Evaluating the Effectiveness of a Peer-Support Network Intervention for Antiretroviral Therapy Adherence Among Young Adults in Windhoek: A Policy Analysis for Namibia

Young adults living with HIV in Namibia face challenges in maintaining adherence to antiretroviral therapy (ART), leading to suboptimal viral suppression. Peer-support networks are a proposed strategy to improve adherence, but their effectiveness within the Namibian context requires evaluation to inform policy. This policy analysis aimed to evaluate the effectiveness of a structured peer-support network intervention on ART adherence among young adults in Windhoek. Its objective was to synthesise evidence to determine the suitability of scaling such an intervention within national HIV/AIDS policy. A desk-based policy analysis was conducted. This comprised a systematic review of literature on peer-support interventions for ART adherence in similar settings, an analysis of Namibian HIV policy documents, and a review of programme reports and grey literature from local pilot interventions. The analysis found consistent evidence that peer-support interventions can improve ART adherence. A key theme was the role of shared experience in reducing stigma. Local pilot data indicated a positive association, with participants in the peer-support group demonstrating a higher rate of optimal adherence compared to a matched control group receiving standard care. Peer-support networks show promise for improving ART adherence among young adults in Windhoek. Integrating such an intervention aligns with Namibia’s public health goals of improving HIV outcomes through community-based strategies. It is recommended that the Ministry of Health and Social Services develop a formal policy framework for implementing standardised peer-support networks within public ART programmes. This should include guidelines for training, monitoring and evaluation protocols, and sustainable funding mechanisms. HIV, antiretroviral therapy, adherence, peer support, young adults, Namibia, health policy This analysis provides evidence to inform national policy on integrating peer-support networks into HIV care programmes, aiming to improve treatment outcomes for young adults in Namibia.