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

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Data processing included a number of steps to prepare data collected in the field for analysis. Theinitial steps included editing questionnaires, both in the field and at KNBS, and double‐data entryof all questionnaire responses to minimise errors. Data were entered using Census and SurveyProcessing System (CSPro) version 3.3. 5 Once all survey responses were transferred to electronicformat, the next step was to ensure full concordance between the two data entry databases, usingpaper questionnaires to resolve any discrepancies in transcription. A series of internal consistencyand range checks helped to identify any illogical responses and to verify that responses adheredto skip patterns in the questionnaire. Data validation programs for data cleaning were written inStata version 8.0 6 and corrections were entered directly in CSPro at KNBS.A concurrent process of cleaning the raw laboratory data was conducted at the NHRL. The final,cleaned questionnaire database at KNBS was merged with the laboratory results database at theNHRL using unique survey identification numbers to ensure accurate matches (>99.9% ofidentification numbers were matched). After successfully merging the questionnaire andlaboratory results databases, cluster and household identification numbers were serialized from 1‐402 and from 1‐25, respectively. Original cluster and household numbers, barcodes, andindividual survey identification numbers were stripped from the database prior to weighting andanalysis to ensure anonymity of survey participants.All results presented in the report are based on weighted data to account for the survey samplingdesign and participation rates. The weights are used to correct for unequal probability ofselection, to produce results that are representative of the larger population from which thesample was drawn and to adjust for survey non‐response. The final weights were derived fromthe design weights of the NASSEP IV sampling frame and subsequently adjusted for nonresponse.Three weights were calculated for analyses: a household weight, an individualinterview weight and a blood draw weight.This report presents the results of univariate and bivariate analyses; analyses are not adjusted forconfounding factors. Multivariate analyses of KAIS data will be presented in other disseminationmaterials, such as peer‐reviewed scientific publications. Data analyses was conducted usingStatistical Analysis System (SAS) version 9.13 7 , which has procedures to account for multi‐stagestratified sampling designs and can produce reliable standard errors and confidence intervals.With the exception of chapter 3 (Trends in HIV Prevalence), statistical significance was assessedbased on chi‐square p‐values. In Chapter 3, we assumed the estimates from each time period (the2003 KDHS and the 2007 KAIS) were independent and used the z‐test to compare two weightedestimates and to determine if differences between 2003 and 2007 were statistically significant.Throughout the report, the term significant indicates a p‐value 8 less than 0.05. Marginally5U.S. Census Bureau, Washington, DC. USA.6Stata Corporation, College Station, Texas. USA.7SAS Institute, Inc. Cary, North Carolina. USA.8A p‐value refers to the probability of obtaining a sample showing an association of the observed size orlarger by chance alone, assuming that no association exists. To minimize the risk that the results found areKAIS 2007 24
significant indicates a p‐value between 0.05 and 0.10, inclusive; and not significant indicates a p‐value greater than 0.10.1.10 COMPARISON OF THE 2003 KDHS AND THE 2007 KAISThe period between the 2003 KDHS and the 2007 KAIS was characterized by the rapid scale up ofHIV prevention, care and treatment services. The GOK implemented the 2007 KAIS in part tounderstand the reach and impact of these scaled‐up services on the HIV epidemic. Theinstitutional partners that implemented the 2003 KDHS also were part of the planning andconduct of the 2007 KAIS. To identify changes in the epidemic since 2003, the 2007 KAIS utilizedmethodology similar to the 2003 KDHS to allow for comparison to 2003 findings. Participation inboth surveys was completely voluntary. Verbal consent was a requisite for participation in both2003 and 2007. Table 1.10 compares elements of survey design and methodology between the 2003KDHS and the 2007 KAIS.Table 1.10 Comparison of survey designs between the 2003 KDHS and the 2007 KAIS.Characteristic 2003 KDHS 2007 KAISHousehold sampling Two‐stage sample design Two‐stage sample designInterviews among men andblood draws among womenand menMen in every otherhousehold selected for thewomen’s questionnairewere eligible for the men’squestionnaire; women andmen in every otherhousehold selected for thewomen’s questionnairewere eligible for blood drawSame sampling for womenand men; same sampling forinterview and blood drawWeighting of sample by sexYes (due to differences insampling by women andmen); non‐responseadjustment appliedNo (due to same sampling forwomen and men); nonresponseadjustment appliedAge of participants 15‐49 years old 15‐64 years olddue to chance alone, a p value is calculated and reported. A p‐value less than 0.05 is a conventionallychosen level to control for chance.KAIS 2007 25
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 22 and 23: 1.7 SURVEY IMPLEMENTATIONTrainingIn
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
Page 72 and 73: 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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