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REAMS workshop

DREAMS Impact Evaluation

Designing Impact Evaluation studies of the Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe (DREAMS) Partnership.

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DREAMS Impact Evaluation aims to help adolescent girls and young women who are at highest risk of HIV infection.

The goal of DREAMS is to help girls develop into Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe women.


On World AIDS Day 2014, PEPFAR launched a bold new initiative – ‘DREAMS’ ( – to reduce new HIV infections by 40 percent among the highest risk adolescent girls and young women in 10 high-burden countries. With an initial commitment of US$385 million, quickly supplemented with $85 million for a DREAMS Innovation Fund, DREAMS partners – PEPFAR, Bill & Melinda Gates Foundation, Girl Effect, Johnson & Johnson, ViiV Healthcare and Gilead Sciences – aim to promote empowerment and prevent HIV acquisition through a core package of interventions for young women, their families, communities and male partners.

The Bill & Melinda Gates Foundation has awarded LSHTM a 4-year grant to lead a portfolio of evaluation studies designed to track the impact of DREAMS in Kenya, South Africa and Zimbabwe. Led by Isolde Birdthistle and Sian Floyd, the evaluation draws on LSHTM expertise in HIV, adolescent health and evaluation across all faculties, and close research partnerships with experienced institutes in each country: the Africa Health Research Institute (AHRI) in Durban, South Africa, the African Population and Health Research Centre (APHRC) in Nairobi, Kenya; the Kenya Medical Research Institute (KEMRI) in Siaya, Kenya; and the Centre for Sexual Health HIV and AIDS Research (CeSHHAR) in Harare, Zimbabwe.

Meet the team
DREAMS meet the team

London School of Hygiene & Tropical Medicine (LSHTM), UK


Isolde Birdthistle  
Sian Floyd  
Annabelle Gourlay

I chair the Data Analysis Working Group, including epidemiologists, statisticians and data managers from each of our partner organisations in Kenya, South Africa and Zimbabwe, as well as colleagues at LSHTM. Recent work has included summarising early awareness and uptake of DREAMS, using population-wide data platforms and/or nested cohorts of AGYW in each setting. I also participate in the Social Science Working Group to keep up-to-date with progress on the process evaluation and facilitate my understanding of the implementation of DREAMS, to help contextualise the quantitative findings.

I have learned that it is very complex to define and measure ‘exposure’ to DREAMS, and that this is a very challenging package of interventions to implement. However, there are encouraging signs from the early analyses and some interesting synergies across settings, despite the different contexts in which DREAMS is being implemented. I’ve also learned that we have a great team of researchers!
Bernadette Hensen
Hensen Bernadette
My role on the DREAMS IE involves supporting the evaluation of DREAMS among young women who sell sex in Zimbabwe. Working with colleagues at the Centre for Sexual Health, HIV/AIDS Research (CeSHHAR) and LSHTM, I support the collection and analysis of data from a cohort of young women. We are aiming to follow-up a cohort of the most vulnerable young women in two DREAMS and four non-DREAMS site to help us understand whether DREAMS has had an impact on the health and well-being of this population. I have learnt so much through working on the DREAMS IE. One of these is that, although challenging, it is possible to identify and reach the most vulnerable young women who sell sex to men in exchange for money or other material support through their networks.
Joanna Busza I contribute to the impact and process evaluations of DREAMS in Zimbabwe. I work closely with the Centre for Sexual Health, HIV/AIDS Research (CeSHHAR) to track inclusion in and experiences of DREAMS activities among the most vulnerable adolescent girls and young women, those involved in exchanging sex for money or other material goods. We are following girls who benefit from different parts of the DREAMS package to try to understand how it affects their lives, particularly in regard to protecting them from risks. Young women’s perceptions of the programme, such as which components work well and which less so, will help answer questions about whether DREAMS is being implemented as planned, whether it is acceptable to those it aims to reach, and what challenges participants face.  I have been impressed with how quickly young women see a change in themselves, particularly in terms of feeling a greater sense of purpose in their present lives and hope for the future. It remains to be seen whether relatively short exposure to DREAMS activities will be able to deliver on young women’s growing expectations.

Despoina Xenikaki

DREAMS IE Project Coordinator

My role on the DREAMS Impact Evaluation is to support the PI’s with the financial management of the project. It also involves liaising with our partner organisations based overseas to organize payments. Together with the project PI’s, I’m responsible for the submission of financial reports to the funder. I also assist with project recruitment, dissemination of results and organization of PI/Management meetings and workshops.

What I’ve learned so far is that it’s wonderful supporting such a multi-disciplinary team and collaborating with our partners from overseas.

Africa Health Research Institute (AHRI), South Africa


Maryam Shahmanesh                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             

Jaco Dreyer

Data Manager

I am the Data Manager on this Evaluation project and responsible for setting up tools to collect the data and export data to datasets for analysis.

I have seen that going into field with a small team that is focused on a specific set of questions is more effective than sending a big team that is trying to combine your questions with the questions from other projects.

Natsayi Chimbindi

Project manager

I am the project manager on the Africa Health Research Institute (AHRI) DREAMS Impact Evaluation.

One thing I have learnt so far is that HIV prevention interventions for young people are complex and require time for scale up and adaptation to context for them to be a good fit. Personally, I have advanced working in a multi-disciplinary team from different sites – the exposure and experience has been enriching.

Thembelihle Zuma

Social Scientist



I am working on the Social Science component of the IE, assessing how communities in Umkhanyakude, one of the DREAMS sites in South Africa are experiencing, perceiving and understanding Dreams.

To reduce HIV incidence among AGYW, multicomponent interventions such as DREAMS are essential, however, AGYW do not exist in isolation, interventions should also have a strong focus on their parents, partners, and spaces they interact with.

Nondumiso Mthiyane




My role is to analyze quantitative data. What I have learned is that working together with fieldworkers gives you a better understanding of the population which you are analyzing the data for.               

Kathy Baisley                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             

African Population and Health Research Centre (APHRC), Kenya


Abdhalah Ziraba


Sheru Muuo


Benedict Orindi


Joyce Mumah


Jane Osindo

Research Officer



My role on the DREAMS Impact Evaluation involves oversight on project activities at the field level. I am responsible for  logistics for the quantitative and qualitative data collection which involves community sensitization on project related activities, preparation of data collection teams through training and field logistics, supervision of data collection activities and data monitoring and quality control. I am also involved in the process evaluation activities through which the progress of the DREAMS implementation gets monitored. I participate in the qualitative data analysis and interpretation and support scientific writing for the quantitative and qualitative arms of the evaluation.

Evaluating the intervention has taught me that despite the efforts to support the most vulnerable in the communities new challenges arise but the work still goes on.

Centre for Sexual Health and HIV/AIDS Research (CeSSHAR), Zimbabwe and Liverpool School of Tropical Medicine (LSTM), UK


Frances Cowan


Phillis Mushati

Sungai Chabata                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             

Tarisai Chiyaka


Kenya Medical Research Institute (KEMRI), Kenya and Liverpool School of Tropical Medicine (LSTM), UK


Penelope Phillips-Howard

Technical support and liaison with Kenya team (KEMRI), advisory on adolescent schoolgirl studies




Learned: diversity of exposures and risks for adolescent girls and young women in seemingly similar ‘impoverished’ settings – which strengthens the justification for implementing a variety of different interventions to address these factors across the causal pathway 

Daniel Kwaro  
Kenneth Ondeng’e
Maquins Sewe                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             

Vivienne Kamire

Study Coordinator



As the study coordinator I have been assisting with the day–to-day survey implementation and work with the PI in developing an in-depth understanding of the study design and goals, and fully participate in the successful implementation and execution of the study. I have Participated in both county and community engagement which involves stakeholder consultation and community mobilization to discuss the study objectives and implications. I have ensured that the field staffs are well trained on the study protocol to enable them execute the field activities as required.

The lesson learnt so far is that before the study is commenced, holding meetings with various stakeholders both at the County and Community level to comprehensively discuss the aims and objectives is very crucial to avoid creating unrealistic expectations. Through this we have seen a positive response from the sampled participants and stakeholders where they are voluntarily participating in the study.
Resources & publications
Publications List Block
Reaching young women who sell sex: Methods and results of social mapping to describe and identify young women for DREAMS impact evaluation in Zimbabwe
Chiyaka, T; Mushati, P; Hensen, B; Chabata, S; Hargreaves, JR; Floyd, S; Birdthistle, IJ; Cowan, FM; Busza, JR
PloS one, 13 (3). e0194301. ISSN 1932-6203 DOI:
Evaluating the impact of DREAMS on HIV incidence among young women who sell sex: protocol for a non-randomised study in Zimbabwe
Hensen, B; Hargreaves, JR; Chiyaka, T; Chabata, S; Mushati, P; Floyd, S; Birdthistle, I; Busza, J; Cowan, F
BMC public health, 18 (1). p. 203. ISSN 1471-2458 DOI:
News & blogs
News & blogs DREAMS
Photo taken in Stellenbosch, South Africa
Photo taken in Stellenbosch, South Africa

DREAMS IE meetings in South Africa

10-15 November 2017

The DREAMS IE team attended a 3 day meeting in Stellenbosch, South Africa to discuss current progress of the study. Representatives of all 4 partners shared progress reports from the implementation of DREAMS IE in Kenya, South Africa and Zimbabwe with the coordinating team from the London School of Hygiene and Tropical Medicine.

Following the meetings in Stellenbosch, the DREAMS IE team attended the AIDS Impact Conference ( in Century City, Cape Town. The contributions of the DREAMS IE team to the conference are listed below with links to presentations and posters.




Monday 13 November

12:30-13:30 – Satellite Oral, Room 1B

Africa Health Research Institute – ViiV adolescent health satellite programme

Youth and HIV in southern Africa:  The convergence of sex, HIV and complex lives.

Chairs: Helen McDowell and Janet Seeley/Maryam Shahmanesh

  • South Africa (Natsayi Chimbindi, AHRI/DREAMS IE): Scaling up multi-level HIV prevention interventions for adolescent girls and young adults in rural KwaZulu-Natal:  Does one size fit all scale-up work? 
13.30-15:30 - Oral presentation, Room 8

HIV prevalence and risk factors for prevalent HIV among young women who sell sex in Zimbabwe: results from a respondent-driven survey conducted for an impact evaluation of DREAMS.

  • Bernadette Hensen, DREAMS IE (LSHTM w/ CeSSHAR)
Poster presentations, Room 11

Community perceptions of DREAMS in urban informal settlements in Nairobi

  • Jane Osindo, DREAMS IE (APHRC w/ LSHTM)

How can a TV drama about love, sex and growing-up increase knowledge and shape the sexual health behaviours of young people?

  • Venetia Baker (LSHTM MSc student w/ MTV Staying Alive Foundation)


Tuesday 14 November

13:30 – 15:30 - Oral presentation, Room 8

Persistently high incidence of HIV in adolescent girls and young women in rural KwaZulu-Natal South Africa: Lessons for DREAMS multilevel HIV prevention scale-up.

  • Maryam Shahmanesh, DREAMS IE (UCL & AHRI w/ LSHTM)
Poster presentation, Room 11

Reaching young women who sell sex: methods and results of mapping to describe and identify young women to prepare for “DREAMS+PrEP” evaluation in Zimbabwe.

  • Tarisai Chiyaka, DREAMS IE (CeSSHAR w/ LSHTM)


Wednesday 15 November

10:30 – 12:00 - Oral presentation, Room 9

High HIV incidence in young male adults living in rural KwaZulu-Natal South Africa:  Will DREAMS provide the services they need?

  • Maryam Shahmanesh, DREAMS IE (UCL & AHRI w/ LSHTM)
Poster presentation, Room 11

Translating combination HIV prevention for adolescent girls and young women into practice: early lessons from DREAMS implementation scale-up in four settings.


Recent levels and trends in HIV incidence rates among adolescents and young adults in high-prevalence countries: A systematic review.

  • Isolde Birdthistle (LSHTM) & Kristen de Graaf (LSHTM MSc student)
Poster Abstracts – available on website and in the programme

Understanding HIV risks among adolescent girls and young women in poor informal settlements pre-DREAMS in Nairobi.

  • Benedict Orindi, DREAMS IE (APHRC w/LSHTM)

DREAMS IE collaborates closely with the following School Centres: