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

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8.9 CURRENTLY PREGNANT WOMEN: HIV, HSV-2 AND SYPHILISHSV‐2 and syphilis infection are known to increase the risk of acquisition and transmission of HIV.Additionally, maternal genital HSV‐2 infection can result in neonatal herpes encephalitis with aninfant mortality rate in excess of 50% despite treatment. Babies born to mothers subclinically sheddingvirus, after acquiring genital herpes in the their third trimester, have a 30‐50% risk of developingneonatal herpes. 6,7,8Figure 8.9a HIV and HSV-2 co-infection among currently pregnant women aged 15-49years, Kenya 2007.HIV only1.8%Both HIVand HSV-27.1%Neither HIV norHSV-258.2%HSV-2 only32.9%Figure 8.9a Forty percent of currently pregnant women were infected with HSV-2.6Boucher FD, Yasukawa LL, Bronzan RN, Hensleigh PA, Arvin AM, Prober CG. A prospective evaluation of primarygenital herpes simplex virus type 2 infections acquired during pregnancy. Pediatr Infect Dis J 1990;9:499–504.7Brown ZA, Benedetti J, Ashley R, Burchett S, Selke S, Berry S, et al. Neonatal herpes simplex virus infection in relationto asymptomatic maternal infection at the time of labor. N Engl J Med 1991;324:1247–52.8Brown ZA, Wald A, Morrow RA, Selke S, Zeh J, Corey L. Effect of serologic status and cesarean delivery ontransmission rates of herpes simplex virus from mother to infant. JAMA2003;289:203–9.KAIS 2007 152
Among currently pregnant women, 7.1% were co‐infected with HIV and HSV‐2, 1.8% were infectedwith HIV only, 32.9% were infected with HSV‐2 only and 58.2% were not infected with either HSV‐2or HIV.HSV‐2 prevalence was significantly higher (2.2 times) among HIV‐infected pregnant womencompared to pregnant women with no HIV infection (80.1% vs. 36.1%, respectively). These estimateswere similar to the 2007 KAIS findings for HSV‐2 in the general population, which are discussed inChapter 12. Among all women aged 15‐49 years, HSV‐2 prevalence was 39.8% and HSV‐2 prevalencewas 2.4 times higher among HIV‐infected women compared to HIV‐infected women (84.1% vs. 35.5%,respectively) (data not shown).Figure 8.9b HIV and syphilis among currently pregnant women aged 15-49 years, Kenya2007.HIV only8.9%Syphilis only1.6%Neither HIV norSyphilis89.5%Figure 8.9b Among currently pregnant women, 1.6% were seropositive for syphilis; noneof these women were co-infected with HIV.Syphilis is most transmissible in the primary and secondary stages, but pregnant women can transmitthe infection to fetuses at any point in the course of their disease, causing congenital syphilis.Among women currently pregnant at the time of KAIS, 1.6% were seropositive for syphilis. Thisestimate matches the overall prevalence of syphilis seropositivity found in the 2007 KAIS for thegeneral population (1.8%) and among all women aged 15‐49 years (1.6%). The 2007 KAIS findings forsyphilis infection in the general population, which are presented in Chapter 13, suggest a strongcorrelation between HIV and syphilis seropositivity; however, no pregnant women were found to beseropositive for both HIV and syphilis in the 2007 KAIS. This may be due to the small number ofpregnant respondents infected with syphilis.KAIS 2007 153
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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
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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
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: 8.8 CURRENTLY PREGNANT WOMEN: HIV T
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
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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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