Twenty-two years into the HIV epidemic, Namibia is developing a response that is based on increasing
amounts of evidence. Information on the trends and distribution of HIV prevalence are available from
the HIV Sentinel Surveillance among pregnant women attending antenatal clinics. Data on services
provided such as the number of people receiving anti-retroviral therapy or the number of pregnant
women receiving anti-retroviral prophylaxis are available from routine health information systems.
Information which is also critical to our understanding of the epidemic are estimates and projections
of the numbers of people living with HIV and in need of treatment. UNAIDS and partners have
developed modeling software which create estimates and projections based on available information
from sentinel surveillance and programme data. These estimates can then be used for advocacy, to
inform planning, and to guide decision-making.
The Estimation and Projections Package (EPP) model calculates national HIV prevalence based on
ANC HIV prevalence and other information. (The current round of estimates and projections
include the 2006 HIV Sentinel Surveillance results.) The results of EPP are fed into another
modeling software called Spectrum. Using national demographic data, programme coverage data,
and assumptions of future programme coverage, patient retention, and survival, Spectrum estimates
the number of people newly infected, number of people living with HIV, the number of women who
will need PMTCT services, and the number of people in need of ART. The model can project these
estimates for up to five years into the future, beyond that period the estimates become unreliable.
The models also provide confidence bounds to reflect our certainty around the estimates.
The results of the models suggest that estimated adult (ages 15-49) HIV prevalence in 2007/08 was
15.4 percent. HIV prevalence is estimated to remain stable at around 15 to 16 percent assuming
there are no significant changes to HIV prevention activities. Despite stabilizing HIV prevalence, the
number of people living with HIV will continue to increase as the total population size in that age
range grows. In 2007/08 approximately 204,000 people were living with HIV while in 2012/13 this
value is predicted to be 247,000 people.
In 2007/08 approximately 14,100 people are newly infected with HIV. This translates to about 39
new infections per day. Of the new infections, about 44 percent are among young people ages 15-
24, 77 percent of which are among young women. In 2007/08 9,400 women were in need of PMTCT
services. This number will grow to 10,200 by 2012/13.
Namibia has made remarkable strides to roll out ART services to those in need. However the
number in need of treatment is still increasing: from 69,500 to 114,500 by 2012/13. This includes
5,900 children under the age of 14 who are in need of treatment in 2007/08. Despite the rollout of
ARVs the number of people dying of AIDS related causes will continue to grow. This is due to the
increasing numbers of people on treatment who might default or have adverse reactions as well as
the increasing ages of those on treatment. This highlights the importance of programmes to improve
adherence and patient retention in the ART services.
This report presents our best current understanding of the HIV epidemic in Namibia.