March 2019

One young woman is making DREAMS into a reality




Adolescent Care & Treatment

Carolina is a 25-year-old mother of two living in Chokwe, Mozambique—a farming district located along the Limpopo River. Nearly half of the teenage girls in Mozambique are either pregnant or have already become mothers. This leads to a high dropout rate of girls in school. Fifty-eight percent of Mozambican women are functionally illiterate.

Carolina has had her challenges. Her father died from AIDS-related causes seven years ago, around the time that she had her first child. Then her mother left the community in search of work. When Carolina was pregnant with her second child, three years later, she tested positive for HIV.

As a young woman living with HIV, Carolina is far from alone. Girls and young women account for 74 percent of new HIV infections among adolescents in sub-Saharan Africa.

AIDS-related illness is the most common cause of death among young people ages 10-24 in this region of the world.

Fortunately, Carolina had access to youth-friendly HIV services. She was prescribed lifesaving antiretroviral medication and was enrolled in prevention of mother-to-child HIV services. Carolina’s daughter and son are both HIV-free. Carolina is raising them herself under the roof of her uncle and aunt.

“When I learned about my HIV-positive status, I cried nonstop for several months,” says Carolina. “I  stayed indoors because I believed that the community would stigmatize me.”

“Then I started going to an adolescent support group. I started participating in discussions. It was good because I shared my experience with other people and I didn’t feel so alone. I took my antiretroviral medication, and I started getting better and better. From that time, I felt empowered,” says Carolina.

Eighteen months ago, one of Carolina’s friends brought her to a DREAMS “safe space.” DREAMS is an ambitious partnership to reduce HIV infections among adolescent girls and young women in 15 countries, including Mozambique. Sponsored by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), DREAMS aims to help girls develop into Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe women.

In Chockwe, DREAMS is supported by the Centers for Disease Control and Prevention (CDC) and administered by the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF).

Chockwe is one of the highest performing DREAMS districts, with a 50 percent decline in new HIV infections among adolescent girls and young women.

DREAMS safe spaces host meetings twice a week for young women 18-25. When they meet, they sing and dance. Then they listen to a talk by a health worker knowledgeable about HIV prevention and sexual health services, and discuss the challenges and triumphs in their lives. They ask health and life questions and share their experiences. Both male and female condoms are freely available for the young women.

The Chokwe DREAMS group has four ambassadors, including Carolina who have been trained to counsel and educate their peers—both during the meetings and in one-on-one sessions. They regularly conduct home visits during the week and even do couples counseling. Some of the girls in the DREAMS group are living with HIV and some are HIV-free. All share a goal to be healthy and independent.

“At the meetings, I saw girls who are vulnerable, who are living with violence,” says Carolina. “I have been supporting and guiding and educating them because I have also faced the same difficult challenges. I suffered a lot. I can be a voice so that they will not feel alone.”

“I like what I do. Girls in this area are vulnerable. Certain girls are making wrong decisions—like having unprotected sex—and I sensitize them. They think that they can’t do anything in their lives. When men come back from the mines during holidays, they can abuse the women—physically, psychologically, and sexually. Sometimes the women don’t trust anyone. I have been trained to counsel them so that they can continue with their educations and succeed.”

From her experience as a DREAMS ambassador, Carolina has learned how she can take steps to better her own life. Although she dropped out of secondary school after grade 9, she is back studying. After she completes 12th grade, she hopes to go to the university and study medicine. Her greatest hope for her daughter and son is that they be educated and independent.