Namibia is a vast country with only 2.1 million inhabitants  and the second lowest population density in the world (2.5 inhabitants/sq km). Its geographic and demographic characteristics pose serious challenges to the planning, organisation and logistics of the national HIV response and result in inadequate and unequal coverage of and access to services.
Namibia's economy is largely dependent on mining, fishery, large-scale farming and high-end tourism. With 51.2 per cent of the work force unemployed and the highest Gini index (74.35 per cent) in the world, socio-economic inequality is widespread and multi-dimensional. It is considered to be both a structural driver of the HIV epidemic and a major challenge for the response as poor and marginalised Namibians have limited access to the full range of HIV-related services.
Namibia’s first case of HIV infection was reported in 1986. Today the country has a generalised, mature epidemic throughout society, with HIV primarily transmitted through heterosexual sex.
The number of new HIV infections peaked between 1998 and 2000 and began to decrease thereafter demonstrating the impact of prevention programmes in place at the time. In 2010/11, HIV prevalence in the general population among people aged 15–49 years was estimated at 13.5 per cent, resulting in around 4,500 AIDS-related deaths in the same period. In 2010/11, approximately 9,300 people were infected with HIV. This steady stream of new infections over a long period of time has resulted in an estimated 189,000 adults and children living with HIV in 2010/1.
HIV prevalence among pregnant women attending antenatal care in the country was 18.8 per cent in 2010 compared to 17.8 per cent in 2008. The prevalence increased from 1992 and peaked in 2002 at 22 per cent followed by a slight decrease and apparent stabilisation between 2004 and 2010. The antenatal care survey results indicate that HIV prevalence peaks in the age group of 35–39 years, with 29.7 per cent, and in the age group 30–34, with 29.6 per cent. Among young women aged 15–24 years attending antenatal care, there has been a decrease in prevalence from 15.2 per cent in 2004 to 10.3 per cent in 2010.