Violette Mushimiyimana has been making and selling face masks in the Eastern Province of Rwanda, where she lives, ever since the Rwandan government mandated mask-wearing to reduce the spread of COVID-19. Twenty-three-year-old Violette is a skilled tailor, having received vocational training through the DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) public-private partnership. DREAMS also provided equipment and start-up materials so that Violette and her colleagues could set up their tailoring business. When the time came to pivot to face masks, DREAMS helped connect the young women to schools and other local businesses who needed a steady supply of masks.

This support presented enormous new opportunities for Violette, the oldest of six children raised by an impoverished single mother.

“I dropped out of school in grade two because my mother could not afford to provide me with a few basic materials,” says Violette. “Life was very tough. Since I am the first born in my family, I had to forego my studies and help my mother to provide a living for my siblings. But now, with my business, I can afford all my basic needs and support my family.”

A lack of access to secondary education, limited economic opportunities and vulnerability to gender-based violence can place adolescent girls and young women like Violette at particularly high risk of HIV infection. That’s why DREAMS offers services including vocational training, educational subsidies, parenting support and violence prevention programs alongside more traditional health care programming such as HIV testing and counseling, youth-friendly sexual and reproductive health services, and pre-exposure prophylaxis (PrEP).

These layered interventions are delivered by mentors, young women who grew up in the communities they serve and have received specialized DREAMS training to help build trust and rapport among program beneficiaries. DREAMS participants don’t just learn the facts about HIV prevention, they learn self-confidence and the skills to care for and advocate for themselves, which has proven invaluable as COVID-19 has stressed social structures, closed schools, threatened livelihoods and increased incidence of gender-based violence.

Because the DREAMS model relies on intensive, in-person relationships between mentors and clients and among adolescent girls and young women (AGYW), the lockdowns and social distancing requirements imposed as a response to COVID-19 posed a major challenge. But DREAMS was set up to provide comprehensive support using multiple channels — and programs were able to adapt creatively.

“We’ve found new ways to deliver services for our beneficiaries while respecting prevention measures,” says Adeline Manikuzwe, Technical Team Leader for Turengere Abana, a DREAMS program funded by PEPFAR through USAID and implemented by FXB Rwanda. “If groups of 15 are banned, but eight are allowed to gather, we reorganize into smaller groups. We create safe spaces outdoors. We make home visits. And we make every effort to reach out to our beneficiaries via phone calls and SMS messages to make sure they are safe and feel supported.”

DREAMS implementers have seen value in some of these adaptations, especially the use of digital platforms to keep in touch with participants. But they stress that significant gaps need to be filled to make sure that all their participants can benefit. In rural areas of Rwanda, only 10 percent of DREAMS participants have their own mobile phones, and while many more have access to a parent’s or guardian’s phone, these devices cannot provide them the confidentiality they may need to discuss sensitive sexual and reproductive health issues.

“It’s very meaningful when a girl receives a phone call from her mentor, because she understands that someone cares about her”, says Esron Niyonsaba, the USAID/Rwanda Orphans and Vulnerable Children (OVC) Specialist. “We really value these virtual platforms and need help from phone companies and other stakeholders in increasing the number of AGYW with access to their own mobile phones and airtime”.

The virtual check-ins have proven to be a critical lifeline during the pandemic. Just as important, DREAMS has persevered in offering safe small group activities. Like many young women, Violette continues to rely on these DREAMS gatherings for vital information, services and support.

“I am glad that I have helped prevent the spread of COVID-19 in my community and also made some income!” Violette says. “But I still regularly attend safe space activities with a DREAMS mentor and peers. The lessons we share there about reducing risk of HIV, unintended pregnancy and violence make me feel empowered enough to prevent HIV infection.”

The Rwanda DREAMS team contributed this story to Protecting Global Gains. Like others on this site, their story shows that the lessons learned through decades of work combating HIV and other diseases are also the key to fighting COVID-19.