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

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1.7 SURVEY IMPLEMENTATIONTrainingIn July 2007, 204 skilled interviewers, laboratorytechnicians, laboratory scientists and fieldsupervisors were recruited and trained for twoweeks in the 2007 KAIS procedures. Thetraining involved didactic presentations, smallgroup discussions and practical sessions, suchas mock interviews and blood draws.INTERVIEWER TRAINING• Informed consent for interview• Administering questionnaires• Objective interview techniques• Explaining KAIS diseasesInterviewers were trained to identify eligible households and individuals, seek informed consent,educate participants about HIV, HSV‐2 and syphilis and administer questionnaires usingobjective using interview techniques. Fieldlaboratory technicians and scientists weretrained in preparing respondents for the blood LAB TECHNICIAN TRAININGdraw and in specimen collection, processing, • Informed consent for blood drawstorage and transportation to the central • Universal precautionslaboratory in Nairobi. Laboratory training • Sample collectionemphasized ways to minimise risks in handling • Sample processingbiological specimens. Laboratory technicians • Return of results voucherswere trained to process and analyse specimensin the laboratory and to issue return of resultsvouchers for participants to retrieve their test results.In September 2007, NASCOP and the TWG conducted intensive one‐week trainings for 202counsellors and health workers involved in returning test results to participants. Counsellors andhealth workers, regardless of their health care experience, were required to attend the training torefresh their counselling skills, learn how to return the 2007 KAIS test results to participants andto refer them and their partners for further testing, care and treatment.Community mobilizationThe 2007 KAIS was officially launched on August 1, 2007. This date marked the start of thenational television, radio, and print media campaign to inform, sensitise and mobilise Kenyansabout the survey and the importance of broad participation. Mobilisation efforts later shifted tocommunity and village level communications to prepare communities before survey teamsarrived. Mobilisation efforts at the community and village level were critically important to thissurvey.KAIS 2007 22
FieldworkA total of 29 field teams, each consisting of six data collectors (four interviewers and twolaboratory technicians), one supervisor and one driver, conducted fieldwork from August toDecember 2007. Teams were provided local language questionnaires in addition to questionnairesin Kiswahili and English to accommodate respondents not conversant in vernacular languages.After obtaining informed consent from the head of the household, interviewers administered thehousehold questionnaire to the head of household followed by individual interviews and blooddraws among all eligible and consenting individuals in the household. Participants receivedbrochures on HIV, HSV‐2, syphilis, and tuberculosis in Kiswahili and English. Completedquestionnaires for each cluster were packed and delivered weekly to KNBS headquarters throughsecured courier services for data processing.SupervisionSix teams of supervisors representing different KAIS collaborating institutions routinely visitedfield teams during data collection. Supervision teams travelled throughout the country to assessmobilisation efforts, perform quality checks on questionnaires and field laboratory procedures,deliver additional survey supplies, troubleshoot challenges and provide psychosocial support tofield teams. Supervision reports were disseminated among the KAIS leadership and key issueswere addressed immediately.1.8 LABORATORY LOGISTICSBlood specimens were collected by the field laboratory teams and shipped two to three times perweek by secured courier services to the NHRL. Each week, an average of 500 samples from theeight provinces were received at the NHRL, logged into a laboratory information managementsystem and screened for HIV, HSV‐2 and syphilis. All reactive samples and 5% of randomlyselectednon‐reactive samples were retested for quality assurance (QA) at the KEMRI QAlaboratory. All HIV seropositive serum samples were referred for immediate CD4 testing at theNHRL. Internal controls with known CD4 quantities were included with each run. Results of HIV,HSV‐2, and syphilis testing conducted by the two laboratories were cross‐checked and verified bythe NHRL laboratory manager to ensure accurate results, and then returned to participants.Detailed information on laboratory testing algorithms and dispatching results are provided inAppendix A.To ensure that the blood samples collected in remote areas in North Eastern province reached theNHRL in a timely fashion, a local airline was contracted to fly blood samples from North Easternprovince to the central laboratory in Nairobi. Overall, 98.9% of whole blood samples and 99.8% ofserum samples collected in the 2007 KAIS were of adequate quality for testing.1.9 DATA PROCESSING AND ANALYSISKAIS 2007 23
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 and 18: Kenya is also committed to the “T
Page 19 and 20: Table 1.4 Distribution of sampled c
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
Page 68 and 69: Figure 4.3c Ever been tested for HI
Page 70 and 71: 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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