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

More documents

Recommendations

Info

$D:\My Documents\HBC\HCBC Implem - Kenya National AIDS & STI ...$

Methods of the 2007 KAISThis Appendix describes the methods of the 2007 KAIS. First we describe survey methods,including the population covered by the survey, sample size, sampling frame and sampleallocation. We summarize field methods, which cover implementation of the surveyquestionnaires, blood draw and related training, community mobilisation, and supervisionof the field teams. Protection of human subjects is described in the following section.Laboratory methods also are included, along with training of staff; sample collection,processing, labeling, and transport; receipt of samples and biological testing; repositorystorage; and data management. We also describes the methods for returning test results toparticipants, including organization and flow of test results from the laboratory to theparticipants, selection of facilities for returning test results, training counsellors, dispatchingresults to the field, documentation, supervision, and data management. The final sectioncovers the methods used for calculating weights, non‐response adjustments, and statisticalanalysis. This final section reminds readers that estimates in this report are unadjustedunivariate and bivariate associations only. Multivariate analysis and associations adjustedfor age and other factors will be provided in manuscripts and other disseminated materials.A.1 SURVEY METHODSGeographic coverage and target populationThe 2007 KAIS was a national, population‐based, cross‐sectional survey. The survey wasconducted among a representative sample of households selected from all eight provincesand covered both rural and urban areas. A household was defined as a person or group ofpeople related or unrelated to each other who live together in the same dwelling unit orcompound (group of dwelling units), share similar cooking arrangements, and identify thesame person as head of household. The 2007 KAIS was designed to allow reliable estimationof HIV prevalence and behavioural indicators relating to HIV/AIDS. All women and menaged 15‐64 years who were either usual residents of the selected households or visitorspresent in the household on the night before the survey were eligible to participate in thestudy provided they gave informed consent. The inclusion criteria may have captured non‐Kenyans living as usual residents or visitors in a sampled household. Military personnel andthe institutionalized population are typically not captured in household‐based surveys;although they may have been included in the 2007 KAIS if at home during the survey.Sampling frameAdministratively, Kenya is divided into eight provinces. Each province is divided intodistricts, each district into divisions, each division into locations, each location into sublocations,and each sub‐location into villages. For the 1999 Population and HouseholdCensus, KNBS delineated sub‐locations into 62,000 small units called Enumeration Areas(EAs) that constituted a village, a part of a village, or a combination of villages. The primaryKAIS 2007 280
sampling unit for Kenya’s master sampling frame, and for KAIS, is a cluster, which isconstituted as one or more EAs.As of February 2009 Kenya was divided into eight provinces and 149 districts; however, thesample frame used for the 2007 KAIS, the National Sample Survey and EvaluationProgramme IV (NASSEP IV), was based on the 1999 Kenya Population and Housing Census,which covered a total of 69 districts. The NASSEP IV was created and is maintained byKNBS. The frame is a two‐stage stratified cluster sample with 1800 clusters, comprised of1,260 rural and 540 urban clusters. The clusters were sampled using the probabilityproportional to measure of size method within each rural and urban stratum. The clusterswere defined based on one measure of size with an average of 100 households and upperand lower limits of 149 and 50 households, respectively.During the creation of the master frame, the country was divided into various districts andrural/urban strata. The six major urban areas (Nairobi, Mombasa, Kisumu, Nakuru, Eldoretand Thika) were further stratified into five socio‐economic classes (upper, upper‐middle,middle, lower‐middle and lower) to account for socio‐economic variations. It should benoted that Nairobi and Mombasa have no rural areas and that Nairobi is both a district anda province. Figure A.1 shows the stratification of enumeration areas before sampling clustersfor NASSEP IV.Figure A.1 NASSEP IV enumeration area stratification, KAIS 2007.KenyaProvinceRural StrataUrban StrataCities(Nairobi,Mombasa)Municipalities/MajorUrban Areas (Kisumu,Nakuru, Eldoret, Thika)Other UrbanSample sizeSESSES, socio-economic statusThe target of the 2007 KAIS sample was to obtain approximately 9,000 completed householdinterviews. Based on the level of household non‐response in the 2003 KDHS (13.2% ofselected households), approximately 10,375 households in 415 clusters (294 rural and 121urban) were selected for potential participation in the 2007 KAIS. Table A.1 shows theprovincial distribution of households and clusters originally sampled for the 2007 KAIS.Table A.1 Distribution of sampled clusters and households by province, KAIS 2007.KAIS 2007 281
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 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:
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
Page 76 and 77:
Figure 4.5a Reasons for not testing
Page 78 and 79:
Increasing access to HIV testing wi
Page 80 and 81:
4.7. Gaps and unmet needs• Two‐
Page 82 and 83:
Page 84 and 85:
Figure 5.3b Self-reported HIV statu
Page 86 and 87:
This section examines participants
Page 88 and 89:
Figure 5.5a Knowledge of HIV status
Page 90 and 91:
Figure 5.5c Percent of partnerships
Page 92 and 93:
uninfected. A couple was considered
Page 94 and 95:
Figure 5.6c Women and men aged 15-6
Page 96 and 97:
Sexual Partners, Sexual DebutCircum
Page 98 and 99:
Figure 6.3b. HIV prevalence among w
Page 100 and 101:
Figure 6.3d. HIV prevalence among w
Page 102 and 103:
Figure 6.3f. Men aged 15-64 years r
Page 104 and 105:
In this section, “consistent cond
Page 106 and 107:
Figure 6.4c. Marital or cohabiting
Page 108 and 109:
Figure 6.5b. Young women and men ag
Page 110 and 111:
Figure 6.5d. Young women and men ag
Page 112 and 113:
Figure 6.6a. Male circumcision amon
Page 114 and 115:
Figure 6.6d. HIV prevalence among m
Page 116 and 117:
Knowledge, Attitudes and Beliefs ch
Page 118 and 119:
Figure 7.3b. Most common source of
Page 120 and 121:
Figure 7.3c Women and men aged 15-6
Page 122 and 123:
Figure 7.3e Overall scores for 12 q
Page 124 and 125:
Figure 7.3g Women and men aged 15-6
Page 126 and 127:
Figure 7.3i Correct responses to se
Page 128 and 129:
• If a female teacher has the AID
Page 130 and 131:
7.5. Perceived risk of HIV infectio
Page 132 and 133:
Figure 7.5c Reasons given for havin
Page 134 and 135:
7.6. Attitudes toward women’s rol
Page 136 and 137:
who had never been tested for HIV o
Page 138 and 139:
8.2 INTRODUCTIONIn the absence of i
Page 140 and 141:
8.3 ANTENATAL CLINIC ATTENDANCE, 20
Page 142 and 143:
8.4 KNOWLEDGE OF MOTHER-TO-CHILD TR
Page 144 and 145:
The analysis in this section consid
Page 146 and 147:
Figure 8.5b Women aged 15-49 years
Page 148:
• Incorrect communication or unde
Page 151 and 152:
8.8 CURRENTLY PREGNANT WOMEN: HIV T
Page 153 and 154:
Among currently pregnant women, 7.1
Page 155 and 156:
Among pregnant, HIV‐uninfected wo
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 and 206:
Figure 11.4d HIV-infected adults ag
Page 207 and 208:
DATA IN CONTEXTHIV Basic Care Packa
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
Page 257 and 258: Figure 14.7b HIV-affected and HIV-u
Page 259 and 260: Table 14.7b Source of bednets among
Page 261 and 262: Overall, 52.3% percent of children
Page 263 and 264: 14.9 CARE AND SUPPORT FOR ORPHANS A
Page 265 and 266: For consistency with other populati
Page 267: Returning Test Results15.1 KEY FIND
Page 270 and 271: Figure 15.3b. Participants aged 15-
Page 272 and 273: Figure 15.3d. Participants aged 15-
Page 274 and 275: Figure 15.3f. Participants aged 15-
Page 276 and 277: 15.4 RETURNING TO RECEIVE TEST RESU
Page 278 and 279: Figure 15.5 Women aged 15-64 years
Page 282 and 283: ClustersHouseholdsProvince Rural Ur
Page 284 and 285: and treatment services and other he
Page 286 and 287: The KEMRI Ethical Review Committee
Page 288 and 289: Red top (5 ml)Whole blood collected
Page 290 and 291: algorithm using two HIV EIAs (Viron
Page 292 and 293: Figure A5.a. Structure and flow of
Page 294 and 295: Recruitment and training of results
Page 296 and 297: observe confidentiality of particip
Page 298 and 299: Documentation. Results counsellors
Page 300 and 301: Normalisation of weightsNormalised
Page 302 and 303: This report presents the results of
show all

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

Create successful ePaper yourself

Delete template?

Save as template?