HIV/AIDS Profile Namibia Demographic Indicators With AIDS Without AIDS With AIDS Without AIDS Series Scenario Series Scenario Population (1,000s) 2,089 2,339 Growth rate 0.9 1.9 Crude birth rate 23 24 Crude death rate 14 5 Infant mortality rate Life expectancy Both sexes 46 21 Both sexes 50 71 Male 49 25 Male 50 69 Female 42 17 Female 49 74 Total fertility rate 2.8 Estimated percentage of adults living with HIV 19.2 Estimated new AIDS cases 24,895 Estimated AIDS deaths 20,000 Percent urban (2007) 33 Note: Indicators are for 2008 unless otherwise noted. The "With AIDS Series" shows an estimate of demographic indicators in the country including AIDS mortality. The "Without AIDS Scenario" reflects a hypothetical population if the country was not affected by the AIDS epidemic. Sources: U.S. Census Bureau, International Data Base and unpublished tables. "Percent urban" from the Population Reference Bureau. Epidemiological Data Epidemic State: Generalized Namibia has been experiencing a steadily worsening epidemic since the early 1990s. It is estimated for 2008 that one in five adults are HIV positive. High HIV prevalence is found among pregnant women; and both urban and rural areas are affected alike. HIV prevalence among pregnant women tested in Windhoek, the capital, rose to nearly eight times what it was in HIV Seroprevalence for Pregnant Women, 1991-1992 by 2000. However, by 2004, in Windhoek, Namibia: 1991-2004 Percent the rate had declined to 16 percent. 50 40 30 20 10 0 1991-92 1994 1996 1998 2000 2002 2004 Year Source: HIV/AIDS Data Base ID Numbers A0319, M0488, N0192, N0251, N0279, N0376. HIV/AIDS Profile Namibia In Namibia, sentinel surveillance data show HIV prevalence among all HIV Seroprevalence for Pregnant Women, pregnant women tested from 1998 to by Age, Namibia: 1998-2004 2004 remained around 20 percent. In Percent 1998 and 2000, among pregnant 50 women tested, those in their twenties 1998* 2000** 2002*** 2004**** and early thirties were the most affected 40 age groups with rates around 20 30 percent. Starting in 2002, HIV began to affect older ages as rates increased 20 among pregnant women ages 35 to 39. 10 By 2004, about a quarter of women 0 ages 25 to 29, 30 to 34, and 35 to 39 <20 20-24 25-29 30-34 35-39 40-44 45+ All Age were HIV positive. *1998: 15 Sites; **2000: 18 Sites; ***2002: 21 Sites; ****2004: 24 Sites Source: HIV/AIDS Data Base ID Numbers A0319, N0251, N0279, N0376. HIV prevalence among pregnant women tested in various districts HIV Seroprevalence for Pregnant Women, increased rapidly throughout the 1990s, in Various Districts, Namibia: 1991-2004 reaching levels ranging around Percent 10 percent to 23 percent by 2000. 50 Gobabis Keetmanshoop Mariental Rates continued to increase in Onandjokwe Swakopmund Onandjokwe, peaking at 28 percent in 40 2002 before declining to 22 percent in 30 2004. Prevalence appears relatively 20 stable in the other districts for 2002 and 2004, ranging from nearly 11 percent in 10 Mariental to 16 percent in 0 Keetmanshoop and Swakopmund. 1991-92 1994 1996 1998 2000 2002 2004 Year Source: HIV/AIDS Data Base ID Numbers A0319, M0488, N0192, N0251, N0279, N0376. Similar rates of HIV prevalence were found among pregnant women tested in urban and rural district sites. The urban HIV Seroprevalence for Pregnant Women, site, Grootfontein, and the rural site, in District Sites, Namibia: 2000-2004 Oshikuku, had rates just below Site 30 percent for 2004. The remaining two Urban Sites urban sites, Outapi and Tsumeb, and Grootfontein the rural site, Rehoboth, had rates Outapi around 15 percent. Tsumeb 2000 2002 2004 Rural Sites Oshikuku Rehoboth 0 10 20 30 40 50 Percent Source: HIV/AIDS Data Base ID Numbers A0319, N0279, N0376. 2 HIV/AIDS Profile Namibia In other urban sites, prevalence among pregnant women has steadily increased HIV Seroprevalence for Pregnant Women, since 1991-1992. The highest in Urban Sites, Namibia: 1991-2004 prevalence was found in Katima Mulilo which reached 43 percent in 2002 and Percent 50 2004. Rates varied in the other sites Katima Mulilo Oshakati Otjiwarongo Rundu Walvisbay since 1998, ranging between 14 percent 40 and 34 percent. 30 20 10 0 1991-92 1994 1996 1997 1998 2000 2002 2004 Year Source: HIV/AIDS Data Base ID Numbers A0319, M0488, N0192, N0226, N0251, N0279, In rural sites of Namibia, prevalence has increased to levels close to those HIV Seroprevalence for Pregnant Women, seen in some urban sites. By 2004, in Rural Sites, Namibia: 1991-2004 18 percent of pregnant women in Percent Andara, Engela, and Nankudu were HIV 50 positive. Andara Engela Nankudu Nyangana Opuwo 40 30 20 10 0 1991-92 1994 1996 1997 1998 2000 2002 2004 Year Source: HIV/AIDS Data Base ID Numbers A0319, M0488, N0192, N0226, N0251, N0279, N0376 In Windhoek, sentinel surveillance among those seeking treatment for sexually transmitted infections (STI) HIV Seroprevalence for STI Patients, rose rapidly from 11 percent in 1991­ in Windhoek, Namibia: 1991-2002 Percent 1992 to 45 percent in 1998. The rate 80 had dropped to 35 percent by 2002. 60 40 20 0 1991-92 1993-94 1998 2002 Year Source: HIV/AIDS Data Base ID Numbers A0319, E0051, N0192, N0251. 3 HIV/AIDS Profile Namibia By 2002, HIV prevalence levels were high among STI patients tested in HIV Seroprevalence for STI Patients, selected sites in Namibia. Gobabis and in Selected Sites, Namibia: 1991-2002 Otjiwarongo had rates below 3 percent in 1991-1992, these increased to Site 31 percent and 21 percent, respectively Gobabis 1991-92 1998 2002 by 2002. Nearly two-thirds were HIV Katima Mulilo positive in Oshakati in 2002, up from Rundu 8 percent nearly ten years earlier. Opuwo Katima Mulilo continued to have high levels with over half of those tested HIV Oshakati positive in 2002. Otjiwarongo 0 20 40 60 80 Percent Source: HIV/AIDS Data Base ID Numbers A0319, N0192, N0251. HIV prevalence for male STI patients was higher than females in the older age groups. In 2002, among females in HIV Seroprevalence for STI patients, their twenties, 34 percent of those by Age and Sex, Namibia: 1998 and 2002 Percent tested ages 20 to 24 and nearly 50 80 percent of those tested ages 25 to 29 Male Female were HIV postive compared to 60 23 percent and 38 percent of males in the same age groups. 40 20 0 4 9 4 9 4 + 4 9 4 9 4 + -2 -2 -3 -3 -4 5 -2 -2 -3 -3 -4 5 0 5 0 5 0 4 0 5 0 5 0 4 2 2 3 3 4 2 2 3 3 4 1998* 2002** Age *1998: 13 Sites; **2002: 15 Sites Source: HIV/AIDS Data Base ID Numbers A0319, N0251. 4 Seroprevalence of HIV-1 for Pregnant Women, by Location, in Namibia: 2004 Outapi Engela Nankudu Katima Mulilo !@ !@ Nyangana ! Opuwo !! !@ U! !Onandjokwe ! !@ !@ Rundu Andara Tsumeb !@ Outjo !Grootfontein !@!@ Otjiwarongo Windhoek Gobabis Percent Seropositive Swakopmund !@ !@ !@ !( 0.0 Walvisbay! !@ =! 0.1 - 0.9 Rehoboth !> 1.0 - 4.9 !@ Mariental U! 5.0 - 9.9 !@ 10.0 - 19.9 Luderitz ! 20+ !@ ! ! Keetmanshoop U.S. Census Bureau, Population Division, International Programs Center, HIV/AIDS Surveillance Data Base, December 2006. HIV/AIDS Profile Namibia Sources by HIV/AIDS Data Base ID Number: A0319 Amathila, L., et al., 2002, Report of the 2002 National HIV Sentinel Survey, Ministry of Health and Social Services, National AIDS Co-ordination Programme, Windhoek, Namibia, unpublished report. E0051 Ekanem, E. E., 1995, HIV/AIDS/STD Epidemiological Surveillance Activities in Namibia: Report on a W.H.O. Mission, W.H.O. Mission Trip, September 15, report. M0488 Ministry of Health, National AIDS Control Programme, 1996, National HIV Sentinel Survey ­ 1996, Ministry of Health and Social Services, Nambia, October report. N0192 Namibia Ministry of Health and Social Services, 1992, National HIV Prevalence Survey 1991 ­ 1992, Ministry of Health and Social Services, Private Bag 13198, Windhoek, Namibia, report. N0226 National AIDS Control Programme, et al., 1997, HIV Sentinel Survey 1997 North-East Health Directorate-Namibia, National AIDS Control Programme, North-East Health Directorate in Cooperation with the Namibian - German AIDS Control project, unpublished report. N0251 Namibia Ministry of Health and Social Services, 1999, Report of the 1998 HIV Sentinel Sero Survey, National AIDS Co-ordination Programme, Ministry of Health and Social Services, Windhoek, Namibia, April, unpublished report. N0279 Namibia Ministry of Health and Social Services, 2001, Report of the 2000 HIV Sentinel Sero Survey, National AIDS Co-ordination Programme, Ministry of Health and Social Services, Windhoek, Namibia, March, unpublished report. N0376 Namibia Ministry of Health and Social Services, 2005, Report of the 2004 National HIV Sentinel Survey, Ministry of Health and Social Services, Directorate of Special Programmes, Windhoek, Namibia, unpublished report. 6 .