Dana*, an 11-year-old living in Kenya with her widowed mother and four siblings, was 9 years old when a male neighbor lured her into his house with the promise of a sugary treat. He then locked the door and covered her mouth to muffle her screams as he sexually assaulted her. He also threatened to further harm her and her family if she told anyone what had happened.
Dana suffered four days of excruciating pain from the rape before she finally told her mother, who took her to a hospital and the police. The 72-hour deadline for Dana to receive post-exposure prophylaxis – medication to reduce her chance of HIV transmission after unprotected sex – had passed, and she tested positive for HIV.
Around the world, stories like Dana’s are far too common. PEPFAR-supported Violence Against Children Surveys show that for as many as one in three girls, their first sexual experience is forced or coerced, which also places them at an elevated risk for HIV infection.
As we celebrate International Women’s Day on March 8th, we know that almost 1,000 young women will be newly infected with HIV on this day alone, and that they are up to 14 times more likely to be infected with HIV compared with young men. The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) is committed to changing these statistics, especially with our DREAMS partnership that helps girls develop into Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe women.
Through this public-private partnership, we are delivering a core package of evidence-based interventions that go beyond the health sector to counter the key drivers of HIV risk for girls and young women. We are empowering young women to become change agents for themselves, their peers, and their communities. We are inspiring and assisting them to write their own success stories about how they stayed in school, benefited – along with their families – from economic strengthening, and addressed sexual- and gender-based violence.
The U.S. government has invested more than $750 million in DREAMS programs to reach over 2.5 million adolescent girls and young women with services and support. In the 10 original DREAMS-supported countries, nearly two-thirds of the highest-HIV-burden communities achieved a 25 to 40 percent or greater reduction in new HIV diagnoses among young women, with new infections declining in almost all DREAMS intervention districts. In addition, thanks to DREAMS, nearly 6,000 adolescent girls and young women have received pre-exposure prophylaxis, or PrEP, for preventing HIV infection. Recently, five more PEPFAR-supported countries began implementing DREAMS programming.
We still have a long way to go. Millions of girls and young women experience physical and sexual violence every year. As it did for Dana, this violence often starts early in life. So PEPFAR is expanding our developmentally appropriate HIV and violence prevention programming for girls ages 9-14 to prevent sexual violence and any form of coercive, forced, or non-consensual sex; delay their sexual debut; help them understand consent; and encourage them to make healthy choices. We also continue to support services, such as post-exposure prophylaxis, for survivors of gender-based violence and are exploring additional methods for community violence prevention.
Today, Dana is adhering to her HIV medication and serves as a DREAMS ambassador, educating and empowering her peers. She hopes one day to become a police officer “to deal with men who do bad things to young girls like me.”
This year, as we mark PEPFAR’s 15 Years of Saving Lives through American Generosity and Partnerships, we celebrate the important progress we have helped girls and young women make through our work in more than 50 countries. In the spirit of International Women’s Day and Women’s History Month, we recommit to partnering with them as they write their own AIDS-free future.
* Editor's Note: This name has been changed.
About the Author: Ambassador Deborah L. Birx serves as the U.S. Global AIDS Coordinator and U.S. Special Representative for Global Health Diplomacy at the U.S. Department of State.
Editor's Note: This entry also appears in the U.S. Department of State's publication on Medium.