Differences in uptake of the DREAMS intervention in Lesotho among adolescent girls and young women

The Determined, Resilient, Empowered, AIDS-Free, Mentored, and Safe (DREAMS) Partnership is an initiative to reduce new HIV infections in Adolescent Girls and Young Women (AGYW) in 15 sub-Saharan countries. It is implemented through the delivery of a comprehensive package of evidence-based approaches and interventions in health, but also with an emphasis on addressing key drivers of high HIV prevalence in AGYW including poverty, gender inequality, sexual violence, lack of education, and social isolation and exclusion, which limit access to information, support, services, and livelihood opportunities. This study aimed to investigate the DREAMS initiative in Lesotho by comparing AGYW and their caregivers who had received two or more of the intervention services to match peers who had not yet participated in the program. A random sample of 150 AGYW were selected from implementing partner intervention lists, 126 (84%) of whom were enrolled. While HIV status was unknown, Dreamers across all age groups reported lower levels of sexual risk (OR 1.28; CI 1.01-1.63) and higher levels of self-efficacy (OR 0.85; CI 0.78-0.93). Dreamers were also more likely to have access to savings (Chi-Square 9.1, df 3, p < 0.05) as well as a plan for how to spend the money they earn (Chi-Square 11.0, df 4, p < 0.05). The parenting program was less successful with no meaningful difference being observed between the two groups of caregivers. These findings suggest that such AGYW in Lesotho who have participated in the initiative have shown improvements in their psychosocial and financial wellbeing as compared to their peers.