During a prenatal visit at a health clinic in Kenya, Doreen, an expectant young mother, revealed her fear of contracting HIV from her HIV-positive husband. Fortunately, her test results that day were negative, but she still worried about becoming infected in the future.

Doreen’s nurse Irine counseled her on her options, including pre-exposure prophylaxis (PrEP) – or pills taken daily to help prevent HIV transmission. Doreen agreed to take PrEP, but expressed concern about the drug harming her unborn baby.

After Irine assured her of PrEP’s safety for pregnancy and breastfeeding, Doreen began the medication and joined the more than 650 clients who have benefited from the Pre-exposure Prophylaxis Implementation for Young Women and Adolescents in Kenya (PrIYA) program.

Doreen is also one of the nearly 6,000 young women and adolescent girls in multiple countries who have received PrEP thanks to PEPFAR’s Determined, Resilient, AIDS-free, Mentored, and Safe (DREAMS) public-private partnership. Since 2015, DREAMS has helped reduce new HIV diagnoses among young women by 25 to 40 percent or greater in nearly two-thirds of the highest-HIV-burden communities in the 10 original DREAMS-supported countries. New infections are declining in almost all DREAMS intervention districts. Recently, five more PEPFAR-supported countries began implementing DREAMS programming.

PEPFAR supports PrIYA through our DREAMS Innovation Challenge, which was created to infuse HIV prevention programming with unique thinking and approaches to meet the urgent and complex needs of young women and girls in sub-Saharan Africa. PrIYA has integrated the delivery of PrEP in 21 maternal and child health and family planning clinics.

PriYA nurses like Irine serve as PrEP ambassadors and are trained to assess HIV-negative clients’ risk of acquiring HIV, taking time to discuss the ways each client can reduce risk. Initiating PrEP is just one of the alternatives PrIYA nurses offer their clients. They also provide self-testing kits for HIV-negative women to take home to their partners, if their status is unknown.

When Doreen returned for her follow-up visit, she was enthusiastic. Her husband and in-laws were supportive of PrEP and reminded her to take her daily doses. Doreen was also thrilled to report that she was not experiencing any side effects from PrEP.

Despite her adherence to the medication, Doreen was still worried about contracting HIV. She was glad to learn that she once again tested negative. Assured that PrEP works when taken correctly and consistently, Doreen chose to continue the medication.

Now the mother of a healthy baby boy, Doreen has herself become something of a PrEP ambassador. She has been telling friends and community members about PrEP, inspiring several women to join the PrIYA program.

U.S. Department of State

The Lessons of 1989: Freedom and Our Future