Abstract:
Human Immunodeficiency Virus (HIV) is one of the epidemics that has affected the world for years now. Namibia remains one of the countries burdened and overstrained by the HIV epidemic. Oral Pre-Exposure Prophylaxis (PrEP) is now included as an additional option for people at substantial risk of HIV infection in the context of a combination HIV prevention package in Namibia. However, the retention rate in PrEP care remains low. This study, therefore, aimed to determine the factors influencing the retention rate of clients receiving PrEP in Engela district, Namibia. The objectives of the study were to determine the retention rate of clients in PrEP care three months after initiation, to identify socio-demographic factors that affected retention in care of clients on PrEP, to describe structural factors affecting retention in care of clients in PrEP, and to determine factors and strategies to improve retention of clients on PrEP in the Engela district, Namibia. A quantitative cross-sectional design was used for this study. Two hundred and fifty participants for the study were selected using a proportional stratified random sampling method. A self-administered questionnaire was used to collect the data. SPSS version 28 was used to analyse the data. Statistical tests used included Chi-square tests and logistic regression. The findings from this study showed that the participants’ retention rate in PrEP care was 35.6%. Chi-square tests showed associations between retention in PrEP care and sex, relationship status, education, and employment status (p55 years. Males were statistically significantly less likely to be retained in PrEP care compared to females. Divorced participants and participants in a relationship were statistically significantly less likely to be retained in PrEP care compared to single participants. The unemployed participants were statistically significantly less likely to be retained in PrEP care compared to the employed. More than three-fifths of the participants agreed or strongly agreed that distance to the healthcare facilities, lack of friendly staff at the healthcare facilities, shortage of staff at the healthcare facilities, and having a supportive partner would strongly influence their retention in PrEP care. In conclusion, it was therefore recommended that PrEP education be offered to patients and the public at healthcare facilities and other public places, PrEP services are ii decentralised, operating hours of healthcare facilities be expanded, healthcare facilities are adequately staffed, and PrEP drugs’ availability is improved.
