22 Letters of Hope

Zimbabwe’s Adolescent Girls and Young Women pen inspiring letters for an AIDS-Free future

By UNDP Zimbabwe

November 26^th, 2023

Zimbabwe is one of five African countries that have achieved the ambitious “95-95-95” targets

As the 2023 International Conference on AIDS and STIs in Africa (ICASA) draws near, Zimbabwe's remarkable progress against HIV is in the spotlight. Preceding the conference is World AIDS Day, observed annually on December 1st, to show support for people living with HIV and to remember those who have died from AIDS-related illnesses

Zimbabwe is one of five African countries that have achieved the ambitious "95-95-95" targets set by the Joint United Nations Programme on HIV/AIDS (UNAIDS). Alongside Botswana, Eswatini, Rwanda, and the United Republic of Tanzania, the country now ensures that 95% of people living with HIV know their status, 95% of those who know their status are on antiretroviral treatment, and 95% of those on treatment have suppressed viral loads—three key conditions for saving lives and stopping transmission.

But progress against HIV is uneven. Adolescent girls and young women remain disproportionately affected by the epidemic. Every week, 4000 adolescent girls and young women became infected with HIV globally in 2022. Over 3100 of these infections occurred in sub-Saharan Africa, where adolescent girls and young women (aged 15-24 years) were more than three times as likely to acquire HIV than their male peers.

Yet Zimbabwe is seeing progress. New HIV infections among adolescent girls and young women in Zimbabwe have declined remarkably, with a 29% drop from 2019 to 2022. This encouraging trend is narrowing the gender disparity in new infections, with the incidence among adolescent girls now six times that of their male counterparts, compared to eight times in 2020.

Various factors, including social isolation, poverty, harmful cultural practices, orphanhood, gender-based violence, and limited education, contribute to the vulnerability of adolescent girls and young women to HIV and hinder them from realizing their full potential.

The COVID-19 pandemic exacerbated the structural factors fuelling new HIV infections in Zimbabwe, particularly among adolescent girls and young women. School dropouts surged, teenage pregnancies escalated, child marriages became more prevalent, and gender-based violence intensified.

Each year in Zimbabwe, 12,000 girls have an opportunity to pursue their education and break the cycle of poverty and vulnerability to HIV, thanks to vital education subsidies. This approach, known as DREAMS modified, is led by the National AIDS Council (NAC) in collaboration with Plan International, with support from UNDP and the Global Fund to Fight AIDS, Tuberculosis and Malaria.

In the spirit of the 2023 World AIDS Day theme, "Let Communities Lead," and ahead of the convening of the 22nd edition of ICASA in Harare, Zimbabwe, from 4-9 December 2023, the NAC, Plan International and UNDP are highlighting the voices of adolescent girls and young women from four districts especially affected by HIV: Chimanimani, Umguza, Kwekwe, and Umzingwane.

Twenty-two voices rise in unison, their stories of courage, hope, resilience, and leadership penned in the form of letters to a friend abroad. These narratives, etched from real-life experiences, echo a shared dream and a call to action – to end AIDS for everyone, everywhere by 2030.

About the Adolescent Girls and Young Women programme

In line with the Government of Zimbabwe's goal of ending AIDS by 2030, UNDP, with funding from the Global Fund, has supported the adolescent girls and young women programme since 2018. The programme aims to contribute to a significant reduction in new HIV infections among adolescent girls and young women aged 10-24 in Zimbabwe by 2025.

The programme prioritizes the most vulnerable adolescent girls and young women, including people from child-headed households, with disabilities, and who dropped out of school or survived gender-based violence. It empowers them to adopt healthy lifestyles that reduce their risk of HIV infection and addresses the sociocultural, religious, and legal barriers that hinder their access to services and increase their vulnerability to HIV.

A standardized risk and vulnerability assessment screening tool is used to identify the most vulnerable adolescent girls and young women, both in and out of school, and those unmarried and married.

The UNDP - Global Fund supported programme in Zimbabwe complements core interventions modified from the DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) partnership, an ambitious public-private partnership aimed at reducing rates of HIV among adolescent girls and young women in the highest HIV burden countries.

In Zimbabwe, the DREAMS programme is coordinated by the National AIDS Council (NAC) at the national, provincial, and district levels. The NAC, with support from Plan International Zimbabwe and the Zimbabwe Association of Church-Related Hospitals (ZACH), implements the UNDP - Global Fund DREAMS modified package in 25 priority hotspot districts across Zimbabwe's 63 districts, ensuring coherence with other HIV programmes targeting adolescent women and girls supported by PEPFAR, UNICEF, UNFPA and other partners.

In four of the 25 priority districts—Chimanimani, Umguza, Kwekwe, and Umzingwane—a comprehensive package (SistatoSista, male mobilisation, SASA!, one stop centre, and DREAMS modified) is implemented to address the specific challenges and high HIV prevalence in these areas.

The DREAMS modified approach

The “DREAMS modified” approach is a layered and holistic package of care for vulnerable adolescent girls and young women aged 9-24.

Key interventions include:

Social Protection: Every year, 12,000 girls in Zimbabwe are empowered to pursue their education thanks to vital education subsidies. The programme, which operates across 110 schools in four districts, alleviates the financial burden for families by covering the costs of school fees, uniforms, essential supplies, and even exam fees. In 2022 alone, the programme directly covered US$190,925 examination fees for 2,586 adolescent girls, enabling them to sit for their Ordinary and Advanced level examinations.
Out-of-school Comprehensive Sexuality Education (CSE): The Sista2Sista programme, a CSE curriculum, provided 14,954 adolescent girls and young women with vital knowledge and skills to make informed decisions about their sexual and reproductive health.
In-school CSE: Equipped 44,818 students with comprehensive sexual and reproductive health education by training teachers to provide guidance and counseling in 2022.
Parenting programme: that fosters open communication between parents and adolescents on crucial issues such as sexual and reproductive health, gender-based violence, and harmful social norms.
Sexual Reproductive Health (SRH) service provision: A comprehensive mobile health programme, including the "Stop the Bus" approach, that provides adolescent girls and young women with on-site HIV, SRH, and gender-based violence (GBV) services. In 2022, 5,164 adolescent girls and young women were reached.
GBV prevention and survivor care: that promotes a culture of gender equality and prevention of GBV through SASA! training and one-stop centres for GBV survivors. In 2022, SASA! champions reached 49,437 people with different modules, empowering individuals, and communities to break the cycle of violence.
Male engagement programme: that engages adolescent girls' and young women's partners through transformative dialogues and referrals to essential services. In 2022, the programme reached 195,890 individuals and connected 20,997 to various services.
Safe accommodation: prevention of adolescent pregnancies, early marriages, and new HIV infections through an in-school programme that provides sustainable and affordable boarding facilities for girls living far from school. As of December 2022, eight boarding facilities have been constructed, serving 280 vulnerable girls.

Footnotes

*Names and identifying details in the letters have been changed for reasons of privacy.

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FootNotes

*Names and identifying details in the letters have been changed for reasons of privacy.

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