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

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algorithm using two HIV EIAs (Vironostika HIV UNIFORM II Plus O v 3.3 and MurexHIV 1.2.0). For quality control, all reactive specimens and 5% of nonreactive specimenswere re‐tested at the QA laboratory using the same testing algorithm. Specimens withdiscordant results between the two laboratories were resolved by HIV DNA PCR orreported as indeterminate.Repository specimensSerum, plasma, packed cells, and DBS samples remaining after testing were stored at ‐80 o Cat the NHRL for future testing. Proposals for the use of repository specimens will bereviewed following standard procedures by KAIS leadership and submitted to the necessaryethical review committees for approval.Field supervisionAs part of the main survey supervision, a member of the central laboratory team visitedfield‐based laboratory staff each month during the data collection period. Laboratorysupervisors ensured high quality of specimens and replenished supplies for field teams.They also helped monitor and evaluate adherence to laboratory‐related procedures,including bio‐safety standards, and provided support to the laboratory field staff andassistance in problem solving any laboratory‐related issues.Laboratory data managementThe LIMS used for the 2007 KAIS was developed by the Ugandan Ministry of Health, CDC‐Uganda and other collaborators for the 2005 Uganda AIS. The platform for the system wasMicrosoft Access software. Upon receipt of specimens at the core laboratory, techniciansscanned barcodes into the LIMS, which immediately identified any duplicate entries. TheLIMS was installed at the NHRL and the KEMRI QA laboratory. During testing, the LIMSautomatically captured HIV, HSV‐2 and CD4 results from laboratory EIA readers. Syphilisresults were double‐entered manually into a separate, stand‐alone database system. TheLIMS, programmed with the approved testing algorithms, generated a final set of results foreach participant.A.5 RETURNING LABORATORY TEST RESULTS TO PARTICIPANTSReturning test results with appropriate post‐test counselling to persons infected with HIVand STIs can help HIV‐infected individuals recognize symptoms, seek care and treatment,reduce transmission to others and protect themselves from acquiring other STIs. Uninfectedpersons who learn their test results can also benefit from risk reduction counsellingmessages on how to protect themselves from acquiring HIV and other STIs.In the 2007 KAIS, participants who consented to blood draw during the survey were givenan opportunity to learn their HIV, syphilis, and HSV‐2 results and CD4 count, if HIVinfected, approximately six weeks after sample collection. This activity was entirelyvoluntary and not a requirement for participation in the 2007 KAIS. The survey utilized aKAIS 2007 290
facility‐based approach in which selected health facilities within and near the study clusterswere involved in returning test results to participants. Persons who received their test resultswere provided post‐test counselling, and if infected they were provided referrals to HIV andSTI prevention, care, and treatment services.This section outlines the methods used to return test results to participants and the datamanagement and analysis procedures used to analyze data on persons who came to selectedhealth faciltlies to have their test results from the 2007 KAIS returned to them.Organization and structure of returning test results to participantsNASCOP coordinated the activity for returning test results to participants in closecollaboration with the NHRL. The NASCOP coordinator for returning test results providedoverall technical, administrative, and logistical oversight of the activity for returning testresults to participants. Trained health workers (results counsellors) who returned test resultsto participants provided appropriate counselling and referral according to nationalguidelines for voluntary counselling and testing. Counsellors recorded information aboutparticipants who returned for results and any referrals that were made during the session.The NASCOP data management team coordinated entry of this information into a databaselinked to the questionnaire and laboratory databases, and the cleaning of these data.KAIS 2007 291
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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
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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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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 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 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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