HIV drug resistance has posed significant challenges to the efficacy of antiretroviral medication, despite their notable benefits. This research aimed to assess HIV drug resistance in the Engela district of Ohangwena, Namibia. The objective was to identify prevalent HIV mutations among patients who failed to achieve viral suppression and examine their impact on the effectiveness of current ARV regimens. The study evaluated HIV drug resistance screening tests conducted between 2018 and 2019, following the implementation of viral load testing in Engela.

The findings revealed a concerning rise in HIV drug resistance. NRTI medicine showed the highest mutation frequency, followed by NNRTI and PI medication. NNRTI medicine displayed the highest level of HIV drug resistance despite a moderate number of mutations. Instances of HIV drug resistance were more prevalent among men and children. Localising laboratory testing and enhancing the capacity of local laboratories significantly improved patient care.

Identified areas for improvement included enhancing sample handling and preparation at clinics, expanding the testing capabilities of local labs and increasing staffing in ART clinics.