Households shun HIV survey

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Alvine Kapitako

Tsumeb-Many households have reportedly refused to participate in the population-based HIV survey, which aims to generate detailed data on the extent and scope of the HIV epidemic in Namibia.
Karen Banda of the Ministry of Health and Social Services told reporters last Friday that participants’ refusal to be surveyed has the potential to negatively affect the data outcome.

“We are supposed to meet a certain percentage of our target population so that our results can have enough power to be representative in terms of statistical power,” explained Banda.

She said the Namibia Population-based HIV Impact Assessment (NAMPHIA) survey, which will measure the impact of HIV programmes in the country and covers at least 12,000 randomly selected households countrywide, started last month in Khomas, Erongo and Omaheke regions.

By Friday, the teams had covered about 140 out of 461 enumeration areas. While in the field, the teams realised that many people refused to participate in the survey.

“We realised that something is wrong and so we stopped. We didn’t go to all the households. We are going to try different mobilization strategies and then we go to the remaining ones because we want to make sure we give them the required information first, and then hopefully they will participate,” said Banda.

She added that there is an attitude in affluent neighbourhoods “that HIV is not for rich people”, which she termed a “misconception” that needs to be addressed.

Banda, who singled out Windhoek and Swakopmund as having the most refusals, said there is a difference in participation rate according to the socio-economic background of the areas.

“Most people are not home when we go there but when we find them they are too busy to take part in the survey. We try to give them information so that they can make an informed decision, but then at the end of day it’s up to them whether they take part or not.”

Before going to an area the teams give out information that they would be going into the neighbourhood to do tests. She explained that this is to prepare people by giving them the correct information for them to participate.
“This is a survey that is going to help all Namibians from all walks of life and it is the duty of everyone in the nation to take part, whether HIV positive or negative we have something to contribute,” said Banda.

The data derived from the survey will be used to, amongst others, advocate for more resources should there be a need for new resources, added Banda. The data from the survey could also be used to change some HIV interventions.
“HIV has a huge socio-economic impact – so you might not actually be positive yourself but it has an overall impact on the economy. In order for the government to start investing in other areas like education, agriculture and so on, we need to deal with this problem of HIV which is affecting our economy,” said Banda.

Communications officer for the NAMPHIA project, Farai Nyakunu, said similar surveys have had a positive impact in other countries.

“For example, Swaziland was recently in the news for having slashed half of their HIV rates, so this is an important opportunity for people to take advantage of the survey,” Nyakunu added.
The goal of NAMPHIA is to examine the current distribution of the HIV epidemic and assess the impact of Namibia’s prevention, care and treatment response across the 14 regions of the country.

NAMPHIA will measure the rate of new HIV infections, HIV prevalence estimates by region and the effectiveness of HIV treatment as measured by viral load suppression among people living with HIV and on antiretroviral treatment (ART) by region.

This will be the first time that population-based information about prevention, care and treatment of HIV in infants and children will be collected on a national scale.

The survey will help people learn about their own health by providing HIV testing and results to participants. People who already know their HIV status are encouraged to participate as the survey services include other tests to assess disease progression, or treatment response, such as CD4 and viral load testing.

The tests are conducted in the convenience and privacy of one’s own home. The survey staff will also provide information about HIV prevention and treatment to all participants.

“We only have the sentinel surveillance data for pregnant women but it’s not representative because it leaves out men and it leaves out women that are not of sexual reproductive age. This is going to be the first population-based data that Namibia is going to get and we will have some really good estimates for each region,” said Banda.
In terms of the technical aspects, Banda said the teams are well trained. “We haven’t had a lot of issues in that regard, even with the lab samples and the tests in the field. We have had very few, if any, discrepancies,” Banda said.

NAMPHIA is a Ministry of Health and Social Services survey, funded by the United States President’s Emergency Plan for AIDS Relief (PEPFAR), through the U.S. Centers for Disease Control and Prevention (CDC).

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