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

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ash, bone marrow toxicity, and liver damage. However, for the vast majority of HIV‐infectedpersons, cotrimoxazole is well tolerated. Not taking cotrimoxizale represents a missedopportunity to reduce the rates of morbidity and mortality among HIV‐infected persons. Noadjustment has been made to coverage and access estimates to account for not takingcotrimoxazole because of potential contraindications to cotrimoxazole or Septrin.DATA IN CONTEXT: Why take cotrimoxazole?People with HIV who take cotrimoxazole every day have decreased risk of malaria,pneumonia, diarrhoea and death and results in fewer hospitalizations.Cotrimoxazole is inexpensive (less than 500 Ksh per year) and relatively safe—only3% of patients stop therapy due to toxic reactions, and for many of these patients,an alternate daily antibiotic can be prescribed. Because cotrimoxazole isrecommended for all people with HIV infection, it does not require testing for CD4cell count or WHO disease staging.Figure 10.3b Cotrimoxazole coverage among HIV-infected adults aged 15-64 years byprovince, Kenya 2007.NairobiCentral13.615.8Coast4.2ProvinceEasternNorth EasternNyanza*6.516.3Rift Valley8.0Western16.2Total12.10 5 10 15 20Cotrimoxazole Coverage (%)Figure 10.3b Cotrimoxazole coverage varied significantly by province and was highestin Nyanza province and lowest in Coast province.*Estimates not presented due to small denominators of less than 25 observations in this category.Coverage of cotrimoxazole varied significantly by province: from a high of 16.3% in Nyanzaprovince to a low of 4.2% in Coast province. Cotrimoxazole coverage was greater among womenthan men (13.3% versus 9.7%, respectively) and this association was marginally significant.KAIS 2007 184
Coverage also varied significantly by age group, education level, and marital status. Theseestimates are provided in Appendix B.10.Figure 10.3c Estimated number of HIV-infected adults aged 15-64 years taking and nottaking cotrimoxazole by province, Kenya 2007.Nairobi25,000 159,000Central 15,00080,000Taking CotrimoxazoleNot Taking CotrimoxazoleCoast 6,000140,000ProvinceEasternNorth Eastern9,000129,000Nyanza*68,000349,000Rift Valley24,000280,000Western19,00096,0000 100,000 200,000 300,000 400,000 500,000Population EstimateFigure 10.3c The estimated number of HIV-infected people taking cotrimoxazolevaried by province. Nyanza had the greatest number of adults taking and not takingcotrimoxazole. Central had the lowest number of adults not taking cotrimoxazole, andCoast had the lowest numbers of adults taking cotrimoxazole.*Estimates not presented due to small denominators of less than 25 observations in this category.Nationwide, there were an estimated 172,000 HIV‐infected adults taking daily cotrimoxazole (orSeptrin) compared with over 1.25 million not taking cotrimoxazole.Nyanza province had the greatest number of HIV‐infected adults taking cotrimoxazole, estimatedat 68,000 persons, followed by Nairobi with 25,000 and Rift Valley with an estimated 24,000persons taking cotrimoxazole. Coast province had the fewest estimated number of HIV‐infectedadults taking cotrimoxazole, estimated at 6,000 persons, followed by Eastern province with anestimated 9,000 persons taking cotrimoxazole.Nyanza and Rift Valley provinces combined are home to over half (52.3%) of adults with HIV andhad the greatest number of HIV‐infected persons not on cotrimoxazole. In Nyanza province, anestimated 349,000 HIV‐infected adults were not taking cotrimoxazole, and in Rift Valley province,an estimated 280,000 were not on cotrimoxazole.KAIS 2007 185
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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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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 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: 10.3 COTRIMOXAZOLE PROPHYLAXIS FOR
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
Page 227 and 228: 12.7 Gaps and unmet needs• Increa
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Page 231 and 232: Figure 13.3b Prevalence of syphilis
Page 233 and 234: 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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