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

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Appendix B.10 provides sample sizes and 95% confidence intervals for estimates presented in thischapter. Throughout the chapter, the term significant indicates a chi‐square p‐value less than 0.05;marginally significant indicates a p‐value between 0.05 and 0.10, inclusive; and not significantindicates a p‐value greater than 0.10.Population estimates reported in this chapter were calculated based on the 2007 projected populationby province, age and sex reported in the Revised Population Projections for Kenya 2000‐2020, KenyaNational Bureau of Statistics (August 2006).Weighted national estimates for selected indicators from the2007 KAIS were used in these calculations. Detailed methods used for calculating population estimatesare described in Appendix A.WHO Clinical Staging 3DATA IN CONTEXTWHO clinical staging of HIV-related disease for adults and children is designed to be used onceHIV infection has been confirmed with an antibody or a virologic test. It is a universal four-stagesystem that includes simplified, standardized descriptors of clinical staging events related tosurvival, prognosis and progression of clinical disease without antiretroviral therapy. It assists inclinical management of HIV, especially where there is limited laboratory capacity.The clinical stage is useful for assessment at baseline (first diagnosis of HIV infection) or entryinto long-term HIV care and in the follow-up of patients in care and treatment programmes. Itshould be used, in conjunction with immunological classification whenever available, to guidedecisions on when to start HIV-related interventions, including when to start ARVs and to assessclinical response to therapy in the absence of appropriate laboratory testing.WHO Clinical Staging of Established HIV Infection.WHO Clinical StageHIV-associated SymptomsIAsymptomaticIIMild symptomsIIIAdvanced symptomsIVSevere symptoms33WHO case definitions of HIV for surveillance, revised clinical staging, and immunological classification of HIV‐relateddisease in adults and children, 2007.KAIS 2007 182
10.3 COTRIMOXAZOLE PROPHYLAXIS FOR HIV-INFECTED ADULTSDaily use of cotrimoxazole (trimethoprim‐sulfamethoxazole) or Septrin® prevents certainbacterial and parasitic infections that cause pneumonia, diarrhoea and malaria and prolongs thelives of adults and children who have HIV (see Data in Context: Why Take Cotrimoxazole?). TheMinistry of Medical Services recommends that all people infected with HIV, regardless of CD4count, take cotrimoxazole, or a similar antibiotic, daily to reduce the risk of illnesses associatedwith HIV/AIDS.Figure 10.3a Cotrimoxazole coverage and access among HIV-infected adults aged 15-64years, Kenya 2007.Unaware of HIVstatus/Not takingcotrimoxazole84.1%Aware of HIVstatus/Not takingcotrimoxazole,3.8%Aware of HIVstatus/Takingcotrimoxazole12.1%Aware of HIVstatus/Nottakingcotrimoxazole23.9%Aware of HIVstatus/Takingcotrimoxazole76.1%Cotrimoxazole access amongHIV-infected adults awareof their statusCotrimoxazole coverage among allHIV-infected adults.Figure 10.3a Coverage of cotrimoxazole among all HIV-infected adults wasapproximately one–tenth. Most people who did not take cotrimoxazole were unawarethey were infected. Of those who knew their HIV status, about three fourths weretaking cotrimoxazole.KAIS estimates indicate that 12.1% of HIV‐infected adults were taking daily cotrimoxazole at thetime of the survey. This low coverage can be explained by the small proportion (16.4%) of HIVinfectedadults in the survey who knew they were infected. With most adults reporting that theynever had been tested for HIV, this likely reflects the lack of access to HIV testing. Among the16.4% of HIV‐infected adults who correctly reported knowing their HIV status, however, access tocotrimoxazole was significantly higher, with 76.1% reporting daily cotrimoxazole use. For a smallpercentage of HIV‐infected persons, cotrimoxazole may cause severe adverse effects such as skinKAIS 2007 183
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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
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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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Page 134 and 135: 7.6. Attitudes toward women’s rol
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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
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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: The Ministry of Medical Services re
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
Page 213 and 214: 11.8 GAPS AND UNMET NEEDS• Counse
Page 215 and 216: 12.3 HSV-2 prevalenceHSV‐2 preval
Page 217 and 218: 807071.0WomenMen64.3HSV-2 Prevalenc
Page 219 and 220: Figure 12.3d HSV-2 prevalence among
Page 221 and 222: Figure 12.4b HSV-2 prevalence among
Page 223 and 224: Figure 12.5a HIV prevalence by HSV-
Page 225 and 226: Figure 12.6b Condom use during last
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Page 231 and 232: 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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