In sub-Saharan Africa, three-quarters of new HIV infections among adolescents occur in adolescent girls and young women (AGYW).* In 2014, to counter this growing challenge, the US President’s Emergency Plan for AIDS Relief (PEPFAR) launched DREAMS, a public-private partnership which addresses factors that amplify this group’s vulnerability to the virus. It aims to help AGYW become Determined, Resilient, Empowered, AIDS-free, Mentored and Safe (DREAMS). Companies including Gilead, GSK/ViiV Healthcare and Johnson & Johnson joined DREAMS, which the Index acknowledged in 2018 as an innovative practice. 

Johnson & Johnson has gone further, exemplifying best practice through a project it launched in South Africa that year. Interviews with AGYW in several African countries made clear it was necessary for them to be directly involved in their own empowerment. As a result, Johnson & Johnson partnered with UNFPA South Africa to establish a youth-led peer-to-peer initiative known as  DREAMS Thina Abantu Abasha (DTAA), which means “we the youth” in Zulu. Like DREAMS, DTAA aims to deepen understanding of the challenges AGYW face, develop sustainable solutions to empower them to remain HIV free and reduce HIV infections overall. 

The DTAA youth leadership team designs and directs its own activities. Since launch, DTAA has reached more than 1.4 million AGYW with modules in the three areas that comprise major factors in preventing HIV spread: i) leadership, ii) employability and iii) sexual and reproductive health resources. It delivers these modules through interactions such as face-to-face sessions in schools and community facilities, radio “edutainment” (broadcasts on university and community radio stations) and community social media. 

This Johnson & Johnson initiative meets all Good Practice Standards: it fulfils specific local needs, has set clear, measurable goals, uses strong governance structures and processes to mitigate conflicts of interest and is measuring its outcomes and the impact of activities. 

Specifically, DTAA has developed its own monitoring and evaluation model to measure outputs and outcomes requesting all participants to complete pre- and post-programme evaluation forms. In 2019, a qualitative evaluation involving nearly 700 participants measured impact on behaviours. This found that 88% of sexually active participants aged 19-24 years (60% of the total cohort) indicated using modern contraception methods and 64% indicated using condoms as a result of programme participation. Additionally, 100% of sexually active participants aged 19-24 years reported they were tested for HIV as a result of program participation.

An alternative to PrEP treatment

While not having any pre-exposure prophylaxis (PrEP) products approved, Johnson & Johnson aims to prevent HIV infections through this alternative route. Its global public health division continues to engage local stakeholders to ensure it understands how to deliver meaningfully on the DTAA mandate and how to engage people locally for successful implementation. Johnson & Johnson also reports on its commitment to ensure that young people remain at the centre of the DTAA initiative.