Safe spaces, vocational training, and prevention programs protect young Ugandan women: findings from Uganda Youth Development Link’s DREAMS initiative for rural communities

Abstract

ABSTRACT Adolescent girls and young women (AGYW) in Uganda, especially those based in rural Africa, experience multiple interrelated adversities that may place them at risk of HIV, alcohol abuse, and being dependent on inequitable power relationships with men for survival and income. With funding from the DREAMS initiative in Africa, a multi-component, community-based intervention was designed to optimize AGYW’s abilities to care for themselves. From 2016 to 2019, the Uganda Youth Development Link established the DREAMS Initiative for Rural Communities in 10 rural sites in the Bukomansimbi, Gomba, and Ssembabule Districts, at which n = 8620 AGYW engaged in vocational training, cognitive-behavioral preventive interventions addressing HIV risk, interpersonal partner violence, substance abuse prevention, parenting classes, and recreational activities. Existing community leaders linked AGYW to these programs. Surveys at recruitment and two years later evaluated the program and assessed its impact on AGYW. AGYW reported multiple risk histories: 41.5% engaged in transactional sex (typically with two past partners); 30.3% were mothers; and 42.5% used alcohol often. There was high uptake of each program component: 89% completed vocational training; 61% received family planning services; 78% were tested for HIV (1% seropositive). Two years post intervention, 70% of those who had learnt to be a tailor were still working; 33% of those who had been trained in hair dressing. Multi-component interventions are required to address the multiple challenges experienced by AGYW. The broad range of experiences within each community allows multiple entry points to care and tailored programming for AGYW.