Namibia grapples with a widespread HIV epidemic, particularly affecting young women during pregnancy and breastfeeding due to various biological, social and cultural factors. Pregnant and postpartum women encountering challenges with conventional prevention methods may find pre-exposure prophylaxis (PrEP) a viable option. This research aimed to gauge HIV risk perception, assess PrEP accessibility and evaluate its acceptability among women accessing antenatal and postnatal care at Katutura Health Centre, Windhoek.

Employing a sequential explanatory mixed-methods approach, the study collected and analysed quantitative data to determine HIV risk and PrEP usage. Interviews were then conducted with selected participants from the same cohort to enrich and explain the statistical findings.

HIV prevalence among pregnant women was at 11,9%, with an annual incidence of 1,8%. Many pregnant and breastfeeding women perceived themselves at high HIV risk, often citing distrust in sexual partners. Although PrEP awareness was high, understanding remained limited, resulting in minimal PrEP usage, exacerbated by service delivery obstacles and highlighting the need for comprehensive strategies to address these gaps.