Patience Makwele
PrEP is a daily pill taken by HIV-negative people to prevent infection. When used consistently, it can reduce the risk of contracting HIV by up to 99%.
HIV remains a concern among young people, especially young women.
Data from the Joint United Nations Programme on HIV/AIDS shows that women aged 15 to 24 in sub-Saharan Africa are more than twice as likely to contract HIV as men of the same age.
Some young people say stigma makes it difficult to access the medication.
Fatima Amukweya (29) said she started using PrEP after losing family members and a friend to AIDS-related illness.
“I have lost two aunties and a friend to the four-letter word deadly disease, and every death hits even harder, so when PrEP was introduced by DREAMS back in the day, I embraced the opportunity because I did not want to live in fear anymore,” she narrates.
“But I also did not want people to assume I am HIV positive just because they know I am from a family where three people have died of AIDS or simply because someone saw pills in my bag.”
She said she first learnt about PrEP at a health stand in Katutura in 2018.
“I was always afraid that someone might see me collecting them because they were going to conclude I was collecting HIV pills. I was sexually active at the time and a mother of two; every time I told my boyfriend about getting tested, he got defensive, so I reached out to a friend who is a nurse, and she told me that it was a daily pill that protects you from HIV. I was shocked; I had never heard of it before, so I did research on Google before she invited me to the clinic in Otjomuise, where she offered a one-on-one session and then did other tests. After that, she put me on medication.”
Another young Namibian Nande Peter Kaalushu said PrEP gives him control over his health.
“When I am, I want to feel safe. But even some nurses questioned why I would be on it if I had no “real reason”. It is like you are only allowed to protect yourself after something bad happens,” he said.
Others say access has become harder in some areas.
Namatama Muluti (24) from the Zambezi region said services declined after some donor programmes ended.
“Before, I used to be an ambassador for PROJECT HOPE, and it was such a lifesaver because there were outreach programmes and youth-friendly services. Now you go to the clinic, and sometimes they tell you to come back next week or, in the worst-case scenario, next month,” she said. “I am scared because stopping and starting is not good, but I have no choice.”
Johannes Petrus (23) from Okakarara said privacy is also a concern.
“When services like DREAMS were more private, it was easier. Now everyone knows why you are going to the clinic so often. People talk. They assume things. Some think you are already sick,” said Petrus.
He said travel costs and long distances make access harder.
“Sometimes I travel and still do not get it. You start asking yourself if it is worth the risk of people seeing you and then still not getting the pills,” he said.
Namibia has made progress in its HIV response. About 93% of people living with HIV know their status and most on treatment have viral suppression. However, suppression rates among young people remain lower.
Youth organisations say stigma plays a role.
Florence /Khaxas said silence around sexual health remains a challenge.
“Young women are disproportionately affected by HIV,” she said. “While we welcome advances like PrEP that support bodily autonomy, we are seeing setbacks when it comes to protecting women’s rights.”
Policy officer Nsozi Mwazi said the issue is both access and attitude.
“Young people have a right to protect themselves,” she said. “Whether it is PrEP, condoms or HIV testing, access should come without shame, questions or judgement. But we are still fighting stigma from service providers and communities and now, in some areas, interruptions in access.”
She said access remains uneven, especially outside cities.
“If you are in Windhoek, you might manage. But what if you are in Okakarara or Outapi? Young people there do not have safe spaces to learn or ask questions. The government needs to invest more in rural youth access and ensure continuity of supply.”
The Ministry of Health and Social Services said PrEP remains available at public facilities as part of its HIV prevention strategy.
It said it continues to work with partners to raise awareness through campaigns such as “My Protection, My Choice”.
*Names have been changed to protect identities.
