Risk factors for HIV infection among voluntary counselling and testing clients in Namibia

Abstract

In an effort to provide useful information that can guide HIV prevention strategies, this study determined 
the risk factors for HIV infection in Namibia. It also estimated the disease risk attributable to selected risk 
factors. The study adopted a cross sectional research design with a sample of 14296 voluntary testing and 
counseling clients from Oshana, Khomas and Kavango regions for the period of 2009 to 2012. Logistic 
regression was used to determine the risk factors for HIV infection among VCT clients. Attributable risk 
measures were then computed for factors amenable to intervention and were used as the basis for 
selecting risk factors posing the greatest disease burden to the population. From a targeting perspective, 
sex (OR = 1.3), condom use (OR= 1.7), male circumcision status (OR = 1.5) among others continue to be 
significant predictors of HIV infection. Not using condoms and not being circumcised are amenable to 
interventions and eliminating these risk factors can avert up to 22% and 18% of the disease burden 
respectively. Elimination of both exposures will result in 37% reduction in disease burden. As such, these 
factors should be the priority for HIV prevention in Namibia. We therefore recommend that the introduction 
of male circumcision in the country should be done concurrently with a strong condom messaging 
programme to increase the use of condoms even among circumcised men whilst at the same time 
addressing other social and structural factors.