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

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Men 5.4 26.3 1.9Total 7.1 35.1 1.8Orphanhood and household characteristicsNationally, 11.1% of children under age 15 years had lost one or both parents, corresponding toan estimated 1.78 million children. In Nyanza province, the prevalence of orphaned children was20.9%, nearly double the national prevalence.Of all households in KAIS, 11.0% of households were affected by HIV, that is, at least oneperson in the household was HIV‐infected. In 75.6% of HIV‐affected households, the HIVinfectedhousehold member was the head of household, defined as the person with decisionmaking authority and usually economic responsibility for the household and its members.In both rural and urban areas, most households did not treat their drinking water (60.1%and 52.1%, respectively), including both HIV‐affected and HIV‐unaffected households. Morethan one in four rural households (27.2%) reported surface water from rivers, dams, ponds,streams, and irrigation channels as their main source of drinking water. Mosquito net ownershipincreased 2.5 times between the 2003 KDHS and the 2007 KAIS; 56.1% of households in 2007owned at least one mosquito net compared to 21.8% in 2003.KAIS 2007 14
Introduction, Overview of Methodsand Response Rates1.1 BACKGROUNDThe control of HIV/AIDS remains a major challenge in Kenya. High prevalence of HIV withregional variations, low levels of HIV testing, HIV discordance within couple relationships andconcurrent epidemics of other sexually transmitted infections (STIs) make the management of theHIV epidemic difficult and complex. To overcome these challenges, policymakers andprogramme planners need the highest quality data to implement, monitor and evaluate HIVprevention, care and treatment services. This report presents the primary findings of the 2007Kenya AIDS Indicator Survey (KAIS) – a nationally and regionally representative householdsurvey that provides information on HIV and STI prevalence, factors associated with infection,and the scope of Kenya’s prevention, care and treatment response.The first case of HIV in Kenya was diagnosed in 1984. Since then, the epidemic and thegovernment’s response to it have expanded. When the epidemic was first recognized, the highestrates of infection were concentrated in marginalised and special‐risk groups, including womenwho were sex workers and their clients, and men in mobile occupations, such as long‐distancetruck drivers. For more than a decade, however, the country has faced a mixed HIV/AIDSepidemic; new infections are occurring both in the general population and in vulnerable, high‐riskgroups.HIV epidemics in each country are intricate and dynamic, and governments must track certainindicators for HIV/AIDS to control their epidemics effectively, including the incidence of newHIV infections; mortality due to HIV‐related illness and coverage; and access to HIV care,treatment and prevention services. Since 1990, Kenya has conducted annual HIV sentinelsurveillance among pregnant women attending antenatal clinics (ANC) and patients attendingSTI clinics. By 2007, sentinel surveillance included 44 rural and urban sites throughout thecountry. Other sources of information on HIV/AIDS include program data from voluntarycounselling and testing (VCT) sites, prevention of mother‐to‐child transmission (PMTCT) services,and blood donation screening, and population‐based data from the 2003 Kenya Demographic andHealth Survey (KDHS), the first survey in Kenya to provide national and provincial estimates ofHIV prevalence.UNAIDS and the World Health Organisation (WHO) recommend that a survey of arepresentative sample of the general population be included in HIV surveillance systems incountries with generalised and mixed epidemics to provide reliable measures of prevalence forwomen and men and information to calibrate the data from routine HIV sentinel surveillance. 22Guidelines for Second Generation HIV Surveillance: WHO/CDS/CSR/2000.5, UNAIDS/00.03E (2000).KAIS 2007 15
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 12 and 13: Among HIV‐uninfected women, 71.2%
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
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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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