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

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Figure 11.4e Cotrimoxazole coverage and access among HIV/TB co-infected adults aged15-64 years, Kenya 2007.Figure 11.4e Approximately one-half (51.2%) of adults co-infected with TB and HIV weretaking cotrimoxazole. Cotrimoxazole access among co-infected adults was 83.7%.Daily cotrimoxazole is recommended for all HIV‐infected persons. Cotrimoxazole coverageamong HIV‐infected people reporting a prior TB diagnosis was 51.2%. Access to cotrimoxazoleamong persons who were aware of their HIV infection and co‐infected with TB and HIV was83.7%. These findings among persons with HIV and TB are consistent with conclusions fromChapter 10, which indicate that coverage of cotrimoxazole among all HIV‐infected adults was lowcompared to access among those who have been diagnosed with HIV and were aware of theirstatus.11.5 PREVENTIVE SERVICES FOR PEOPLE WITH HIV: CLEAN WATERChronic diarrhoea is a leading killer of people infected with HIV. Contaminated water is often thesource of microbes that cause diarrhoea. Treating water to make it safe for drinking dramaticallyimproves the health of all people, particularly those with HIV infection who may have a weakerimmune response to fight against simple waterborne infections. The Ministry of Medical Servicesrecommends safe water systems for all households affected by HIV. Although boiling water, ifdone properly, can effectively kill most diarrhoea‐causing organisms, consistent application ofthis practice may not be feasible because of limited sources of wood or fuel. In these areas,inexpensive and readily available chemical disinfectants may be more suitable.KAIS 2007 206
DATA IN CONTEXTHIV Basic Care PackageA number of low-cost and practical interventions have been shown to reduce HIV-relatedmorbidity and mortality and prevent HIV transmission. Cotrimoxazole preventive therapy, longlastinginsecticide treated bednets, and safe water systems are inexpensive and can benefitpeople living with HIV/AIDS in sub-Saharan Africa by reducing the incidence of opportunisticinfections (e.g., malaria and diarrhea). 1-3 The GOK recommends that all HIV-infected adults andchildren regardless of immunological status have access to these interventions and refers tothem as the Basic Care Package (BCP). In addition to cotrimoxazole, bednets, and a safe watersystem, the BCP in Kenya includes condoms and information, education and communication(IEC) materials for HIV-infected persons and their families. Various combinations of theseinterventions have been packaged and distributed in countries such as Uganda and southernSudan. A pilot program to scale-up access to BCP contents in Coast, Nyanza and Westernprovinces has been under development since early 2009. Experience gained during the pilot willguide the expansion of the BCP at the national level.123In this section, we examine water treatment practices of households with HIV‐infected members.The GOK recommends that in households affected by HIV, water from all sources, includingpiped systems, a public tap, dug wells, rainwater or surface water should be treated beforedrinking, with an exception only for bottled water. Drinking water treatment practices werecollected at the household level, not at the individual level.1World Health organization. Guidelines on co‐trimoxazole prophylaxis for HIV‐related infections among children,adolescents and adults in resource‐limited settings: Recommendations for a public health approach. Geneva: WorldHealth Organization; 2006. (http://www.who.int/hiv/pub/guidelines/WHO%20CTX. pdf)2Mermin J, Lule J, Ekwaru JP, et al. Effect of co‐trimoxazole prophylaxis on morbidity, mortality, CD4‐cell count, andviral load in HIV infection in rural Uganda. Lancet. 2004; 364 (9443): 1428‐34.3Kamya MR, Gasasira AF, Achan J, et al. Effects of trimethoprim‐sulfamethoxazole and insecticide‐treated bednets onmalaria among HIV‐infected Ugandan children. AIDS 2007; 21 (15): 2059‐66.KAIS 2007 207
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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
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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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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
Page 203 and 204: Figure 11.4b HIV-infected adults ag
Page 205: Figure 11.4d HIV-infected adults ag
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
Page 229 and 230: also at substantially elevated risk
Page 231 and 232: Figure 13.3b Prevalence of syphilis
Page 233 and 234: Figure 13.3d Prevalence of syphilis
Page 235 and 236: Figure 13.3f Prevalence of syphilis
Page 237 and 238: Figure 13.4b Prevalence of syphilis
Page 239 and 240: 13.6 GAPS AND UNMET NEEDS• Patien
Page 241 and 242: Household Characteristics andImpact
Page 243 and 244: Figure 14.3a Sex of head of househo
Page 245 and 246: Figure 14.3d Household population,
Page 247 and 248: 14.5 PREVALENCE OF HIV-AFFECTED HOU
Page 249 and 250: Figure 14.5c HIV-affected household
Page 251 and 252: social and economic conditions of h
Page 253 and 254: households used chemical disinfecta
Page 255 and 256: 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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