Understanding High HIV Prevalence Along a Major Southern African Transport Corridor (Namibia HIV Pilot)

Funded by a UCSD Center for AIDS Research Developmental Grant P30 AI-36214; PI: Kimberly Brouwer

Namibia

Namibia

The purpose of this project is to initiate an exploration into issues surrounding risk behaviors, mobility, and HIV transmission in two rural Namibian communities at the epicenter of the HIV/AIDS epidemic in southern Africa. Situated along the Trans-Caprivi Highway linking landlocked Botswana, Zambia and Zimbabwe, these communities have some of the highest HIV infection rates in the world – over 30% prevalence in some parts. The recent paving of the Trans-Caprivi Highway, peace in northern neighbor Angola, increasing immigration from economically depressed Zimbabwe, and a growing stream of long-haul truckers from throughout southern Africa have increased traffic significantly through the Caprivi and likely complicated the HIV epidemic. Transportation corridors have been shown to be important conduits of HIV transmission, although their role in the diffusion of both positive (e.g. educational messages) and negative (e.g. drug resistance, new viral subtypes) factors remains to be fully elucidated. The specific aims of this project are to:

  1. Estimate the prevalence of HIV in two communities at varying distances from the Trans-Caprivi highway
  2. Determine correlates of HIV infection, including sociodemographics, risk behaviors, and knowledge and attitudes regarding HIV/AIDS
  3. Assess the relationship between mobility and transient non-resident interactions, with HIV prevalence, access to health services, and knowledge and attitudes about HIV
  4. Begin an exploration into the molecular epidemiology of HIV in the area and establish a blood spot repository to enable future HIV sequencing

The proposed project, to be conducted in collaboration with well-established Namibian non-governmental organization (NGO) partners, will be the first community-based HIV survey in this region. It is expected to lead to a better understanding of factors associated with HIV transmission and will provide information useful to Namibian policy makers and health officials.