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

More documents

Recommendations

Info

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

Recruitment and training of results counsellors. Effective results counselling in KAISrequired that all counsellors be equipped with basic knowledge of the STIs covered in thesurvey and with appropriate counselling skills according to national voluntary counsellingand testing guidelines. The results coordinator in collaboration with the Provincial AIDS/STICoordinators (PASCOs) identified, recruited, and assisted in the training of the 2007 KAISresults counsellors. In September 2007, a total of 202 health workers attended a training onhow to return KAIS test results to participants. Counsellors and health workers, regardlessof their health care experience, attended the training to refresh their counselling skills, learnhow to return the 2007 KAIS test results to participants, and to refer them and their partnersfor further testing, care and treatment if necessary. The training covered the following topicareas:• Overview of HIV and CD4, HSV‐2, and syphilis• Protocol for returning HIV, CD4 count, HSV‐2, and syphilis results• Counselling and referral messages• Effective counselling skills• Documentation of information from persons who receive their test results• Confidentiality• SupervisionThe training also included role plays and other opportunities for building practicalexperience in results counselling.Documentation of results at laboratory. Upon completion of laboratory testing for a givencluster, the LIMS coordinator produced a laboratory results form through an automated,computer‐based process for each cluster, listing out the test results for all individuals whoprovided a blood specimen for testing. The form was populated with the province, district,and cluster names; dates of sample collection; study identification numbers for a cluster;positive, negative, or indeterminate results for HIV, syphilis, HSV‐2, and CD4 counts forHIV‐infected persons; and codes indicating the reason for any missing results (e.g.insufficient sample, rejection sample, DBS only). Forms were submitted for review by theNPHLS lab coordinator (see Figure A5.c). After reviewing the results and resolving anydiscrepancies, the laboratory coordinator delivered hard copy results forms to the NASCOPresults coordinator.Dispatching results to the field. Upon receiving results from NHRL, the NASCOP resultsteam logged in the cluster numbers with results and arranged for a courier service to pick‐upthe paper results and deliver to the selected health facilities. The courier service was giventhe mobile telephone numbers of results counsellors so they could communicate directly toarrange a secure drop off.Methods for returning test results to participants. Results counsellors were trained tofollow a standardized protocol for returning test results to participants. Counsellors wereprovided with counselling messages for each test result to guide them during thecounselling session and to ensure consistency in the quality of counselling. The 2007 KAISfollowed similar procedures for returning laboratory results that are followed in generalhealth care settings in Kenya, including abbreviated counselling on basic information onKAIS 2007 294
HIV and STI, an explanation of the meaning of test results, the importance of partner testing,counselling on risk reduction practices, and referrals for further care and treatment services.Procedures for returning test results to minors complied with Kenyan law, Ministry ofHealth policy guidelines and international standards of ethics and practice. Youth wereencouraged but not required to come with a parent or guardian to receive their test results.Test results were first returned to the minor and then, upon consent of the minor, sharedwith the accompanying parent or guardian.The following core elements for returning test results to participants were emphasizedduring specimen collection and counselling session for returning test results:Validity of KAIS test results and importance of further testing. In addition todelivering KAIS test results, results counsellors discussed the reliability of results withparticipants. Due to the time lapse between sample collection and returning test results,reported results reflected the participant’s infection status at the time of specimencollection. When giving test results to participants, results counsellors explained that theparticipant’s current status might be different based on the window period of HIVinfection and recent exposures. Participants with negative test results were advised toseek further testing if they had engaged in unsafe risk behaviour after sample collection.Relations between HIV, genital herpes, and syphilis. Counselling of respondentsemphasized the links between HIV and tuberculosis, and between HIV and genitalherpes and syphilis.Partner testing. Partner testing or couples testing is a main strategy of national testinginitiatives in Kenya. During specimen collection, respondents were encouraged to learntheir test results with their partner.Prevention of transmission to partners and children. Participants who received their testresults as individuals (instead of as a couple) were encouraged to disclose their testresults to their sexual partners. Participants were also offered free condoms when theyreceived their test results, except at mission hospitals which did not supply condoms.Additionally, results counsellors provided specific messages to both male and femaleparticipants on prevention of transmission of HSV‐2, syphilis and HIV to children.Referrals for follow‐up testing and counselling. Results counsellors providedappropriate referrals to infected persons for additional testing, counselling, care andtreatment services. All participants received brochures on HIV, TB, syphilis, and genitalherpes.Confidentiality. During sample collection, laboratory technicians explained the need forparticipants to keep their results vouchers safe to ensure confidentiality of test results. Aresults voucher served as the only basis for providing test results to the 2007 KAISrespondents. Results counsellors verified that the sex of the person who returned for theirtest result was the sex of the participant who received the results voucher by crosscheckingwith the sex indicated on the voucher. Results counsellors were trained toKAIS 2007 295
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 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 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 ...

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?