Adolescent Girls & Women

Adolescent Girls & Women: Creating Gender Equity

Date: 2016 Location: Botswana Description: A group of schoolgirls © Holly Powers/USAID/Southern Africa

  • Every day, around 1,000 adolescent girls and young women are infected with HIV.
  • Girls account for 74% of new HIV infections among adolescents in sub-Saharan Africa.
  • In fiscal year 2017, PEPFAR supported HIV testing and counseling for more than 11.2 million pregnant women.
  • One in three women will experience gender-based violence in their lifetime, making them much more likely to be infected with HIV.


Date: 2015 Description: Young women graduates © Irene Angwenyi/USAID Kenya

No greater action is needed right now to control the HIV/AIDS epidemic than empowering adolescent girls and young women.

Due to the Millennium Development Goals’ success at reducing child mortality by over 50 percent as well as continued high fertility rates, significantly larger numbers of young women who survived childhood are now entering their most vulnerable years for HIV infection, particularly in sub-Saharan Africa. In 2017, 360,000 adolescent girls and young women were infected with HIV – almost 1,000 a day.

Many factors make girls and young women particularly vulnerable to HIV, including gender-based violence, exclusion from economic opportunities, and a lack of access to secondary school. Ninety-eight million girls around the world are not in school, yet we know that a girl who has a basic education is three times less likely to contract HIV.

PEPFAR is deeply committed to addressing the vulnerabilities of adolescent girls and young women and ensuring their access to HIV prevention and treatment services.

Empowering Adolescent Girls and Young Women to Achieve Their DREAMS

  • Date: 2012 Location: Ghana Description: Ghana woman at USAID health event ? USAID/Kasia McCormick
  • Date: 2016 Description: logo for the DREAMS Initiative. DREAMS - Working together for an AIDS-Free Future for Girls & Women ? PEPFAR

PEPFAR, in collaboration with private sector partners – the Bill & Melinda Gates Foundation, Girl Effect, Johnson & Johnson, Gilead Sciences, and ViiV Healthcare – is driving the ambitious DREAMS Partnership to help girls develop into Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe women.

The goal of DREAMS is to deliver on bold U.S. targets by supporting a multi-sectoral core package of interventions that goes beyond the health sector, addressing the structural drivers that directly and indirectly increase girls’ HIV risk, including poverty, gender inequality, sexual violence, and lack of education.

PEPFAR has helped drive down new HIV diagnoses among adolescent girls and young women by 25-40 percent or more in nearly two-thirds of the highest-HIV-burden communities implementing its DREAMS public-private partnership across 10 sub-Saharan African countries since 2015. Since its launch, DREAMS has reached over 2.5 million adolescent girls and young women with critical comprehensive HIV prevention in high-burden geographic areas to reduce their risk of HIV infection, help them to know their HIV status, and ultimately prevent the spread of HIV/AIDS. 

To increase the effectiveness of DREAMS efforts, PEPFAR is investing to reach more men with HIV treatment and voluntary medical male circumcision for HIV prevention, targeting the same districts with high HIV burdens where we have DREAMS programming. Unless more men access and adhere to HIV prevention and treatment services, we are only confronting half of the crisis.

The DREAMS Innovation Challenge

Date: 2016 Description: Schoolchildren in Botswana ? Holly Powers/USAID/Southern Africa

To complement the DREAMS Partnership, the DREAMS Innovation Challenge was launched to build upon existing evidence-based approaches and infuse additional resources and innovative ideas to better meet the urgent and complex needs of adolescent girls and young women in sub-Saharan Africa.

PEPFAR, Janssen Pharmaceutica NV (a Johnson & Johnson company), and ViiV Healthcare have committed $85 million to support solutions that address unmet needs not covered by the DREAMS Core Package of interventions. The DREAMS Innovation Challenge has awarded funding to 56 organizations chosen from 10 sub-Sarahan African countries to create change and increase impact in six critical focus areas that will reduce new HIV infections among adolescent girls and young women.

Ending Violence, Ending AIDS

Date: 2015 Description: Shadow of a woman ? AP Image

Gender-based violence is not only a violation of human rights, but also fosters the spread of HIV/AIDS by limiting one’s ability to negotiate safe sexual practices, disclose HIV status, and access services due to fear of reprisal.

Women and girls are disproportionately affected by violence, and an estimated one in three women worldwide has been beaten, coerced into sex, or otherwise abused in her lifetime. PEPFAR-supported Violence Against Children surveys (VACs) have helped raise awareness about the nature and magnitude of child abuse.

These surveys, which have been conducted in 11 countries, found that an average of one in three young women reported their first sexual experience as forced or coerced. Based on these and other data, PEPFAR supports programs that respond to the complexities of childhood violence. PEPFAR also works with governments to develop and implement national, multi-sectoral plans that address maltreatment and sexual abuse.

Increased risk of negative health conditions associated with exposure to childhood sexual violence reported by females 13-24

"" Negative Health Conditions Risk
HIV/STIs 3.7x
Pregnancy Complications 3.5x
Alcohol Use 3.0x
Unwanted Pregnancy 2.9x
Feeling Depressed 2.3x
Suicidal Ideation 2.3x
Attempted Suicide 2.0x
Difficulty Sleeping 1.8x
Cigarette Use 1.2x

Source: CDC Violence Against Children Surveys

Date: 2016 Description: Graph - Percentage of 13- to 24-year-old female respondents who reported first sex as forced/coerced. Swaziland - 50, Tanzania - 25, Kenya - 20, Haiti - 25, Malawi - 40, Nigeria - 25, Zambia - 30 ? CDC

Harnessing the Data Revolution to Reach Women and Girls

Date: 2012 Location: Mozambique Description: Smiling group of young women ? Sarah Day Smith / PEPFAR

The PEPFAR Dashboards disaggregate data by sex, age, and geography, helping target and tailor PEPFAR’s efforts to reach those most in need. These data are critical to supporting adolescent girls and young women, who in some countries are up to three times more likely to have HIV than their male peers.

PEPFAR is a partner of Data2X, a collaborative platform for gender data. The partnership is working with the United Nations Development Program and others to build a global technical standard to harmonize gender results reporting, increase the use and visualization of sex- and age- disaggregated data, and train partners on decision-making with gender results data.


PEPFAR has publicly opened our data, leading by example to drive greater program efficiency, transparency, coordination, and mutual accountability. With the PEPFAR Dashboards, you can explore PEPFAR's global investments and achievements in responding to the HIV epidemic. Take a look at the slideshow below to learn more about how PEPFAR is making an impact in the global HIV response.

Partnerships and Initiatives

  • Date: 2016 Description: logo for the DREAMS Initiative. DREAMS - Working together for an AIDS-Free Future for Girls & Women ? PEPFAR

    DREAMS, an ambitious partnership, supports adolescent girls in becoming Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe women. With the support of private sector partners, PEPFAR aims to reduce new HIV infections among adolescent girls and young women within the highest-burden areas of 10 sub-Saharan African countries.
  • Date: 06/08/2016 Location: AIDS-Free logo Description: AIDS-Free logo ? PEPFAR & UNAIDS

    Start Free, Stay Free, AIDS Free is a super fast-track framework for ending AIDS in children, adolescents, and young women by 2020.
  • Date: 04/01/2016 Description: Pink Ribbon Red Ribbon logo ? PRRR

    Pink Ribbon Red Ribbon is a public-private partnership with the shared goal of reducing deaths – especially in high-risk HIV-positive women – from cervical cancer and breast cancer in low- and middle-income countries.
  • Date: 2016 Description: MTV Shuga logo ? MTV

    MTV Shuga, a long-running drama series and multimedia campaign, follows the lives of young people and raises HIV/AIDS awareness across sub-Saharan Africa.
  • Date: 2016 Description: Together for Girls - Ending Violence against Children ? Together For Girls

    Together for Girls is a global public-private partnership dedicated to ending violence against children, with a focus on sexual violence against girls.
  • Date: 2016 Description: Saving Mothers Giving Life ? Saving Mothers Giving Life

    PEPFAR’s investment in Saving Mothers, Giving Life increases the number of pregnant women reached with HIV services, reduces maternal mortality, and improves health systems that impact maternal health.