Despite the remarkable success in Zimbabwe’s effort to reduce HIV incidence, with an overall 70% reduction from 2010 to 2021, there is less progress among adolescent girls and young women (AGYW), who are the group with the highest HIV incidence and one that is almost 10 times higher than in their male counterparts. AGYW are thus a high-priority group for enhanced access to comprehensive HIV prevention services.
The DREAMS initiative, a core component of the U.S. government’s PEPFAR program, aims to reduce HIV incidence among AGYW by providing them with a combination of biomedical, structural, cultural and socio-economic interventions to address key drivers for HIV transmission for themselves, their partners and families. In Zimbabwe, CDC has been implementing the DREAMS program since 2020 in four districts in Matabeleland North, the province with the second highest HIV prevalence in Zimbabwe.
To address the priorities of the GH-23-0019 NOFO, Zim-TTECH (the Zimbabwe Technical Assistance, Training and Education Center for Health) is proposing activities that will help reduce HIV risk among AGYW in selected districts in Matabeleland North. Zim-TTECH is a locally registered Zimbabwean organization that works with the Ministry of Health and Child Care (MoHCC) and other ministries to implement comprehensive HIV prevention and clinical services. It has been implementing CDC’s DREAMS program since October 2020, and in that time has enrolled 41, 361 AGYW (110% of the PEPFAR target).
To address the priorities of the GH-23-0019 NOFO, Zim-TTECH will lead and coordinate a consortium of local implementing partners that includes Pangaea Zimbabwe AIDS Trust (PZAT) and the Southern Africa AIDS Dissemination Service (SAfAIDS) who will implement a peer-led DREAMS program in the selected districts as well as two technical assistance partners: the International Training and Education Center for Health (I-TECH), a center in the University of Washington Department of Global Health and No Means No Worldwide (NMNW) an organization whose mission is to end sexual violence against women and children. These organizations, with extensive HIV experience in Zimbabwe, are uniquely positioned to implement all of the DREAMS interventions with fidelity.
To reach the program objectives, Zim-TTECH and its partners will deliver the primary package of interventions such as HIV and violence prevention, financial literacy and social asset building, layered with secondary services interventions such as education and economic strengthening support for AGYW, their parents and families and to address structural barriers and harmful social norms in the community. Additionally, Zim-TTECH will support and strengthen mentorship and coaching approaches to sustain DREAMS-related gains. Zim-TTECH and its partners will work closely with all relevant ministries to enhance sustainability as well as with faith- and community organizations to ensure program acceptance. Zim-TTECH and its partners will support the generation of high-quality program data to reliably monitor the layering, completion and coverage of interventions and will conduct selected evaluations to identify approaches for program improvement.
Zim-TTECH’s already established robust data systems and the extensive networks built over the years in the four districts make Zim-TTECH uniquely poised to successfully implement a high quality, multisectoral and sustainable DREAMS package of interventions to contribute to the reduction of new HIV infection among AGYW.
