Longitudinal Assessment of Health Knowledge, Life Skills, and Gender‐Based Violence Awareness Among Adolescent Girls and Young Women: Insights From the Dreams Experience in Central Uganda

Background Adolescent girls and young women (AGYW) in Uganda face disproportionate HIV and gender‐based violence (GBV) risks. The determined, resilient, empowered, AIDS‐free, mentored, and safe (DREAMS) program delivers layered biomedical, behavioral, and structural support, yet evidence of sustained benefit is limited. Methods Secondary data from 2829 DREAMS beneficiaries aged 9–28 years in four central districts were analyzed. Participants completed baseline and two six‐monthly follow‐ups (2022‐2023). A single‐group longitudinal quasiexperimental design assessed changes in health knowledge and practices (HKP), personal life skills (PLS), and knowledge/awareness of GBV (KAGBV). Mixed‐effects linear models tested time effects and interactions with age, district, and schooling/marital status. Results Scores improved significantly from baseline to 12 months ( p < 0.001): HKP + 6.9, PLS + 2.4, and KAGBV + 12.4 points. Older AGYW (20–28 years) gained more than 9‐ to 14‐year‐olds (age × time p = 0.002). Kassanda and Mityana showed the largest HKP increases; Luwero started lowest but matched peers by follow‐up. Married, out‐of‐school participants outperformed in‐school peers on HKP and PLS. Key indicators rose markedly: HIV‐transmission knowledge + 30%, condom‐negotiation confidence + 25%, and GBV‐service awareness + 40%. Conclusions One year of DREAMS participation produced substantial, sustained gains in health knowledge, life skills, and GBV awareness among Ugandan AGYW, with differential benefits by age, district, and schooling/marital profile. Scale‐up should combine age‐appropriate content for younger girls with focused support in lagging districts to ensure equitable impact.