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Background: Daily oral preexposure prophylaxis (PrEP) is one strategy employed to decrease HIV transmission among adolescent girls and young women (AGYW). The Determined, Resilient, Empowered, AIDS-Free, Mentored, and Safe (DREAMS) program, funded by PEPFAR/USAID and implemented by the Project HOPE Namibia (PHN)-led consortium, provided services in the Khomas, Oshikoto, Zambezi, and Oshana regions. This study assessed the one-month PrEP retention rate among AGYW 15–24 and the associated factors. Methods: The program’s target populations for PrEP included AGYW aged 15–24 years who were at substantial risk for HIV, tested HIV-negative, and resided in the regions where the PHN-led consortium was implementing the DREAMS program. Data between 2018 and 2024 were exported from DHIS2 to IBM SPSS version 29 for secondary data analysis. We analyzed the data using Chi-squared tests and binomial and multinomial logistic regression. Results: Among the 17,277 participants newly initiated on oral PrEP and included in this study, only 2466 returned on time for their one-month appointment. The one-month PrEP retention rate among AGYW was 14.3%, 95% CI (13.8–14.8%). The most common reasons for PrEP discontinuation were traveling away from home, not needing PrEP anymore, forgetfulness, and side effects. Participants from Oshakati and Onandjokwe exhibited a higher likelihood of one-month PrEP retention. Additionally, participants who were in the programs for 7–12 months or over 36 months, who attended the safe space HIV prevention sessions, who were unaware of their partners’ HIV status, and who considered themselves at risk of HIV also exhibited a lower likelihood of one-month PrEP retention. In contrast, individuals who had 1–2 children and those who were either pregnant or breastfeeding exhibited a higher likelihood of one-month PrEP retention, (COR) = 1.28, 95% CI (1.15–1.43), and COR = 2.00, 95% CI (1.62–2.46), respectively. Conclusions: Targeted, innovative, and context-specific strategies should be developed to support AGYW in identifying their HIV risk and continuing the use of daily oral PrEP during periods of heightened risk. Additionally, prioritizing the introduction of discreet, long-acting PrEP options that require less frequent administration may better align with their needs and preferences.

Background: Adolescent girls and young women (AGYW) who engage in alcohol and substance abuse face more significant health and social consequences compared to the general population. This study evaluated the prevalence and associated factors of alcohol abuse and substance use among AGYW in Namibia. Methods: We conducted a retrospective analysis of programmatic data from AGYW aged 10–24 who participated in the Determined, Resilient, Empowered AIDS-free, Mentored, and Safe (DREAMS) component of the Reducing HIV Vulnerability: Integrated Child and Youth Health (REACH) Project HOPE Namibia from March to December 2024. Data analysis was conducted employing chi-squared tests alongside binomial and multinomial logistic regression. Results: Among the 19,662 participants included in this analysis, 2068 (10.5%) abused alcohol and/or substances in the previous six months. Participants who were HIV-negative or did not know their status (AOR = 1.57, 95% CI (1.15–2.14), and AOR = 1.50, 95% CI (109–2.07), respectively), from outside Windhoek, those who had failed or repeated school in the previous year (COR = 1.77, 95% CI (1.54–2.05)), those not disabled (AOR = 1.27, 95% CI (1.06–1.52)), those who had dropped out of school or had completed their studies, and those with no adult emotional support (AOR = 1.25, 95% CI (1.11–1.40)), were more likely to have abused alcohol and/or substances recently. In contrast, participants who were not depressed were less likely to have recently abused alcohol and substances. Conclusions: The prioritization of strategies to identify AGYW experiencing depression and to provide them with treatment is essential. Moreover, it is important to encourage parents and guardians to provide emotional support to AGYW, as it prevents them from abusing alcohol and substances.

Background: Namibia is experiencing a generalized HIV epidemic, with 7.5% of the population living with HIV. Adolescent girls and young women (AGYW) aged 15–24 account for 28.6% of new infections annually. Various factors increase AGYW’s vulnerability to HIV. To address this, Project HOPE Namibia (PHN)-led consortium implemented the PEPFAR/USAID-funded DREAMS project in Khomas, Oshikoto, and Zambezi regions from 2018 to 2023. This study estimated the AGYW population most in need of HIV prevention and assessed geographic and age-specific gaps to improve program effectiveness and efficiency. Methods: This secondary data analysis utilized the Namibia Population-Based HIV Impact Assessment (NamPHIA) 2017, the Namibia census, and service data from the DREAMS project, which includes entry points for recruitment, screening, and enrolment. We used Python to conduct unadjusted and adjusted Poisson regression and UpSet plots for data visualization. Results: Analysis of NamPHIA data revealed low HIV prevalence in 10–14-year-olds, with only Oshikoto showing a detectable rate of 2.76%, mostly attributed to perinatal HIV transmission. Of the 12 DREAMS eligibility criteria, three could be mapped to 10–14-year-olds, while all except sexually transmitted infections could be mapped for 15–19 and 20–24-year-olds. Nationally, 17.3% of 10–14-year-old AGYW, 48.0% of 15–19-year-olds, and 50% of 20–24-year-olds met at least one DREAMS eligibility criterion. Among 15–19-year-olds, a history of pregnancy, no/irregular condom use, and out-of-school status were positively associated with HIV status. For 20–24-year-olds, transactional sex was positively associated with HIV status. Overall, 62% of screened individuals were eligible, and 62% of eligible individuals enrolled. PHN screened 134% of the estimated 37,965 10–14-year-olds, 95% of the estimated 35,585 15–19-year-olds, and 57% of the 24,011 20–24-year-olds residing in the five districts where DREAMS was implemented. Conclusions: We recommend the refinement of the DREAMS eligibility criteria, particularly for AGYW 10–14, to better identify and engage those at risk of HIV acquisition through sexual transmission. For 15–19-year-olds, PHN efforts should interrogate geographic variability in entry points for recruitment and screening practices. PHN should enhance the recruitment and engagement of AGYW 20–24, with a particular focus on those engaged in transactional sex.

Tuberculosis (TB) is one of the top-ranking causes of death in many countries, including Namibia. The purpose of this research study was to determine the knowledge and the attitudes of religious leaders and congregants regarding TB and to describe practices of TB prevention among religious leaders and congregants in Khomas Region, Namibia. The researcher developed strategies for enhancing the prevention of TB by religious leaders in Khomas Region, Namibia. The Health Belief Model and the Socio-ecological Model were adopted for the study.A mixed-method convergent design was used in this study. Phase one of the study involved the use of a quantitative descriptive design and phase two comprised a sequential mixed-method study using the Delphi technique. Explorative, descriptive and contextual designs were applied in phase two. Data were collected using semi-structured questionnaires in both phase one and phase two. Phase one included 299 participants and phase two included 100 experts in TB and religion. A quantitative data analysis was done using Moon Stats 2018, version 2.0. A qualitative data analysis was done following the steps of content analysis.This study found that the participants were very knowledgeable about TB in that 241 (80.87%) participants indicated that bacteria are the cause of TB and 292 (97.99%) indicated that TB bacteria are spread through the air from one person to another. The participants had a good attitude towards TB in that 227 (76.65%) participants agreed that anyone can be infected with TB and 140 (47.78%) expressed compassion for people who have TB. Participants of the study had good practices for TB prevention, like seeking medical attention if they suspect they have TB. A total of 28 strategies for the primary, secondary and tertiary prevention of TB were developed.The recommendation made in this study is that religious leaders should be at the forefront of TB prevention activities due to their sphere of influence in society. All health sector stakeholders should support efforts by religious leaders to combat TB through sponsorships.

Background: Namibia is experiencing a generalized HIV epidemic, with 7.5% of the population living with HIV. Adolescent girls and young women (AGYW) aged 15–24 account for 28.6% of new infections annually. Various factors increase AGYW’s vulnerability to HIV. To address this, Project HOPE Namibia (PHN)-led consortium implemented the PEPFAR/USAID-funded DREAMS project in Khomas, Oshikoto, and Zambezi regions from 2018 to 2023. This study estimated the AGYW population most in need of HIV prevention and assessed geographic and age-specific gaps to improve program effectiveness and efficiency. Methods: This secondary data analysis utilized the Namibia Population-Based HIV Impact Assessment (NamPHIA) 2017, the Namibia census, and service data from the DREAMS project, which includes entry points for recruitment, screening, and enrolment. We used Python to conduct unadjusted and adjusted Poisson regression and UpSet plots for data visualization. Results: Analysis of NamPHIA data revealed low HIV prevalence in 10–14-year-olds, with only Oshikoto showing a detectable rate of 2.76%, mostly attributed to perinatal HIV transmission. Of the 12 DREAMS eligibility criteria, three could be mapped to 10–14-year-olds, while all except sexually transmitted infections could be mapped for 15–19 and 20–24-year-olds. Nationally, 17.3% of 10–14-year-old AGYW, 48.0% of 15–19-year-olds, and 50% of 20–24-year-olds met at least one DREAMS eligibility criterion. Among 15–19-year-olds, a history of pregnancy, no/irregular condom use, and out-of-school status were positively associated with HIV status. For 20–24-year-olds, transactional sex was positively associated with HIV status. Overall, 62% of screened individuals were eligible, and 62% of eligible individuals enrolled. PHN screened 134% of the estimated 37,965 10–14-year-olds, 95% of the estimated 35,585 15–19-year-olds, and 57% of the 24,011 20–24-year-olds residing in the five districts where DREAMS was implemented. Conclusions: We recommend the refinement of the DREAMS eligibility criteria, particularly for AGYW 10–14, to better identify and engage those at risk of HIV acquisition through sexual transmission. For 15–19-year-olds, PHN efforts should interrogate geographic variability in entry points for recruitment and screening practices. PHN should enhance the recruitment and engagement of AGYW 20–24, with a particular focus on those engaged in transactional sex.

The purpose of this study was to explore the factors that contributed to the contraction of Tuberculosis (TB) amongst the patients who were newly diagnosed with TB at Katutura TB state hospital Windhoek, Namibia. Quantitative, descriptive research was conducted to explore the factors that contributed to contraction of TB among the newly diagnosed patients. Data was collected using questionnaires from 8th June 2016 to the 8th September 2016. The respondents were the newly diagnosed TB patients (n=40) admitted at Katutura TB state hospital. The findings revealed that there is a change in gender infection rate, men are now on the forefront, comprising 57.5% (n=23) of the sample surveyed. Furthermore, some other factors emerged on the study like TB stigma, poor nutrition, and lack of education. However, some factors are very controversial such as accommodation and sanitation as they need to be explored more to see their influence on TB infection rate