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

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Among HIV‐uninfected women, 71.2% reported wanting to delay pregnancy by two or moreyears; 45.6% of these women were using modern contraception.Blood safetyNationwide, an estimated 2.3% of adults reported donating blood in the year prior to the survey;among these adults, 48.3% reported they were approached by a blood transfusion service, themajority of which fall within the Kenya National Blood Transfusion Service network. Of theremainder, 40.4% of participants reported that a family or friend asked them to donate, mostlikely as a family/replacement donor. The majority of adults who reported donating blood in theyear prior to the survey were men: 69.2% of male donors reported they had been requested todonate by a blood transfusion service, and 81.4% were requested by friends orfamily. Among donors who were requested to donate by a blood transfusion service, 69.2% wereunder 25 years of age. By comparison, persons who were requested to donate by family orfriends were older, with 60.9% aged 30 years or older. HIV prevalence among persons whoreported donating blood in the year before the survey was 4.7% and differed marginally by sourceof donation request. Among donors who had received a request to donate to a blood transfusionservice, the prevalence was 2.5% compared to 7.4% among persons who reported donating for afamily or friend.KEY FINDINGS: HIV CARE AND TREATMENT• Among all HIV-infected persons in KAIS, cotrimoxazole coverage was low at 12.1%. Lowcoverage was associated with low awareness of HIV status. Among HIV-infected personswho were aware of their HIV status, 76.1% reported taking daily cotrimoxazole.• Among all HIV-infected persons with a CD4 cell count of
those unaware (51.2% and 22.9%, respectively). Similarly, those aware of their HIV infection wereapproximately four times more likely to report an overnight hospitalization than those unaware(14.1% and 3.2%, respectively).Among all HIV‐infected adults, 9.6% reported a previous tuberculosis (TB) diagnosis. More thanhalf of these adults (61.1%) were aware of their HIV status; the majority had reported completingTB treatment (85.3%); and approximately half (51.2%) reported taking daily cotrimoxazole. Thismeans that nearly half (48.8%) were not taking cotrimoxazole, which is recommended for all HIVinfectedadults. It was not possible to determine whether HIV infection preceded TB infection orvice versa from the survey data.Many HIV‐infected individuals have chronic health care needs and could benefit from an array ofprevention, acute care and long‐term care services. In particular, the Ministry of Medical Servicesrecommends safe drinking water, mosquito bednets and daily multi‐vitamins for all HIV‐infectedpersons. At the time of the 2007 KAIS, 45.5% of HIV‐infected adults in Kenya lived in a householdthat treated its main source of drinking water; the most commonly reported method of treatmentwas boiling. Among all HIV‐infected adults, 45.3% slept under a bednet the night before thesurvey; 20.2% slept under an insecticide‐treated net. There were no significant differences inwater treatment practices and bednet usage between those aware or unaware of their HIV status.Among HIV‐infected adults aware of their HIV status, 36.4% reported taking daily multivitamins.HSV‐2, syphilis and co‐infection with HIVThe national prevalence of herpes simplex virus type 2 (HSV‐2), the virus that causes genitalherpes was estimated at 35.1%, indicating that an estimated 7 million adults aged 15‐64 yearswere infected with HSV‐2 at the time of the survey. Women were more likely to be infected thanmen (41.7% and 26.3%, respectively). Men who were uncircumcised (38.3%) were more likely tobe infected with HSV‐2 compared to men who were circumcised (24.0%). HSV‐2 prevalenceincreased significantly with increasing number of lifetime sexual partners among women andmen. Among individuals with HSV‐2, 16.4% were also infected with HIV, which was eight timesgreater than the HIV prevalence among individuals without HSV‐2 (2.1%).The national prevalence of active syphilis infection (defined as having seropositive results on botha Treponema pallidum particle agglutination assay and a rapid plasma reagin test result) was 1.8%.Prevalence was similar between women (1.7%) and men (1.9%) and increased significantly withage, number of lifetime sexual partners and lack of male circumcision. Among those infected withsyphilis, 16.9% were also infected with HIV, 71.5% were also infected with HSV‐2, and 15.9%were infected with both HIV and HSV‐2.Prevalence of HIV, HSV-2 and syphilis among women and men aged 15-64 years,2007.HIV (%) HSV-2 (%) Syphilis (%)Women 8.4 41.7 1.7KenyaKAIS 2007 13
Page 1 and 2: KAIS 2007 1
Page 4 and 5: P.O. Box: 9361 Code: 00202 Nairobi,
Page 6: KEMRIKNASPKNBSKshLLITNMCHmlμLMOMSM
Page 10 and 11: KEY FINDINGS: HIV PREVENTION• Amo
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
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3.10 WEALTH INDEXFigure 3.10a HIV p
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DATA IN CONTEXT: APPROACHES TO HIV
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Population estimates reported in th
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Figure 4.3c Ever been tested for HI
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Figure 4.3e Ever been tested for HI
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Figure 4.3g Women aged 15-49 years
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Figure 4.4a Time since last HIV tes
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Figure 4.5a Reasons for not testing
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Increasing access to HIV testing wi
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4.7. Gaps and unmet needs• Two‐
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Population estimates reported in th
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Figure 5.3b Self-reported HIV statu
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This section examines participants
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Figure 5.5a Knowledge of HIV status
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Figure 5.5c Percent of partnerships
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uninfected. A couple was considered
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Figure 5.6c Women and men aged 15-6
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Sexual Partners, Sexual DebutCircum
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Figure 6.3b. HIV prevalence among w
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Figure 6.3d. HIV prevalence among w
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Figure 6.3f. Men aged 15-64 years r
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In this section, “consistent cond
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Figure 6.4c. Marital or cohabiting
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Figure 6.5b. Young women and men ag
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Figure 6.5d. Young women and men ag
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Figure 6.6a. Male circumcision amon
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Figure 6.6d. HIV prevalence among m
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Knowledge, Attitudes and Beliefs ch
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Figure 7.3b. Most common source of
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Figure 7.3c Women and men aged 15-6
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Figure 7.3e Overall scores for 12 q
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Figure 7.3g Women and men aged 15-6
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Figure 7.3i Correct responses to se
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• If a female teacher has the AID
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7.5. Perceived risk of HIV infectio
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Figure 7.5c Reasons given for havin
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7.6. Attitudes toward women’s rol
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who had never been tested for HIV o
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8.2 INTRODUCTIONIn the absence of i
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8.3 ANTENATAL CLINIC ATTENDANCE, 20
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8.4 KNOWLEDGE OF MOTHER-TO-CHILD TR
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The analysis in this section consid
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Figure 8.5b Women aged 15-49 years
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• Incorrect communication or unde
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8.8 CURRENTLY PREGNANT WOMEN: HIV T
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Among currently pregnant women, 7.1
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Among pregnant, HIV‐uninfected wo
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Figure 8.11b Desire for a child in
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8.12 CONTRACEPTIVE USEThe next figu
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Figure 8.12c Contraceptive use* amo
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Blood and Injection Safety chapter
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D ATA IN C ONTEXT: N ATIONAL B LOOD
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Figure 9.3a Source of blood donatio
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Figure 9.3b Source of blood donatio
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Figure 9.3d Source of blood donatio
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9.4 Blood transfusionsAlthough the
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10080Injec tionsPillsNo preferenceW
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HIV prevalence among adults who rep
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9.6 Gaps and unmet needs• HIV pre
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The Ministry of Medical Services re
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10.3 COTRIMOXAZOLE PROPHYLAXIS FOR
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Coverage also varied significantly
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10.4 ARV ELIGIBILITY, COVERAGE AND
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ARV coverage was estimated by takin
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Figure 10.4b ARV coverage among HIV
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DATA IN CONTEXTEstimates of HIV-inf
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10.5 GAPS AND UNMET NEEDS• The es
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debilitating illness leading to hos
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Among HIV‐infected adults (83.6%
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Figure 11.3d HIV-infected adults ag
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Figure 11.4b HIV-infected adults ag
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Figure 11.4d HIV-infected adults ag
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DATA IN CONTEXTHIV Basic Care Packa
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Figure 11.5b HIV-infected adults ag
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Figure 11.6b Percent of HIV-infecte
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11.8 GAPS AND UNMET NEEDS• Counse
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12.3 HSV-2 prevalenceHSV‐2 preval
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807071.0WomenMen64.3HSV-2 Prevalenc
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Figure 12.3d HSV-2 prevalence among
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Figure 12.4b HSV-2 prevalence among
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Figure 12.5a HIV prevalence by HSV-
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Figure 12.6b Condom use during last
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12.7 Gaps and unmet needs• Increa
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also at substantially elevated risk
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Figure 13.3b Prevalence of syphilis
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Figure 13.3d Prevalence of syphilis
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Figure 13.3f Prevalence of syphilis
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Figure 13.4b Prevalence of syphilis
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13.6 GAPS AND UNMET NEEDS• Patien
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Household Characteristics andImpact
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Figure 14.3a Sex of head of househo
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Figure 14.3d Household population,
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14.5 PREVALENCE OF HIV-AFFECTED HOU
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Figure 14.5c HIV-affected household
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social and economic conditions of h
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households used chemical disinfecta
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14.7 HOUSEHOLD OWNERSHIP OF MOSQUIT
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Figure 14.7b HIV-affected and HIV-u
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Table 14.7b Source of bednets among
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Overall, 52.3% percent of children
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14.9 CARE AND SUPPORT FOR ORPHANS A
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For consistency with other populati
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Returning Test Results15.1 KEY FIND
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Figure 15.3b. Participants aged 15-
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Figure 15.3d. Participants aged 15-
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Figure 15.3f. Participants aged 15-
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15.4 RETURNING TO RECEIVE TEST RESU
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Figure 15.5 Women aged 15-64 years
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Methods of the 2007 KAISThis Append
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ClustersHouseholdsProvince Rural Ur
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and treatment services and other he
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The KEMRI Ethical Review Committee
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Red top (5 ml)Whole blood collected
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algorithm using two HIV EIAs (Viron
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Figure A5.a. Structure and flow of
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Recruitment and training of results
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observe confidentiality of particip
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Documentation. Results counsellors
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Normalisation of weightsNormalised
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This report presents the results of
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