KAIS 2007 1 - Kenya National AIDS & STI Control Programme ...

More documents

Recommendations

Info

$D:\My Documents\HBC\HCBC Implem - Kenya National AIDS & STI ...$

KEY FINDINGS: HIV PREVENTION• Among adults aged 15-64 years, 33.9% had been tested for HIV and received test results,44.6% of women and 25.6% of men.• Knowledge of HIV status was low: only 16.4% of HIV-infected respondents knew they had HIV.Knowledge of partner’s HIV status was also low. Among those respondents who reported oneor more sexual partners in the past 12 months, their partners had been tested for HIV anddisclosed their status to the respondent in only 22.2% of partnerships reported in the year priorto the survey.• Among women who reported having a live birth between 2003 and 2007, 10.4% did not visit anANC. Among those who visited an antenatal clinic (ANC), HIV testing increased from 50.4% in2003 to 78.6% in 2007.• Condom use at last sex was low in marital/cohabiting partnerships (4.2% among partnershipsreported by women and 5.9% among partnerships reported by men) compared to nonmarital/non-cohabitingpartnerships (35.7% among partnerships reported by women and52.6% among partnerships reported by men).• Co-infection with STIs and HIV was common: 16.9% of persons with syphilis were infected withHIV, as were 16.4% of persons with HSV-2 infection.• Among married/cohabiting couples, 9.7% had at least one HIV-infected partner. At the time ofthe survey, an estimated 344,000 HIV-discordant couples needed targeted HIV testing andprevention.• Overall, 57.5% of women and 56.4% of men reported having had unprotected sex with at leastone partner of HIV-discordant or unknown HIV status in the 12 months prior to the survey.HIV preventionHIV counselling and testing are key elements in a comprehensive response to the HIV epidemic.The proportion of adults who reported that they had ever been tested for HIV increased from15.2% in 2003 to 36.6% in 2007 among adults aged 15‐49 years. Of respondents aged 15‐64 yearsthat had ever been tested for HIV, 49.5% had tested within the 12 months prior to KAIS. Womenwere significantly more likely to have been tested for HIV (44.6%) than men (25.6%). Amongadults who had never been tested, 47.2% did not test for HIV because they perceived themselvesto be at low risk for HIV infection. According to the 2007 KAIS, 83.6% of all HIV‐infected adultswere unaware that they were infected. HIV testing must increase substantially to reach Kenya’sgoal of 80% testing coverage for all adolescents and adults by 2010.Overall, 86.5% of respondents who had ever been tested for HIV and self‐reported positive ornegative also reported they had disclosed their HIV status to their sexual partners; however, in77.9% of sexual partnerships, respondents reported they did not know their partners’ HIV status;this percentage was especially high in casual partnerships (92.2%). HIV‐infected adults who wereaware of their status were significantly more likely to know their partners’ HIV status than otherinfected and uninfected adults. Overall, 5.9% of married or cohabitating couples in Kenya werediscordant for HIV, that is, one partner was infected and the other was not. This corresponds to anestimated 344,000 HIV‐discordant couples nationwide. HIV testing efforts should be strengthenedfor individuals and their partners.KAIS 2007 10
Number of sexual partners, inconsistent condom use, young age at first sex, and lack of malecircumcision were some of the key factors associated with acquisition and sexual transmission ofHIV. The majority of adults aged 15‐64 years (52.2% of women and 73.1% of men) have had morethan one sexual partner in their lifetime; 1.7% of women and 11.9% of men had more than onesexual partner in the 12 months prior to the survey. Consistent condom use with sexual partnersin the 12 months preceding the survey was low, even among women and men who reported morethan one sexual partner in the 12 months before the survey. The median age at sexual debut was17.5 years for both young women and men aged 15‐24 years. Twenty percent (20.0%) of youngwomen and 22.4% of young men reported they had first sex by 15 years of age.Overall, 85.0% of men reported being circumcised; the proportion of men who were circumcisedwas lowest in Nyanza province (48.2%). Uncircumcised men were three times more likely to beinfected with HIV (13.2%) than circumcised men (3.9%).Knowledge about HIV, realistic perceptions of risk, and stigma reduction are considered criticalfor reducing the risk of HIV acquisition and transmission. Among all respondents, 98.3% hadheard about AIDS. Comprehensive knowledge of HIV and AIDS had improved since 2003, andknowledge was highest among persons with more years of education and among urban residents.Excluding respondents who self‐reported positive, 70.7% believed themselves to be at low or norisk for acquiring HIV; among these adults, 76.7% reported having only one partner as the reasonthey were at low risk. Overall, willingness to care for an HIV‐infected family member was high(91.5%).Mother‐to‐child transmissionThe prevention of mother‐to‐child transmission (PMTCT) program in Kenya was launched in2000 and has undergone a substantial scale‐up since 2003. A total of 89.6% of women betweenages 15‐54 years who were pregnant between 2003 and 2007 reported attending an ANC at leastonce during their pregnancy. HIV testing at ANCs increased steadily since 2003, and in 2007,78.6% of women who reported attending an ANC also reported receiving an HIV test at the ANC.HIV testing at ANCs accounted for a substantial proportion of HIV testing among women ofreproductive age (aged 15‐49 years); 63.8% of women who reported ever having been tested at anANC had never tested elsewhere. Nonetheless, 10.4% of women who reported having a birthbetween 2003 and 2007 did not visit an ANC indicating a need for sustained efforts to increaseANC attendance and to consider PMTCT services beyond established ANCs.Reproductive health: pregnancy and contraceptionHIV prevalence among women who reported they were currently pregnant was 9.0%. AmongHIV‐uninfected pregnant women, and currently breastfeeding women who reported unprotectedsex in the year before the survey, the HIV status of their partners was unknown in 72.7% and77.6% of partnerships, respectively.Among all women of reproductive age (15‐49 years), 70.5% reported wanting to delay pregnancyby two or more years; that is, they either did not want a child within the next two years or did notwant a child (or more children) ever in the future. Less than half (45.0%) of these women werereportedly using modern contraception. Among HIV‐infected women, 66.8% reported wanting todelay pregnancy by two or more years; 40.5% of these women were using modern contraception.KAIS 2007 11
Page 1 and 2: KAIS 2007 1
Page 4 and 5: P.O. Box: 9361 Code: 00202 Nairobi,
Page 6: KEMRIKNASPKNBSKshLLITNMCHmlμLMOMSM
Page 12 and 13: Among HIV‐uninfected women, 71.2%
Page 14 and 15: Men 5.4 26.3 1.9Total 7.1 35.1 1.8O
Page 17 and 18: Kenya is also committed to the “T
Page 19 and 20: Table 1.4 Distribution of sampled c
Page 22 and 23: 1.7 SURVEY IMPLEMENTATIONTrainingIn
Page 24 and 25: Data processing included a number o
Page 26 and 27: Characteristic 2003 KDHS 2007 KAISQ
Page 28 and 29: Figure 1.11 Sampled clusters and el
Page 30 and 31: Table 1.11c Survey response rates b
Page 32 and 33: Population estimates reported in th
Page 34 and 35: 2.4 HIV PREVALENCE AMONG YOUTHFigur
Page 36 and 37: Figure 2.6b HIV prevalence among ru
Page 38 and 39: 2.7 HIV PREVALENCE BY PROVINCEFigur
Page 40 and 41: Figure 2.7c Estimated number of HIV
Page 42 and 43: 2.9 HIV PREVALENCE BY EDUCATION LEV
Page 44 and 45: Figure 2.10b HIV prevalence among r
Page 46 and 47: 2.11 HIV PREVALENCE BY TIME AWAY FR
Page 48 and 49: 2.13 MALE CIRCUMCISION AND ASSOCIAT
Page 50 and 51: Figure 2.13c HIV prevalence among c
Page 52 and 53: Comparison of HIV Prevalence in the
Page 54 and 55: 3.3 SEXFigure 3.3a HIV prevalence a
Page 56 and 57: Figure 3.4b. HIV prevalence among m
Page 58 and 59: 3.7 PROVINCEFigure 3.7a HIV prevale
Page 60 and 61:
2003 KDHS 1 2007 KAIS 2Marital stat
Page 62 and 63:
3.10 WEALTH INDEXFigure 3.10a HIV p
Page 64 and 65:
DATA IN CONTEXT: APPROACHES TO HIV
Page 66 and 67:
Population estimates reported in th
Page 68 and 69:
Figure 4.3c Ever been tested for HI
Page 70 and 71:
Figure 4.3e Ever been tested for HI
Page 72 and 73:
Figure 4.3g Women aged 15-49 years
Page 74 and 75:
Figure 4.4a Time since last HIV tes
Page 76 and 77:
Figure 4.5a Reasons for not testing
Page 78 and 79:
Increasing access to HIV testing wi
Page 80 and 81:
4.7. Gaps and unmet needs• Two‐
Page 82 and 83:
Population estimates reported in th
Page 84 and 85:
Figure 5.3b Self-reported HIV statu
Page 86 and 87:
This section examines participants
Page 88 and 89:
Figure 5.5a Knowledge of HIV status
Page 90 and 91:
Figure 5.5c Percent of partnerships
Page 92 and 93:
uninfected. A couple was considered
Page 94 and 95:
Figure 5.6c Women and men aged 15-6
Page 96 and 97:
Sexual Partners, Sexual DebutCircum
Page 98 and 99:
Figure 6.3b. HIV prevalence among w
Page 100 and 101:
Figure 6.3d. HIV prevalence among w
Page 102 and 103:
Figure 6.3f. Men aged 15-64 years r
Page 104 and 105:
In this section, “consistent cond
Page 106 and 107:
Figure 6.4c. Marital or cohabiting
Page 108 and 109:
Figure 6.5b. Young women and men ag
Page 110 and 111:
Figure 6.5d. Young women and men ag
Page 112 and 113:
Figure 6.6a. Male circumcision amon
Page 114 and 115:
Figure 6.6d. HIV prevalence among m
Page 116 and 117:
Knowledge, Attitudes and Beliefs ch
Page 118 and 119:
Figure 7.3b. Most common source of
Page 120 and 121:
Figure 7.3c Women and men aged 15-6
Page 122 and 123:
Figure 7.3e Overall scores for 12 q
Page 124 and 125:
Figure 7.3g Women and men aged 15-6
Page 126 and 127:
Figure 7.3i Correct responses to se
Page 128 and 129:
• If a female teacher has the AID
Page 130 and 131:
7.5. Perceived risk of HIV infectio
Page 132 and 133:
Figure 7.5c Reasons given for havin
Page 134 and 135:
7.6. Attitudes toward women’s rol
Page 136 and 137:
who had never been tested for HIV o
Page 138 and 139:
8.2 INTRODUCTIONIn the absence of i
Page 140 and 141:
8.3 ANTENATAL CLINIC ATTENDANCE, 20
Page 142 and 143:
8.4 KNOWLEDGE OF MOTHER-TO-CHILD TR
Page 144 and 145:
The analysis in this section consid
Page 146 and 147:
Figure 8.5b Women aged 15-49 years
Page 148:
• Incorrect communication or unde
Page 151 and 152:
8.8 CURRENTLY PREGNANT WOMEN: HIV T
Page 153 and 154:
Among currently pregnant women, 7.1
Page 155 and 156:
Among pregnant, HIV‐uninfected wo
Page 157 and 158:
Figure 8.11b Desire for a child in
Page 159 and 160:
8.12 CONTRACEPTIVE USEThe next figu
Page 161 and 162:
Figure 8.12c Contraceptive use* amo
Page 163 and 164:
Blood and Injection Safety chapter
Page 165 and 166:
D ATA IN C ONTEXT: N ATIONAL B LOOD
Page 167 and 168:
Figure 9.3a Source of blood donatio
Page 169 and 170:
Figure 9.3b Source of blood donatio
Page 171 and 172:
Figure 9.3d Source of blood donatio
Page 173 and 174:
9.4 Blood transfusionsAlthough the
Page 175 and 176:
10080Injec tionsPillsNo preferenceW
Page 177 and 178:
HIV prevalence among adults who rep
Page 179 and 180:
9.6 Gaps and unmet needs• HIV pre
Page 181 and 182:
The Ministry of Medical Services re
Page 183 and 184:
10.3 COTRIMOXAZOLE PROPHYLAXIS FOR
Page 185 and 186:
Coverage also varied significantly
Page 187 and 188:
10.4 ARV ELIGIBILITY, COVERAGE AND
Page 189 and 190:
ARV coverage was estimated by takin
Page 191 and 192:
Figure 10.4b ARV coverage among HIV
Page 193 and 194:
DATA IN CONTEXTEstimates of HIV-inf
Page 195 and 196:
10.5 GAPS AND UNMET NEEDS• The es
Page 197 and 198:
debilitating illness leading to hos
Page 199 and 200:
Among HIV‐infected adults (83.6%
Page 201 and 202:
Figure 11.3d HIV-infected adults ag
Page 203 and 204:
Figure 11.4b HIV-infected adults ag
Page 205 and 206:
Figure 11.4d HIV-infected adults ag
Page 207 and 208:
DATA IN CONTEXTHIV Basic Care Packa
Page 209 and 210:
Figure 11.5b HIV-infected adults ag
Page 211 and 212:
Figure 11.6b Percent of HIV-infecte
Page 213 and 214:
11.8 GAPS AND UNMET NEEDS• Counse
Page 215 and 216:
12.3 HSV-2 prevalenceHSV‐2 preval
Page 217 and 218:
807071.0WomenMen64.3HSV-2 Prevalenc
Page 219 and 220:
Figure 12.3d HSV-2 prevalence among
Page 221 and 222:
Figure 12.4b HSV-2 prevalence among
Page 223 and 224:
Figure 12.5a HIV prevalence by HSV-
Page 225 and 226:
Figure 12.6b Condom use during last
Page 227 and 228:
12.7 Gaps and unmet needs• Increa
Page 229 and 230:
also at substantially elevated risk
Page 231 and 232:
Figure 13.3b Prevalence of syphilis
Page 233 and 234:
Figure 13.3d Prevalence of syphilis
Page 235 and 236:
Figure 13.3f Prevalence of syphilis
Page 237 and 238:
Figure 13.4b Prevalence of syphilis
Page 239 and 240:
13.6 GAPS AND UNMET NEEDS• Patien
Page 241 and 242:
Household Characteristics andImpact
Page 243 and 244:
Figure 14.3a Sex of head of househo
Page 245 and 246:
Figure 14.3d Household population,
Page 247 and 248:
14.5 PREVALENCE OF HIV-AFFECTED HOU
Page 249 and 250:
Figure 14.5c HIV-affected household
Page 251 and 252:
social and economic conditions of h
Page 253 and 254:
households used chemical disinfecta
Page 255 and 256:
14.7 HOUSEHOLD OWNERSHIP OF MOSQUIT
Page 257 and 258:
Figure 14.7b HIV-affected and HIV-u
Page 259 and 260:
Table 14.7b Source of bednets among
Page 261 and 262:
Overall, 52.3% percent of children
Page 263 and 264:
14.9 CARE AND SUPPORT FOR ORPHANS A
Page 265 and 266:
For consistency with other populati
Page 267:
Returning Test Results15.1 KEY FIND
Page 270 and 271:
Figure 15.3b. Participants aged 15-
Page 272 and 273:
Figure 15.3d. Participants aged 15-
Page 274 and 275:
Figure 15.3f. Participants aged 15-
Page 276 and 277:
15.4 RETURNING TO RECEIVE TEST RESU
Page 278 and 279:
Figure 15.5 Women aged 15-64 years
Page 280 and 281:
Methods of the 2007 KAISThis Append
Page 282 and 283:
ClustersHouseholdsProvince Rural Ur
Page 284 and 285:
and treatment services and other he
Page 286 and 287:
The KEMRI Ethical Review Committee
Page 288 and 289:
Red top (5 ml)Whole blood collected
Page 290 and 291:
algorithm using two HIV EIAs (Viron
Page 292 and 293:
Figure A5.a. Structure and flow of
Page 294 and 295:
Recruitment and training of results
Page 296 and 297:
observe confidentiality of particip
Page 298 and 299:
Documentation. Results counsellors
Page 300 and 301:
Normalisation of weightsNormalised
Page 302 and 303:
This report presents the results of
show all

KAIS 2007 1 - Kenya National AIDS & STI Control Programme ...

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?