Adolescent girls and young women at Omuukwiyugwemanya Combined School, Oshikoto region in December 2018. Photo by Dr. Samson Ndhlovu for IntraHealth International.

In the Oshikoto region of Namibia, the number of adolescent girls and young women taking pre-exposure prophylaxis (or PrEP) increased by over 100% in just three months—an uptick from 82 to 172. That means over twice as many at-risk girls and women are now lowering their risk of infection by using this daily medication. PrEP is highly effective when taken consistently and can prevent people who are HIV-negative from getting infected.

This is one of the early, promising results of IntraHealth International and IntraHealth Namibia's work on the Determined, Resilient, AIDS-free-Mentored & Safe (DREAMS) project funded by PEPFAR through USAID in Namibia. The DREAMS project is implemented by a consortium of partners led by Project HOPE Namibia.

DREAMS is helping Namibia prevent new HIV infections among adolescent girls and young women by addressing the structural factors in health, education, and society that make them more susceptible to HIV infection. These include gender inequality, early sexual debut, teenage pregnancy, physical and sexual violence, and limited access to comprehensive sexual education. Though the country has made significant progress toward epidemic control, Namibian girls and young women are at particularly high risk.

As the clinical partner for DREAMS in Namibia, IntraHealth International is focusing on HIV prevention in three districts in the Oshikoto region. Oshikoto has a youth (ages 15-34) population of 68,733—that’s 8% of the country’s total youth population as of 2016. DREAMS is also building the capacity of independent, local entity IntraHealth Namibia to take on this important role.

Health workers provided clinical services to an additional 235 adolescent girls and young women—a 33% increase.

“We are starting to see the positive impact that DREAMS has on the lives of adolescent girls and young women,” says Lavinia Shikongo, general manager of IntraHealth Namibia. “IntraHealth Namibia is proud to be contributing to efforts aimed at ensuring that adolescent girls and young women have access to information and services to protect themselves from HIV infection and unwanted pregnancies.”

Both partners have worked together to provide training and ongoing mentorship to dedicated DREAMS nurses in six implementing health facilities, while also orienting other Ministry of Health and Social Services’ nurses in clinical services for sexual health and risk-reduction in seven satellite sites.

During the current quarter, IntraHealth Namibia has trained 24 nurses on adolescent-friendly health services and 21 nurses on the ministry’s new PrEP guidelines. From January to March 2019, these health workers provided clinical services to an additional 235 adolescent girls and young women—a 33% increase over the previous quarter.

The trained nurses are already working to decentralize DREAMS services to the rest of the facilities in Oshikoto.

DREAMS health workers act as a critical gateway to the youth-friendly health services adolescent girls and young women receive, including screening for gender-based violence and HIV testing services.

IntraHealth’s work on Namibia DREAMS is part of a larger public-private partnership between PEPFAR, the Bill & Melinda Gates Foundation, Girl Effect, Johnson & Johnson, Gilead Sciences, and ViiV Healthcare to reduce HIV infections among adolescent girls and young women in sub-Saharan Africa.