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

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ClustersHouseholdsProvince Rural Urban Total Rural Urban TotalNairobi 0 58 58 0 1,450 1,450Central 48 7 55 1,200 175 1,375Coast 24 22 46 600 550 1,150Eastern 50 5 55 1,250 125 1,375North Eastern 23 5 28 575 125 700Nyanza 54 7 61 1,350 175 1,525Rift Valley 51 12 63 1,275 300 1,575Western 44 5 49 1,100 125 1,225Total 294 121 415 7,350 3,025 10,375Of the original 415 clusters, 402 were accessed and surveyed. Thirteen clusters wereinaccessible due to impassable roads or tenuous security situations. All reported estimatesand design weights for households, individual interviews, and blood draws were based ondata from the 402 clusters. Details about how cluster‐level non‐response was accounted forin the calculation of weights are provided in Section A.6 of this appendix. The survey wasnot designed to produce reliable district‐level estimates; estimates are presented byrural/urban residence, and by province.KAIS sample allocationThe 2007 KAIS sample used a stratified, two‐stage cluster sample design for comparability tothe 2003 KDHS. The first stage involved sampling clusters from NASSEP IV, and the secondstage involved selecting households for the survey.Selection of clusters (probability sampling units). The sample was allocated first toprovinces in proportion to the square root of the number of households in the 1999 censusand among rural and urban areas of the districts within each province based on the distributionof households.A simple systematic sampling method was used to select 294 clusters in rural areas and 121clusters in urban areas for a total of 415 clusters. KNBS selected clusters from the NASSEP IVframe using the equal probability selection method independently within rural and urbandomains of each district. The resulting sample retained the properties of probabilityproportionate to size, as used in creation of the frame. EAs were arranged in serpentine orderprior to the 1999 Census, and later clusters in the NASSEP IV master frame were serialized in thesame order within districts and rural and strata. The systematic random sampling method had asampling procedure with a random start, then every kth cluster was sampled in eachcategory until the sample was achieved.Selection of households. Household listings in 111 clusters were updated immediately beforecommencement of the survey and listing in the remaining 301 clusters had been updated in2005‐2006 for other national surveys.KAIS 2007 282
An equal probability systematic sampling method was applied in each cluster to reach auniform sample of 25 households per cluster. The following procedure was used to samplehouseholds from clusters:Let L be the total number of households listed in the cluster; let Random be a randomnumber between (0, I) (Random numbers are different and independent from cluster tocluster); let n be the number of households to be selected in the cluster; let I = L/n be thesampling interval.(1) The first selected sample household is k (k is the serial number of the household in thelisting) if and only if:k = Random*I, where I is the sampling interval as defined above.(2) The subsequent selected households are those having serial numbers:k + (j‐1)*I, (rounded to integers) for j = 2, 3, … n;A.2 FIELD METHODSData CollectionQuestionnaires. Two questionnaires were used in the 2007 KAIS: a household andindividual questionnaire. The content of the questionnaires was adapted from standardAIDS Indicator Survey questionnaires developed by ORC MACRO and technical partners,the 2003 KDHS HIV Module and previous surveys conducted in Africa. Stakeholdersincluding NACC, the National AIDS and STI Control Programme (NASCOP) and otherHIV/AIDS organizations working in Kenya met to determine the key HIV programinformation needs and gaps. The KAIS Technical Working Group (TWG) collated opinionsfrom these stakeholders, modified existing questions and designed new questions to reflectissues relevant to Kenya’s current epidemic. The final questionnaires were translated fromEnglish into Kiswahili and 11 vernacular languages and back‐translated into English toensure accuracy. The questionnaires were further refined after a pilot study prior todistribution of the final versions to field staff.The household questionnaire gathered basic information from the heads of the householdson each usual member and visitor in the household, including age, sex, relationship to thehead of the household and orphanhood among children. Information was collected oncharacteristics of the household’s dwelling unit, such as the source of water, type of toiletfacilities, materials used for the floor of the house, property ownership and mosquito nets.Information was also collected on whether the household had received specific types of careand support in the year before the survey for any chronically ill adults, household memberswho died and orphans and vulnerable children. The household questionnaire was also usedto record respondents’ consent for blood collection and testing.The individual questionnaire collected information from eligible women and men aged 15‐64 years and covered basic demographic characteristics, reproductive history, fertilitypreferences, family planning, marriage and sexual activity. The individual questionnairealso captured HIV and STI knowledge, attitudes and behaviours, HIV testing, access to careKAIS 2007 283
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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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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
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 280 and 281: Methods of the 2007 KAISThis Append
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
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