Abstract
The Human Immunodeficiency Virus (HIV) continues to be a leading cause of mortality in Namibia, with a prevalence rate of 11.6%, making the country the sixth highest globally. The administration of Pre-Exposure Prophylaxis (PrEP) plays a crucial role in reducing the spread of HIV. When taken daily, PrEP can reduce the risk of HIV infection by up to 99%. Healthcare workers are instrumental in managing the disease and providing PrEP services. Development Aid from People to People (DAPP)-Total Control of the epidemic (TCE) field officers, as community health workers, operate across all 11 regions of Namibia to identify, educate, and refer HIV-negative individuals at risk of infection for PrEP. However, gaps in knowledge, attitudes, and practices among DAPP-TCE field officers may significantly affect the implementation of PrEP programmes.
The study aimed to assess the knowledge, attitudes, and practices of field officers and identify potential barriers to implementing PrEP activities within DAPP-TCE.
The study was conducted within Namibia four regions, Oshana, Oshikoto, Omusati, and Ohangwena. The study utilised a mixed-methods approach to examine PrEP utilisation among DAPP-TCE field officers. Using convenience sampling, the quantitative phase recruited 133 DAPP-TCE field officers obtained from a total of 203 working within the four regions for quantitative data. The qualitative arm used purposive sampling to recruit 20 respondents guided by data saturation. Data collection involved questionnaires and focus group interviews. The study’s socio-demographic variables or characteristics’ were analysis using Chi-square and the data was presented using percentages and frequencies. Bivariate and multivariate logistic regression were used to assess the association between respondent’s characteristics’ and the main outcome variable knowledge, attitudes and practice using odds ratios, 95 confidence interval and, variables (p ≤ 0.05). Thematic analysis was applied to qualitative data to provide deeper insights into contextual factors influencing PrEP uptake and to develop themes and subthemes.
Most of the respondents were drawn from Ohangwena (91%), followed by Oshikoto (25.5 %), Omusati (23, 4 %), and Oshana (12.4 %). The respondents were predominantly female (69.4 %)Village setting constituted most of the respondents (79%) than those from town setting (53 %). DAPP–TCE field officers generally possessed adequate knowledge of PrEP (86.2 %) particularly its purpose, eligibility, and effectiveness, though gaps remained regarding side effects, adherence, and differentiation from ART. Attitudes were largely positive (90 %), with most officers willing to use PrEP themselves and recommend it to clients; however, concerns about stigma and safety tempered this enthusiasm. In practice, officers actively engaged in counselling and referrals, yet faced persistent challenges with client follow‑up and adherence, often linked to misconceptions and community stigma. Regression analysis showed that Only...