS initiative highlights how shifting harmful gender norms—particularly those that disempower adolescent girls and young women and condone gender-based violence—is essential for reducing HIV risk. The program uses community mobilization and engagement of male partners and leaders to transform norms around gender, sexuality, and power dynamics. Safe spaces and mentor-led peer groups also support individual empowerment and collective resilience.
Objectives This article describes the rationale, components, and implementation principles of the DREAMS core package, a comprehensive initiative to prevent new HIV infections among adolescent girls and young women aged 15–24 in sub-Saharan Africa by addressing structural and social determinants of risk.
Methods This is an overview of a programmatic intervention rather than a research study. The article draws on programmatic documentation, monitoring data, and systematic evidence reviews to describe how evidence-based interventions were selected, adapted, and implemented. Implementation and impact are monitored through geo-statistical modeling, process evaluations, and layered data triangulation across sites.
Intervention Details DREAMS delivers a layered package of interventions in partnership with governments and private sector organizations across 10 high-burden countries. Core components include biomedical services (e.g., pre-exposure prophylaxis, HIV testing), social asset building (e.g., safe spaces and mentorship), economic empowerment (e.g., educational subsidies, microfinance), family strengthening (e.g., parenting programs), and community mobilization (e.g., school-based sexuality education and norms change efforts like SASA! and SHARE). Interventions are tailored by age group and individual need and require coordination across multiple sectors and stakeholders.
Results Initial modeling and evaluations show that DREAMS has contributed to reductions in new HIV diagnoses among adolescent girls and young women. Successes include improved uptake of HIV prevention services, increased access to education, strengthened family and peer support, and more widespread community dialogue about gender and HIV. However, challenges remain in reaching the most vulnerable girls and ensuring comprehensive intervention layering.
Conclusions Biomedical interventions alone are insufficient to reduce HIV incidence among adolescent girls and young women. A holistic, multisectoral, and layered approach that addresses social norms, economic inequality, and structural violence is essential. The DREAMS model provides a promising blueprint for sustainable HIV prevention and broader empowerment of young women in high-burden settings.