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

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assent were both required for participation. Participants could consent to the interview and blooddraw or to the interview alone. The inclusion criteria may have captured non‐Kenyans living asusual residents or visitors in a sampled household. Military personnel and the institutionalizedpopulation (e.g. imprisoned) are typically not captured in similar household‐based surveys mayhave been included in the 2007 KAIS if at home during the survey.Sampling frame and designAdministratively, Kenya is divided into eight provinces. Each province is divided into districts,each district into divisions, each division into locations, each location into sub‐locations, and eachsub‐location into villages. For the 1999 Population and Household Census, the Kenya NationalBureau of Statistics (KNBS) delineated sub‐locations into small units called Enumeration Areas(EAs) that constituted a village, a part of a village, or a combination of villages. The primarysampling unit for Kenya’s master sampling frame, and for the 2007 KAIS, is a cluster, which isconstituted as one or more EAs, with an average of 100 households per cluster.The master sampling frame for the 2007 KAIS was the National Sample Survey and EvaluationProgramme IV (NASSEP IV) created and maintained by KNBS. The NASSEP IV frame wasdeveloped in 2002 based on the 1999 Census. The frame has 1800 clusters, comprised of 1,260rural and 540 urban clusters. Of these, 294 (23%) rural and 121 (22%) urban clusters were selectedfor KAIS.The overall design for the 2007 KAIS was a stratified, two‐stage cluster sample for comparabilityto the 2003 KDHS. The first stage involved selecting 415 clusters from NASSEP IV and the secondstage involved the selection of households per cluster with equal probability of selection in therural‐urban strata within each district. The target of the 2007 KAIS sample was to obtainapproximately 9,000 completed household interviews. Based on the level of household nonresponsereported in the 2003 KDHS (13.2% of selected households), 10,375 households in 415clusters were selected for potential participation in the 2007 KAIS. Table 1.4 shows the provincialdistribution of households and clusters originally sampled for the 2007 KAIS.KAIS 2007 18
Table 1.4 Distribution of sampled clusters and households by province, KAIS 2007.ClustersHouseholdsProvince Rural Urban Total Rural Urban TotalNairobi 4 0 58 58 0 1,450 1,450Central 48 7 55 1,200 175 1,375Coast 24 22 46 600 550 1,150Eastern 50 5 55 1,250 125 1,375North Eastern 23 5 28 575 125 700Nyanza 54 7 61 1,350 175 1,525Rift Valley 51 12 63 1,275 300 1,575Western 44 5 49 1,100 125 1,225Total 294 121 415 7,350 3,025 10,375Of the original 415 clusters, 402 were accessed and surveyed. Thirteen clusters were inaccessibledue to impassable roads or tenuous security situations. All reported estimates and design weightsfor households, individual interviews, and blood draws are based on data from the 402 clusters.Details on methods for performing an adjustment for cluster‐level non‐response in the calculationof weights are provided in Appendix A. The survey was not designed to produce reliable districtlevelestimates. Estimates are presented by rural/urban residence, and by province.1.5 DATA COLLECTION TOOLSQuestionnairesTwo questionnaires were used: a household questionnaire and an individual questionnaire. Thecontent of the questionnaires was adapted from standard AIDS Indicator Survey questionnairesdeveloped by ORC Macro, the 2003 KDHS HIV Module and previous surveys conducted inAfrica. Various stakeholders in NACC, the National AIDS and STI Control Programme(NASCOP) and other HIV/AIDS organizations working in Kenya met to determine the key HIVprogram information needs and gaps. The KAIS Technical Working Group (TWG) modifiedexisting questions and designed new questions to reflect current and emerging issues inHIV/AIDS in the country. The final questionnaires were translated from English into Kiswahiliand 11 vernacular languages and back‐translated into English to ensure accuracy. Thequestionnaires were further refined after a pilot study prior to distribution of the final versions tofield staff.The household questionnaire gathered basic information from the head of the household on usualmembers and visitors in the household, including age, sex, education, relationship to the head ofhousehold, and orphanhood among children. Information was collected on characteristics of thehousehold’s dwelling unit, such as the source of water, type of toilet facilities, materials used forthe floor of the house, property ownership, and mosquito nets. Information was also collected onwhether the household had received specific types of care and support in the 12 months prior to4Nairobi is exclusively urban; there were no rural clusters in Nairobi.KAIS 2007 19
Page 1 and 2: KAIS 2007 1
Page 4 and 5: P.O. Box: 9361 Code: 00202 Nairobi,
Page 6: KEMRIKNASPKNBSKshLLITNMCHmlμLMOMSM
Page 10 and 11: KEY FINDINGS: HIV PREVENTION• Amo
Page 12 and 13: Among HIV‐uninfected women, 71.2%
Page 14 and 15: Men 5.4 26.3 1.9Total 7.1 35.1 1.8O
Page 17: Kenya is also committed to the “T
Page 22 and 23: 1.7 SURVEY IMPLEMENTATIONTrainingIn
Page 24 and 25: Data processing included a number o
Page 26 and 27: Characteristic 2003 KDHS 2007 KAISQ
Page 28 and 29: Figure 1.11 Sampled clusters and el
Page 30 and 31: Table 1.11c Survey response rates b
Page 32 and 33: Population estimates reported in th
Page 34 and 35: 2.4 HIV PREVALENCE AMONG YOUTHFigur
Page 36 and 37: Figure 2.6b HIV prevalence among ru
Page 38 and 39: 2.7 HIV PREVALENCE BY PROVINCEFigur
Page 40 and 41: Figure 2.7c Estimated number of HIV
Page 42 and 43: 2.9 HIV PREVALENCE BY EDUCATION LEV
Page 44 and 45: Figure 2.10b HIV prevalence among r
Page 46 and 47: 2.11 HIV PREVALENCE BY TIME AWAY FR
Page 48 and 49: 2.13 MALE CIRCUMCISION AND ASSOCIAT
Page 50 and 51: Figure 2.13c HIV prevalence among c
Page 52 and 53: Comparison of HIV Prevalence in the
Page 54 and 55: 3.3 SEXFigure 3.3a HIV prevalence a
Page 56 and 57: Figure 3.4b. HIV prevalence among m
Page 58 and 59: 3.7 PROVINCEFigure 3.7a HIV prevale
Page 60 and 61: 2003 KDHS 1 2007 KAIS 2Marital stat
Page 62 and 63: 3.10 WEALTH INDEXFigure 3.10a HIV p
Page 64 and 65: DATA IN CONTEXT: APPROACHES TO HIV
Page 66 and 67: Population estimates reported in th
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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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Population estimates reported in th
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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
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7.6. Attitudes toward women’s rol
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who had never been tested for HIV o
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8.2 INTRODUCTIONIn the absence of i
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8.3 ANTENATAL CLINIC ATTENDANCE, 20
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8.4 KNOWLEDGE OF MOTHER-TO-CHILD TR
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The analysis in this section consid
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Figure 8.5b Women aged 15-49 years
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• Incorrect communication or unde
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8.8 CURRENTLY PREGNANT WOMEN: HIV T
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Among currently pregnant women, 7.1
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Among pregnant, HIV‐uninfected wo
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Figure 8.11b Desire for a child in
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8.12 CONTRACEPTIVE USEThe next figu
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Figure 8.12c Contraceptive use* amo
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Blood and Injection Safety chapter
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D ATA IN C ONTEXT: N ATIONAL B LOOD
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Figure 9.3a Source of blood donatio
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Figure 9.3b Source of blood donatio
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Figure 9.3d Source of blood donatio
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9.4 Blood transfusionsAlthough the
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10080Injec tionsPillsNo preferenceW
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HIV prevalence among adults who rep
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9.6 Gaps and unmet needs• HIV pre
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The Ministry of Medical Services re
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10.3 COTRIMOXAZOLE PROPHYLAXIS FOR
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Coverage also varied significantly
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10.4 ARV ELIGIBILITY, COVERAGE AND
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ARV coverage was estimated by takin
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Figure 10.4b ARV coverage among HIV
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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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