Biosocial Analysis of the DREAMS Program in Tanzania

In Tanzania, the HIV epidemic is impacting many people throughout the country. However, this impact is not equally distributed among all people. Different areas in Tanzania suffer higher prevalence rates of HIV than others. In addition, females, especially adolescent girls and young women (AGYW), are at greater risk when it comes to HIV infection. These inequitable prevalence rates are caused by a number of factors, including but not limited to gender-based violence, lack of education, and involvement in transactional sex and sex work. In order to address HIV in Tanzania, U.S.-based groups including President's Emergency Plan for AIDS Relief (PEPFAR), the Centers for Disease Control and Prevention (CDC), and ICAP have designed and implemented the DREAMS program, which aims to protect AGYW from HIV infection via empowerment, education, and testing services. While this is a multi-faceted intervention that aims to protect women and address more than just the biological factors that spread disease, there are possible unintended consequences that can lead to harm.