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

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8.12 GAPS AND UNMET NEEDS• Although ANC attendance rates were high, one in 10 women did not attend anANC and could not access PMTCT services. Efforts should be directed toreaching those women not attending an ANC.• ANC testing increased over the years, but gaps still remain: some womenattending ANC in 2007 were not offered HIV testing. Additional efforts arerequired to ensure “opt-out” HIV testing is offered to all ANC attendees as wellas testing options for sexual partners.• Most ANC attendees received testing and counseling for HIV; considerationshould be given to the future use of PMTCT program data to replace ANCsentinel surveillance.• ANC attendance was low among women in their first and second trimesters ofpregnancy. A greater number of women may have exposure to HIV testing andPMTCT services if ANC begins earlier in pregnancy. Early prenatal care shouldbe a priority.• Prevention of HIV infections in pregnant and breastfeeding women must beaddressed; among HIV-uninfected pregnant or breastfeeding women whoreported having unprotected sex, the majority of their sexual relationshipswere with men whose HIV status was unknown to them.• There is a large unmet need for family planning among all women; this needshould be addressed most urgently among HIV-infected women. Fertilitydesires among women were significantly associated with knowledge of HIVstatus, but contraceptive use was not. Fertility desires should be considered inconjunction with contraceptive options.KAIS 2007 162
Blood and Injection Safety chapter 99.1 Key Findings• Among all respondents aged 15‐64 years, 2.3% reported donating blood in the yearbefore the survey; almost half of donors (48.3%) reported donating in response to arequest from a blood transfusion service.• Among adults who reported ever receiving a blood transfusion, 7.0% were HIVinfected.This figure was not significantly different from persons who did notreceive a blood transfusion (7.1%).• An estimated 33.1% of adults reported that they received at least one medicalinjection in the year before the survey. Though HIV prevalence was significantlyhigher among both women and men who reported medical injections in the pastyear compared to women and men who did not, causality cannot be determined andfurther adjustments are needed to control for possible confounders.• The use of clean needle packets for medical injections appeared to be widelyadopted in clinical settings.9.2 IntroductionAssuring a safe and adequate the blood supply is the priority of the Kenya National BloodTransfusion Service (KNBTS), which has evolved from individual hospital‐based blood programs to anational network of regional blood collection, processing and distribution to transfusing facilities thatprovides coverage for much of the nation. However, coverage is not 100%. There are still somefamily/replacement donors (that is, persons who donate at the request of family or friends) in theKNBTS system and some hospitals continue to operate independently, such as Aga Khan, a privateteaching hospital in Nairobi which has large labour and delivery services. Donations from volunteersand family/replacement donors are all subject to the same testing by the KNBTS and the quality ofhospital programs ranges from basic to international standards with external quality assurancesystems.In November 2001 Kenya introduced its first blood safety policy and in January 2007 establishedNational Standards for Blood Banks and Transfusion Services. KNBTS is structured to collect, screenand distribute blood from regular, voluntary, non‐remunerated (that is, non‐paid) donors based oninternational standards of quality management, testing algorithms and standardised procedures.KAIS 2007 163
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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
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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
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: Figure 8.12c Contraceptive use* amo
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
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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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