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. Author manuscript; available in PMC: 2024 Jul 15.
Published in final edited form as: AIDS Educ Prev. 2023 Jul;35:20–38. doi: 10.1521/aeap.2023.35.suppA.20

TABLE 2.

Prevalence of DREAMS Eligibility Criteria Among HIV-Negative Adolescent Girls and Young Women Ages 13–24 years, by Age Group, Uganda (2015), Zimbabwe (2017), Cote d’Ivoire (2018), Lesotho (2018), Kenya (2019), Namibia (2019), and Mozambique (2019)

Ages 13–14 Years Ages 15–19 Years Ages 20–24 Years
DREAMS criteria Weighted % (95% CI)
n 		Weighted % (95% CI)
n 		Weighted % (95% CI)
n
Uganda (unweighted n) 620 1274 1224
 Ever had sexa 7.2 (3.1, 11.4)
36		 50.6 (45.6, 55.7)
645		 93.1 (90.4, 95.7)
1165
 History of pregnancyb 0.0 (0.0, 0.1)c
1		 25.7 (20.2, 31.1)
401		 75.2 (69.9, 80.4)
997
 Lifetime experience of sexual violenced 23.2 (16.2, 30.2)
173		 46.9 (42.0, 51.8)
567		 50.4 (45.8, 54.9)
617
 Physical or emotional violence in the past 12 monthsa, e 57.4 (49.6, 65.2)
396		 38.4 (32.3, 44.5)
593		 28.4 (23.6, 33.1)
368
 Early (13–14) or recent heavy alcohol use (15–19; 20–24)f 16.5 (10.5, 22.5)
72		 4.2 (1.9, 6.4)
46		 9.0 (5.7, 12.3)
87
 Out of schoolb,g 13.8 (7.8, 19.9)
84		 23.5 (18.6, 28.4)
325		 5.1 (2.5, 7.8)
122
 Orphanhoodb, h 21.3 (14.0, 28.6)
132		 21.9 (17.1, 26.7)
339		 28.5 (22.9, 34.0)
382
 Multiple sexual partners in the past 12 monthsi, j 32.1 (0.0, 73.2)c
5		 15.6 (7.9, 23.2)
46		 4.1 (2.1, 6.1)
41
 STIi, k 5.0 (1.4, 8.7)c
24		 9.1 (5.9, 12.4)
177		 20.1 (16.1, 24.2)
324
 Lifetime experience of transactional sexi, l 2.0 (0.0, 4.3)c
5		 19.0 (13.3, 24.6)
110		 17.3 (12.4, 22.2)
181
 No or irregular condom use in the past 12 monthsi, j, m 99.6 (98.7, 100.0)
15		 58.2 (49.8, 66.7)
254		 37.4 (31.3, 43.5)
402
 DREAMS eligible (1 or more criteria) 81.4 (75.9, 86.9)
507		 74.5 (69.5, 79.4)
964		 76.6 (72.2, 81.1)
947
 2 or more criteria 43.4 (34.1, 52.7)
277		 38.1 (32.9, 43.2)
547		 34.1 (29.1, 39.1)
480
Zimbabwe (unweighted n) 1311 3408 2945
 Ever had sexa 1.0 (0.4, 1.7)c
12		 26.9 (25.0, 28.8)
904		 81.6 (79.9, 83.2)
2401
 History of pregnancyb 0.1 (0.0, 0.3)c
1		 18.9 (17.3, 20.4)
631		 71.7 (69.7, 73.7)
2092
 Lifetime experience of sexual violenced 3.8 (2.8, 4.9)
51		 12.1 (10.8, 13.3)
412		 16.2 (14.7, 17.7)
487
 Physical or emotional violence in the past 12 monthsa, e 18.5 (15.9, 21.0)
237		 16.4 (15.0, 17.9)
571		 13.2 (11.8, 14.6)
389
 Early (13–14) or recent heavy alcohol use (15–19; 20–24)f 2.4 (1.5, 3.2)
35		 2.5 (1.9, 3.0)
93		 3.3 (2.7, 4.0)
107
 Out of schoolb, g 11.0 (9.0, 13.0)
143		 18.9 (17.3, 20.5)
634		 0.7 (0.3, 1.0)
20
 Orphanhoodb, h 26.4 (23.5, 29.2)
317		 32.1 (30.4, 33.9)
1023		 40.2 (38.1, 42.3)
1083
 Multiple sexual partners in the past 12 monthsi, j 0.0 (0.0, 0.0)
0		 2.3 (1.1, 3.5)
16		 2.7 (2.0, 3.3)
58
 STIi, k 0.6 (0.2, 0.9)c
9		 1.0 (0.7, 1.3)
35		 3.3 (2.5, 4.0)
89
 Lifetime experience of transactional sexi, l 23.0 (0.0, 50.5)c
2		 4.3 (2.8, 5.8)
37		 3.7 (2.9, 4.5)
89
 No or irregular condom use in the past 12 monthsi, j, m 34.4 (0.0, 70.9)c
3		 21.9 (18.4, 25.3)
161		 13.5 (11.9, 15.1)
284
DREAMS eligible (1 or more criteria) 47.0 (43.8, 50.1)
607		 57.7 (55.8, 59.5)
1956		 28.1 (26.3, 29.9)
838
2 or more criteria 11.3 (9.5, 13.1)
147		 23.0 (21.3, 24.7)
775		 6.4 (5.4, 7.4)
193
Cote d’Ivoire (unweighted n) 208 502 485
 Ever had sexa 10.3 (5.7, 15.0)
27		 60.3 (54.1, 66.5)
309		 93.4 (90.4, 96.4)
461
 History of pregnancyb 1.3 (0.0, 3.0)c
3		 24.6 (18.3, 30.9)
147		 68.8 (60.6, 77.0)
363
 Lifetime experience of sexual violenced 18.4 (12.2, 24.6)
34		 29.1 (23.3, 34.8)
148		 41.1 (35.2, 47.0)
172
 Physical or emotional violence in the past 12 montha, e 57.3 (48.3, 66.3)
108		 46.6 (39.7, 53.5)
211		 40.1 (33.3, 46.8)
170
 Early (13–14) or recent heavy alcohol use (15–19; 20–24)f 15.0 (5.4, 24.6)c
27		 11.6 (7.7, 15.5)
56		 20.2 (15.1, 25.4)
85
 Out of schoolb, g 21.0 (14.3, 27.7)
47		 13.7 (9.7, 17.6)
83		 27.1 (21.6, 32.5)
160
 Orphanhoodb, h 11.5 (5.5, 17.4)
27		 23.7 (18.6, 28.9)
118		 32.5 (24.7, 40.3)
152
 Multiple sexual partners in the past 12 monthsi, j 4.9 (0.0, 14.7)c
1		 5.6 (2.4, 8.8)
19		 7.9 (4.7, 11.2)
23
 STIi, k 5.8 (1.2, 10.5)c
8		 6.5 (3.6, 9.5)
35		 12.0 (7.1, 17.0)
59
 Lifetime experience of transactional sexi, l 11.0 (0.0, 30.4)c
2		 7.0 (1.9, 12.0)c
22		 10.7 (5.6, 15.8)
40
 No or irregular condom use in the past 12 monthsi, j, m 58.5 (24.2, 92.8)
13		 55.0 (44.8, 65.1)
155		 33.8 (27.4, 40.1)
150
 DREAMS eligible (1 or more criteria) 75.4 (66.3, 84.5)
155		 73.9 (68.3, 79.4)
392		 64.4 (58.8, 70.0)
297
 2 or more criteria 43.7 (32.6, 54.7)
82		 44.4 (37.4, 51.4)
237		 33.5 (28.0, 38.9)
143
Lesotho (unweighted n) 1,486 3,218 2,397
 Ever had sexa 2.4 (1.4, 3.3)
34		 41.7 (39.0, 44.3)
1159		 86.8 (84.9, 88.7)
1895
 History of pregnancyb 0.2 (0.0, 0.4)c
2		 14.9 (12.9, 16.9)
420		 53.6 (50.3, 56.8)
1204
 Lifetime experience of sexual violenced 5.3 (3.7, 6.9)
68		 18.2 (16.2, 20.2)
500		 25.3 (22.5, 28.1)
507
 Physical or emotional violence in the past 12 monthsa, e 36.1 (32.3, 40.0)
490		 37.7 (34.3, 41.1)
1100		 31.9 (29.0, 34.9)
676
 Early (13–14) or recent heavy alcohol use (15–19; 20–24)f 7.2 (5.5, 8.9)
102		 2.3 (1.7, 2.9)
69		 9.2 (7.4, 11.0)
181
 Out of schoolb, g 4.0 (2.7, 5.3)
59		 12.8 (11.2, 14.4)
415		 1.4 (0.8, 2.0)
34
 Orphanhoodb, h 36.0 (32.8, 39.2)
472		 44.4 (42.2, 46.6)
1221		 46.2 (43.0, 49.4)
950
 Multiple sexual partners in the past 12 monthsi, j 3.1 (0.0, 9.2)c
1		 8.5 (6.5, 10.6)
91		 11.0 (9.0, 13.0)
168
 STIi, k 0.1 (0.0, 0.2)c
1		 2.0 (1.4, 2.7)
59		 6.2 (5.0, 7.3)
139
 Lifetime experience of transactional sexi, l 9.6 (0.0, 23.1)c
2		 4.9 (3.1, 6.7)
50		 5.0 (3.9, 6.1)
89
 No or irregular condom use in the past 12 monthsi, j, m 45.4 (21.8, 69.0)
10		 27.4 (23.8, 31.0)
264		 24.6 (22.1, 27.1)
386
 DREAMS eligible (1 or more criteria) 61.0 (57.3, 64.6)
850		 64.2 (62.0, 66.5)
1876		 46.3 (43.3, 49.2)
957
 2 or more criteria 22.5 (19.4, 25.6)
298		 28.2 (26.1, 30.3)
806		 17.5 (15.3, 19.7)
343
Kenya (unweighted n) 285 604 441
 Ever had sexa 6.2 (2.0, 10.3)
10		 25.6 (21.2, 30.0)
164		 77.9 (72.5, 83.3)
344
 History of pregnancyb 0.0 (0.0, 0.0)
0		 11.2 (8.1, 14.2)
72		 55.0 (48.7, 61.2)
258
 Lifetime experience of sexual violenced 14.7 (9.9, 19.5)
37		 25.8 (21.0, 30.5)
151		 29.5 (25.1, 33.8)
121
 Physical or emotional violence in the past 12 monthsa, e 57.0 (51.1, 62.9)
158		 50.7 (45.4, 56.1)
309		 49.2 (43.8, 54.7)
203
 Early (13–14) or recent heavy alcohol use (15–19; 20–24)f 1.6 (0.1, 3.0)c
5		 3.3 (1.1, 5.5)c
15		 4.3 (1.6, 6.9)c
17
 Out of schoolb, g 1.8 (0.2, 3.3)c
12		 9.5 (5.6, 13.3)
62		 5.1 (2.8, 7.4)
39
 Orphanhoodb, h 15.1 (9.6, 20.7)
36		 18.3 (13.8, 22.8)
115		 23.9 (19.3, 28.6)
96
 Multiple sexual partners in the past 12 monthsi, j 3.4 (0.9, 5.8)c
1		 5.5 (0.9, 10.2)c
7		 5.1 (2.5, 7.8)
13
 STIi, k 0.0 (0.0, 0.0)
0		 0.8 (0.0, 1.5)c
5		 3.3 (1.6, 4.9)
17
 Lifetime experience of transactional sexi, l 0.0 (0.0, 0.0)
0		 12.3 (5.2, 19.4)
21		 8.3 (4.0, 12.6)
29
 No or irregular condom use in the past 12 monthsi, j, m 51.5 (5.6, 97.4)c
4		 41.3 (30.3, 52.3)
53		 29.1 (23.2, 35.0)
74
 DREAMS eligible (1 or more criteria) 65.0 (58.6, 71.3)
184		 52.1 (46.8, 57.4)
316		 45.0 (40.2, 49.8)
187
 2 or more criteria 25.0 (19.5, 30.6)
62		 19.2 (14.9, 23.4)
122		 15.1 (11.1, 19.0)
59
Namibia (unweighted n) 745 1,711 1,580
 Ever had sexa 3.9 (2.4, 5.5)
39		 40.5 (35.9, 45.1)
754		 90.2 (88.3, 92.1)
1380
 History of pregnancyb 0.3 (0.1, 0.6)c
8		 15.3 (12.4, 18.2)
252		 56.5 (51.6, 61.4)
878
 Lifetime experience of sexual violenced 10.6 (5.2, 16.0)
76		 19.3 (15.2, 23.4)
301		 24.6 (21.1, 28.1)
326
 Physical or emotional violence in the past 12 monthsa, e 49.5 (42.5, 56.5)
317		 44.8 (40.5, 49.0)
675		 18.2 (15.6, 20.7)
271
 Early (13–14) or recent heavy alcohol use (15–19; 20–24)f 20.6 (15.6, 25.7)
115		 9.6 (7.2, 12.0)
152		 18.2 (15.6, 20.7)
271
 Out of schoolb, g 2.7 (1.0, 4.5)c
23		 5.5 (4.1, 6.8)
113		 2.5 (1.0,4.1)c
66
 Orphanhoodb, h 18.8 (14.1, 23.6)
139		 22.9 (19.6, 26.2)
412		 31.8 (27.4, 36.2)
467
 Multiple sexual partners in the past 12 monthsi, j 4.3 (0.0, 12.1)c
2		 10.0 (5.5, 14.5)
46		 8.0 (5.6, 10.4)
78
 STIi, k 0.8 (0.0, 2.5)c
2		 0.7 (0.1, 1.3)c
14		 2.8 (1.8, 3.9)
37
 Lifetime experience of transactional sexi, l 4.6 (0.0, 10.4)c
4		 3.6 (1.3, 5.8)c
37		 3.6 (2.6, 4.7)
53
 No or irregular condom use in the past
12 monthsi, j, m 		33.8 (19.2, 48.4)
15		 46.6 (39.6, 53.7)
278		 52.3 (47.1, 57.4)
605
 DREAMS eligible (1 or more criteria) 70.6 (65.2, 76.0)
457		 53.4 (49.6, 57.2)
969		 61.3 (57.0, 65.5)
937
 2 or more criteria 26.8 (21.0, 32.6)
184		 23.1 (20.2, 26.1
405		 20.8 (18.6, 22.9)
303
Mozambique (unweighted n) 371 904 757
 Ever had sexa 20.5 (11.2, 29.9)
45		 67.7 (61.7, 73.7)
624		 95.6 (93.1, 98.2)
733
 History of pregnancyb 3.5 (0.6, 6.4)c
9		 43.4 (38.1, 48.7)
388		 81.8 (76.6, 87.0)
647
 Lifetime experience of sexual violenced 15.2 (11.0, 19.4)
44		 22.3 (17.3, 27.2)
167		 23.1 (18.5, 27.6)
130
 Physical or emotional violence in the past 12 monthsa, e 32.9 (25.5, 40.3)
96		 27.9 (23.5, 32.2)
211		 22.5 (18.0, 27.0)
163
 Early (13–14) or recent heavy alcohol use (15–19; 20–24)g 1.4 (1.1, 1.7)
6		 4.8 (2.1, 7.5)
35		 9.2 (5.4, 13.1)
60
 Out of schoolb, g 28.2 (21.7, 34.7)
93		 31.0 (26.3, 35.7)
277		 10.0 (7.1, 13.0)
68
 Orphanhoob, h 24.3 (18.3, 30.3)
86		 25.3 (20.7, 29.9)
249		 26.4 (20.8, 32.1)
209
 Multiple sexual partners in the past 12 monthsi, j 4.4 (0.0, 10.1)
3		 6.9 (3.3, 10.6)
25		 5.8 (2.4, 9.2)
31
 STIi, k 0.1 (0.0, 0.2)c
1		 2.4 (1.4, 3.5)
25		 4.5 (1.7, 7.3)c
36
 Lifetime experience of transactional sexi, l 10.1 (0.6, 19.6)c
6		 7.4 (3.1, 11.6)
41		 3.5 (1.5, 5.4)
28
 No or irregular condom use in the past
12 monthsi, j, m 		43.1 (26.4, 59.7)
20		 27.5 (21.4, 33.6)
150		 25.3 (18.6, 32.0)
135
 DREAMS eligible (1 or more criteria) 72.0 (64.7, 79.3)
226		 78.1 (73.4, 82.8)
719		 43.7 (37.2, 50.3)
296
 2 or more criteria 34.2 (26.6, 41.7)
96		 44.5 (39.2, 49.8)
389		 14.1 (9.5, 18.6)
85

Note. DREAMS = Determined, Resilient, Empowered, AIDS-Free, Mentored, and Safe. aRisk factor only represents an eligibility criterion for the 10–14-year age group in DREAMS and thus is not included in overall eligibility estimates for the 15–19-year or 20–24-year age groups in this analysis; bRisk factor only represents an eligibility criterion for the 10–14 year and 15–19-year age band in DREAMS and thus is not included in overall eligibility estimates for the 20–24-year age groups in this analysis; c>30% relative standard error (RSE); dSexual violence included any experience of forced or pressured sex, attempted forced sex, or unwanted sexual touching by any person; ePhysical violence included any experience of slapping, punching, kicking, whipping, beating with an object, and threats or use of a knife gun or other weapon by a parent or other adult caregiver, a peer, or an intimate partner. For Uganda and Zimbabwe, the questionnaire only asked about emotional violence by parents and other adult caregivers. In all other countries, questions about emotional violence by parents and adult caregivers, intimate partners, and peers were included. For emotional violence by a parent, the measure included calling names, telling the child they were not loved or did not deserve to be loved, or were useless or stupid. Emotional violence by an intimate partner included insulting, humiliating, or making fun of them, keeping them from owning their own money, trying to keep them from seeing family or friends, keeping track of them or demanding to know what they were doing, or making threats to physically harm them. Emotional violence by a peer included making them feel really bad through name calling, saying mean things, or saying they did not want them around, telling lies, spreading rumors, or trying to make others dislike them, keeping them out of things on purpose, excluding them from a group of friends, or ignoring them. The questions on physical and emotional violence differed slightly based on individual VACS country questionnaires; fEarly alcohol use was defined as any alcohol use in the lifetime for those ages 13–14 years and recent heavy alcohol use was defined as 4 drinks in a row at any time in the past 30 days; gOut of school refers to not currently attending school for AGYW ages 13–17 and never attending school for those 18–24 years old; hOrphanhood includes the death of a biological mother or father (single orphan) or both (double orphan) before age 18; iRisk factor only represents an eligibility criterion for the 15–19-year and 20–24-year age groups in DREAMS and thus is not included in overall eligibility estimates for the 13–14-year age group in this analysis; jAmong those who had sex in the past 12 months; kAny lifetime sexually transmitted infection diagnosis; lEver exchanging sex for food, money, goods, or other favors among those who had sex; mIrregular condom use includes those who sometimes or never used a condom with a nonmarital partner or with any partner if more than one sexual partner for those who are married, among those who had sex in the past 12 months. Values in bold denote estimates that represent eligibility criteria for that age group.