Changing hearts and minds: Results from a multi-country gender and sexual diversity training

Engaging key populations, including gender and sexual minorities, is essential to meeting global targets for reducing new HIV infections and improving the HIV continuum of care. Negative attitudes toward gender and sexual minorities serve as a barrier to political will and effective programming for HIV health services. The President’s Emergency Plan for AIDS Relief (PEPFAR), established in 2003, provided Gender and Sexual Diversity Trainings for 2,825 participants including PEPFAR staff and program implementers, U.S. government staff, and local stakeholders in 38 countries. The outcomes of these one-day trainings were evaluated among a subset of participants using a mixed methods pre- and post-training study design. Findings suggest that sustainable decreases in negative attitudes toward gender and sexual minorities are achievable with a one-day training

The DREAMS core package of interventions: A comprehensive approach to preventing HIV among adolescent girls and young women.

In sub-Saharan Africa, adolescent girls and young women (AGYW) are 5 to 14 times more likely to be infected with HIV than their male peers. Every day, more than 750 AGYW are infected with HIV. Many factors make girls and young women particularly vulnerable to HIV, including gender-based violence, exclusion from economic opportunities, and a lack of access to secondary school. The President's Emergency Plan for AIDS Relief (PEPFAR) is dedicating significant resources through the Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe (DREAMS) partnership to impact the lives of women and girls based on PEPFAR's mission to help countries achieve epidemic control of HIV/AIDS. The data show that new HIV infections must be reduced in AGYW, or the global community risks losing the extensive progress made towards reaching epidemic control. With support from PEPFAR and private sector partners-the Bill & Melinda Gates Foundation, Gilead Sciences, Girl Effect, Johnson & Johnson and ViiV Healthcare, DREAMS works together with partner governments to deliver a core package of interventions that combines evidence-based approaches that go beyond the health sector, addressing the structural drivers that directly and indirectly increase girls' HIV risk. Not only is DREAMS an effort to reduce new HIV infections, but it aims to reduce other critical vulnerabilities such as gender-based violence. When girls and young women thrive, the effects are felt throughout their families, communities and countries

Percent of respondents who agree and strongly agree with statements.

<p>Percent of respondents who agree and strongly agree with statements.</p

Demographics of training participants.

<p>Demographics of training participants.</p

Multivariable ordinal logistic regression models of factors associated with attitudes toward gender and sexual minorities.

<p>Multivariable ordinal logistic regression models of factors associated with attitudes toward gender and sexual minorities.</p

Illustrative quotes of participant changes after gsd training.

<p>Illustrative quotes of participant changes after gsd training.</p

Study design for gender and sexual diversity training.

<p>Study design for gender and sexual diversity training.</p

Average scale scores from pre-training, post-training, and 3–6 month follow-up.

<p>Average scale scores from pre-training, post-training, and 3–6 month follow-up.</p