Sentinel Survey on HIV Outcome – a wakeup call for Namibia

In Namibia, HIV prevalence has shifted from young women to older women, a recent study has revealed.

The finding came out in a Sentinel Survey on HIV prevalence conducted last year among pregnant women who attended antennal care at public health centres throughout the country.
According to the survey conducted the Ministry of Health and Social Services at 34 health districts in all 13 administrative regions, HIV prevalence is highest among women aged 35 to 39 and lower among women aged 15 to 19 years and women aged 20 to 24 years.
The shift is a result of the successful expansion of national antiretroviral treatment (ART) programme, as evidenced by the fact that nearly half of all women that tested HIV positive were already on ART before the survey.
Namibia has made major strides in efforts to curb the spread of HIV/AIDS and is working towards zero new HIV infections, which point to zero AIDS-related death.
However, the finding by the sentinel survey on HIV prevalence is something that we must take seriously.
It indicates that in our ongoing battle against the HIV/AIDS pandemic, we have somehow taken things for granted – by paying too much attention to the younger generation and leaving behind the older generation.
The survey exposed an oversight that we somehow assumed that older people are well equipped with enough knowledge about HIV/AIDS.
The fact that there is lower HIV prevalence among pregnant younger women is an indication that preventative programmes in Namibia are bearing fruits – and that knowledge about HIV/AIDS among our youth has improved.
They are aware of the danger of HIV and how to prevent themselves from contracting the virus.
This is not surprising because HIV/AIDS awareness campaigns have been tailored towards the young people, and health workers and doctors are more inclined to talk to young people about their sex lives.
Unfortunately, the same cannot be said about the older generation, as was pointed out in the 2012 National Survey on HIV Prevalence by the Ministry of Health and Social Services.
So, why is this the case if most young people are dependent on the guidance of their parents when it comes to life’s challenges, including how to deal with HIV/AIDS?
Several factors might be responsible, for instance, lack of information. Most older women are aware of HIV/AIDS-related information, but do they really comprehend what is being communicated to them?
They also have to deal stigma not only related to HIV/AIDS but also related to cultural norms like openly discussing sexual issues.
I believe it is also because of this stigma surrounding HIV/AIDS in our communities that most of them do not go for voluntary testing.
From my experience, I’ve realised that due to lack of information, in most cases, older people end up ignoring signs of HIV/AIDS for other ailments, than their younger counterparts.
In order to reverse this unfortunate situation, I suggest that health workers including medical practitioners become frank with our older generations in discussing issues seen as a taboo, for example, how to use contraception to prevent HIV/AIDS and other sex related issues.
I believe as a country, the findings of the National Sentinel Survey on HIV prevalence must be a wakeup call that we need to take along our older generation with regard to HIV/AIDS prevention. Otherwise, our investment in the fight will be in vain.
UNAIDS Country Co-ordinator, Henk van Renterghem, has also warned Namibia against being complacent in this regard. Speaking during the announcement of the HIV Sero Sentinel Survey in Khomas region in Windhoek last week, Van Renterghem said the reduction of HIV prevalence among 15-24-year-olds is an indication that prevention efforts in addressing sexual transmission of HIV in the region are bearing fruits.
He said although this is worth a celebration, the country needs to review its intervention strategies in terms of resource mobilisation, partnership network, exchange activities and sharing best practices as well as advocacy and information dissemination.
Namibia is among the United Nations member states that agreed to meet the 10 targets by 2015, as parts of a Political Declaration of the June 2011 Geneva Assembly held in New York.
Having made that commitment, we are expected to annually monitor our progress towards universal access target and this year there will be a review on National Strategic Framework for HIV/AIDS as well as the UN 2011 Political Declaration.
These targets include reducing of sexual transmission of HIV by half, eliminating vertical transmission of HIV and reducing AIDS maternal mortality by half as well as universal access to ART for eligible people living with HIV and AIDS.

March 2013
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