Hilda,* 16, didn’t know she was HIV-positive when she joined the DREAMS (Determined, Resilient, Empowered, AIDS-Free, Mentored, and Safe) peer group in her home village of Kitoko in Tanzania.

“The first DREAMS sessions were exciting. We learned about HIV and gender-based violence, and we were offered HIV testing,” she recalled.

Hilda told Fatima,* the ICAP DREAMS Community Outreach Volunteer who encouraged her to join the group, that she needed more time to decide if she wanted to be tested for HIV. The following week, she said yes, and ICAP staff soon coordinated for a government health care worker to visit the group and meet one-on-one with participants to counsel them and administer HIV testing. It was then that Hilda discovered she was HIV positive.

“The moment I was diagnosed with HIV was the worst and scariest moment of my life,” Hilda said. “All I could think about was how I was going to tell my mother, and how my friends would react if they knew my HIV status. Fatima really helped me to overcome this stress. She advised me to stay in my DREAMS group because the services for reproductive health education, empowerment, and savings would benefit me.”

The DREAMS initiative is part of ICAP’s work to reach key and vulnerable populations in Tanzania, including adolescent girls and young women. Since October 2018, with funding by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC), ICAP has been implementing DREAMS activities in Muleba District Council in the western Tanzanian region of Kagera, with a goal of reaching 17,200 women and girls aged 15 to 24 years with a package of services, including HIV awareness and testing, peer support through DREAMS groups, and economic empowerment through group savings and income-generating activities.

With support from Fatima and her DREAMS peers, Hilda was able to disclose her status to her mother, who has become one of her treatment supporters, helping her remember to take her pills every day.

In addition to health services, DREAMS offers the “WORTH+” training program, encompassing personal development, savings and loans, and establishing a business—one more way of empowering young women by addressing the structural and social drivers that increase girls’ HIV risk, including poverty, gender inequality, sexual violence and a lack of education. Hilda’s group collectively saves 36,000 Tanzanian shillings (about $16) every week, which is available to members when they need a loan to invest in their education or start or expand a business. Hilda decided to take a loan from the group fund to start a fruit business at the Kitoko Market, which is providing a source of income so she can take care of her own needs and pay back her loan on time.

In total, with the strong support of local government authorities in Kagera Region, ICAP has engaged 68 DREAMS Community Outreach Volunteers like Fatima, who in turn have successfully recruited 6,170 DREAMS members like Hilda. Even more, DREAMS groups have collectively saved 16,829,550 Tanzanian shillings (approximately $7,263), opening up new avenues for economic empowerment and independence for young women across the district.

*Names have been changed

Photo captions—Header image: Hilda (left) and Fatima exchange ideas after a DREAMS group meeting. Photo 2: A group of mothers congregates at an ICAP-supported clinic in Kagera, Tanzania.

A global health leader since 2003, ICAP was founded at Columbia University with one overarching goal: to improve the health of families and communities. Together with its partners—ministries of health, large multilaterals, health care providers, and patients—ICAP strives for a world where health is available to all. To date, ICAP has addressed major public health challenges and the needs of local health systems through 6,000 sites across more than 30 countries. For more information about ICAP, visit: icap.columbia.edu


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