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

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Characteristic 2003 KDHS 2007 KAISQuestionnaireFocus on demographic,gender, fertility andreproductive healthquestions; administered inKiswahili, English and 12local languagesFocus on HIV/AIDS indicatorsincluding knowledge of selfand partner HIV status andutilization of HIV care andtreatment services;administered in Kiswahili,English and 12 locallanguagesHIV serologic testing Antibody only Antibody plus antigenType of blood drawDBS from finger prick onlyPrimarily venipuncture(0.92% provided DBS)Laboratory tests conductedHIV serologyHIV, HSV‐2 and syphilisserology and CD4 cell countsfor HIV‐infected persons(only HIV for personsproviding DBS)Access to HIV status andother STI testing resultsFree VCT vouchersprovided to access HIVtesting and referrals atmobile or stationary VCTsitesResults vouchers provided torespondents to access HIV,HSV‐2 and syphilis resultsand CD4 cell counts andreferrals at nearby facilitiesThe household sampling strategy was similar between surveys though sampling strategies forindividuals differed. In the 2003 KDHS, every other household selected was eligible for the men’sindividual interview and for a blood draw from eligible adults; this difference in sampling doesnot compromise comparability between the 2003 KDHS and the 2007 KAIS as the selection ofhouseholds in both surveys was random. While the 2003 KDHS covered a broader range ofdemographic and reproduction health measures, the 2007 KAIS focused mostly on HIV/AIDSindicators; thus there are notable differences in the types of questions asked. Where possible, thesame or similar wording was used for questions repeated from the 2003 KDHS to enhancecomparability. Training of the 2007 KAIS field teams was also similar to the training of the 2003KDHS field teams, and both questionnaires were administered in 11 different vernacularlanguages in addition to English and Kiswahili.Similar techniques for weighting were applied to datasets in the 2003 KDHS and in the 2007 KAIS;however, separate weights for women and men were calculated in 2003, given that samplingsystematically varied by sex in 2003. In the 2007 KAIS, women and men were sampled using thesame techniques; therefore the 2007 dataset did not require separate weights for women and men.KAIS 2007 26
HIV testing was performed using antibody/antigen assays in the 2007 KAIS, compared toantibody‐only assays in the 2003 KDHS. The antibody/antigen approach is more sensitive forcapturing recent infections. Differences in results produced by these two assays are usually smallin populations with relatively low incidence, such as Kenya, which had an incidence of HIVbetween 0.80% and 0.85% in 2007 according to GOK estimates using UNAIDS Estimation andProjection Package (EPP)/Spectrum software. Point estimates calculated from results of the twotesting approaches may differ but are likely to fall within similar 95% confidence intervals.Additional laboratory tests were performed in 2007 compared to 2003 and therefore, the vastmajority of KAIS participants gave venous blood rather than DBS samples; in 2003, only DBSsamples were collected since only HIV serology was performed. Although the methods forreturning test results to participants were different in the 2003 KDHS and 2007 KAIS, bothsurveys offered participants a chance to learn their HIV status. Finally, the 2007 KAIS includedadults up to 64 years of age, but throughout the report, when comparisons are made to the 2003KDHS results, analyses are limited to participants aged 15‐49 years.1.11 RESPONSE RATESFigure 1.11 illustrates a diagram of sampled clusters, eligible households, and individualparticipation in the 2007 KAIS. Overall, participation rates in the 2007 KAIS were high. Wecalculated household response rate as the number of households consenting to the householdinterview divided by the total number of sampled households that were located and occupied.The individual interview response rate was calculated as the number of individuals whocompleted interviews divided by the number of individuals eligible for the individual interviewbased on the household census. Only those participating in the individual interview were eligibleto participate in the blood draw. We calculated blood draw coverage as the number of blooddraws divided by the number of all individuals eligible for the individual interview; the blooddraw response rate reflects the number of successful blood draws divided by the number ofindividuals who completed individual interviews.KAIS 2007 27
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 24 and 25: Data processing included a number o
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
Page 74 and 75: 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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