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

More documents

Recommendations

Info

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

and treatment services and other health issues, such as tuberculosis, blood donation history,and medical injections.Figure A.2. Data collection tools, KAIS 2007.HOUSEHOLD QUESTIONNAIRE• Household census• Parental survivorship• Household characteristics• Mosquito net use• Support to households for sick andrecently deceased adults, and OVCsINDIVIDUAL QUESTIONNAIRE• Socio‐demographic characteristics• HIV/STI knowledge and attitudes• Marriage and sexual partnerships• Fertility and family planning• Use of HIV prevention, care andtreatment servicesBLOOD DRAW• Venous blood:HIV, HSV‐2, syphilis testing; CD4for those with HIV• Dried blood spot:HIV testing onlyRESULTS FORM• Specific test results retrieved• Individual or couple counselling• Minors with or without parents• Referrals providedBlood draw. All eligible women and men were asked individually for their voluntaryconsent to provide a venous blood sample in the home for HIV, syphilis, and HSV‐2 testing,as well as CD4 cell quantification if seropositive for HIV. They also were asked to consent toextended storage of their samples for future, unspecified testing.Experienced technicians were responsible for the collection of blood from the arm byvenipuncture. Blood was collected into two separate tubes, one with anticoagulant fromwhich serum was obtained for HIV, HSV‐2, and syphilis testing and the other designed tostabilise CD4 cells for up to seven days after collection. For participants who were willing toparticipate but refused the venous blood sample, dried blood spot (DBS) samples from afinger prick were collected. DBS samples were also collected in cases in which thevenipuncture process was not feasible.Training. In July 2007, 204 skilled interviewers, laboratory technicians, laboratory scientistsand field supervisors were recruited and trained for two weeks in the procedures for thesurvey. Interviewers were trained to identify eligible households and individuals, conductinformed consent, educate participants about HIV, HSV‐2, and syphilis, use objectiveinterview techniques, and administer the household and individual questionnaires. Fieldlaboratory technicians and scientists were trained in preparing respondents for the blooddraw and in collection, processing, storage, and transportation of specimens to the centrallaboratory in Nairobi. Laboratory training emphasized ways to minimise risks in handlingbiological specimens. Laboratory technicians were trained to process and analyse specimensKAIS 2007 284
in the laboratory and to issue vouchers for participants to retrieve their test results. Thetraining involved didactic presentations, small group discussions and practical sessions,such as mock interviews and blood draws.Community mobilisation. On August 1, 2007, KAIS was officially launched in conjunctionwith a national television, radio, and print media campaign to educate, sensitise, andmobilise Kenyans about the survey and the importance of broad participation. Mobilisationefforts then shifted to interpersonal communications at the community and village levels toraise awareness of the survey as a major surveillance initiative by the Government of Kenya.This also served to prepare communities before survey teams arrived.District statistical officers and enumerators helped to locate sampled clusters and sampledhouseholds. As KNBS staff, these officers and enumerators were knowledgable about censusenumeration systems and had developed a rapport with community and village leadersthrough previous surveys. Teams of trained community mobilisers then visited the villageleaders to discuss the survey and when possible held community meetings to explain thepurpose and process of the survey and to answer questions in a public forum. Mobiliserscommunicated regularly with data collection teams and were able to convey estimated datesof data collection to the sampled households.Fieldwork. Each field team consisted of four interviewers, two laboratory technicians, onesupervisor and one driver. A total of 29 field teams conducted fieldwork over a period offour months from August to December 2007. Teams were given local languagequestionnaires in addition to instruments in Kiswahili and English to accommodaterespondents who were not conversant in the local languages. Completed questionnaires foreach cluster were packed and delivered to KNBS headquarters in Nairobii through securedcourier services for data processing.After obtaining consent from the head of the household, interviewers administered thehousehold questionnaire to the household heads. This was followed by interviews andblood draws among all eligible and consenting individuals in participating households.Participants received bilingual (English and Kiswahili) brochures on HIV, HSV‐2, syphilis,and tuberculosis, including information on the association between the diseases and thevalue of knowing one’s HIV status.Supervision. Data collection teams were routinely visited by teams of supervisorsrepresenting different KAIS collaborating institutions. These supervision teams travelledthroughout the country to meet with field teams, deliver survey supplies, perform qualitychecks on questionnaires, assess mobilisation efforts, and help address challenges to datacollection. Supervision reports were circulated to the 2007 KAIS TWG members and pendingissues in the field were resolved after discussion.A.3 HUMAN SUBJECTSKAIS 2007 285
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 280 and 281: Methods of the 2007 KAISThis Append
Page 282 and 283: ClustersHouseholdsProvince Rural Ur
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?