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

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The analysis in this section considers women aged 15‐54 years whose last live birth was between 2003and 2007 and who attended ANC at least once during that pregnancy.Figure 8.5a Women aged 15-54 years attending an ANC from 2003 to 2007 by year of lastlive birth and whether the woman was offered, tested, or not offered or tested at the ANC,Kenya 2007.1008043.235.536.825.917.93.529.6Testing Experience at ANC (%)6040206.550.47.0 7.157.5 56.04.869.378.65.564.902003 2004 2005 2006 2007 TotalYear of Last Live BirthTested at ANC Offered, but not tested at ANC Not offered, not tested at ANCFigure 8.5a A significantly higher percent of ANC attendees received an HIV test iftheir last live birth was in 2007 than if their last live birth was in 2003.The percent of ANC attendees offered an HIV test increased from 56.9% in 2003 to 82.1% in 2007,resulting in a significantly greater percent of ANC attendees being tested in 2007 (78.6%) compared to2003 (50.4%). The proportion of women offered a test but not tested was small (3.5% in 2007), and maybe attributable to test kit stock‐outs, absence or unavailability of testing staff, or refusal (“opt‐out”)when offered an HIV test.Of women attending public ANCs between 2003 and 2007, 69.8% were offered HIV testing and 64.4%received a test (data not shown). Similar rates were seen at other types of ANC facilities and amongwomen receiving antenatal care at home. These estimates are provided in table 8.5 in Appendix B.8.KAIS 2007 144
4D ATA I N C ONTEXTANC Sentinel Surveillance 4HIV sentinel surveillance is carried out at sites throughout Kenya using unlinked anonymous HIVtesting of leftover blood samples routinely collected for other purposes. Sentinel surveillancedata are used to track trends in HIV prevalence in specific populations over time and to identifydisparities in infection. One of the populations surveyed is women aged 15-49 years attendingANC for the first time during their current pregnancy. ANC clinic attendees are believed torepresent healthy, sexually active women of reproductive age and represent a proxy for thegeneral population. In 2005, approximately 12,800 women were sampled from 43 sites over athree-month period for ANC surveillance.National ANC sentinel surveillance reports show that HIV prevalence among pregnant womenaged 15-49 years decreased from 9.4% in 2003 to 6.9% in 2006. ANC sentinel surveillance isone of several sources of national HIV data. Because it uses anonymous testing, it is free fromparticipation and self-reporting biases. As the proportion of women who are tested in ANC risesand gets closer to 100%, however, the need for anonymous testing decreases because thepopulation being tested routinely for clinical purposes approximates the population that wouldhave been tested anonymously.In a few countries, such as Botswana and Thailand, anonymous testing has been dropped fromANC sentinel surveillance, and data from routine clinical testing are being used. In Kenya, wheremore than 90% of young pregnant women (aged 25-29 years) came to ANC for care in 2007 and80% were offered testing, ANC sentinel surveillance will soon be able to transition fromanonymous surveys to reportable, routine testing to gather HIV surveillance data amongpregnant women.Please refer to the “Data in Context” section in Chapter 3 for more on ANC sentinel surveillanceand alternate approaches to national HIV surveillance.4NASCOP, Sentinel Surveillance of HIV and STDs in Kenya Report, 2006.KAIS 2007 145
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KAIS 2007 1
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P.O. Box: 9361 Code: 00202 Nairobi,
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KEMRIKNASPKNBSKshLLITNMCHmlμLMOMSM
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KEY FINDINGS: HIV PREVENTION• Amo
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Among HIV‐uninfected women, 71.2%
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Men 5.4 26.3 1.9Total 7.1 35.1 1.8O
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Kenya is also committed to the “T
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Table 1.4 Distribution of sampled c
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1.7 SURVEY IMPLEMENTATIONTrainingIn
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Data processing included a number o
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Characteristic 2003 KDHS 2007 KAISQ
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Figure 1.11 Sampled clusters and el
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Table 1.11c Survey response rates b
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Population estimates reported in th
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2.4 HIV PREVALENCE AMONG YOUTHFigur
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Figure 2.6b HIV prevalence among ru
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2.7 HIV PREVALENCE BY PROVINCEFigur
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Figure 2.7c Estimated number of HIV
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2.9 HIV PREVALENCE BY EDUCATION LEV
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Figure 2.10b HIV prevalence among r
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2.11 HIV PREVALENCE BY TIME AWAY FR
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2.13 MALE CIRCUMCISION AND ASSOCIAT
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Figure 2.13c HIV prevalence among c
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Comparison of HIV Prevalence in the
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3.3 SEXFigure 3.3a HIV prevalence a
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Figure 3.4b. HIV prevalence among m
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3.7 PROVINCEFigure 3.7a HIV prevale
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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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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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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
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 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
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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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