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

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Documentation. Results counsellors recorded information about respondents who receivedtheir test results and any referrals onto the results form. This information included the sex ofthe person collecting the result, specific test results returned, the date results were returned,and whether the person came as an individual or was accompanied by a spouse or partner.All forms were submitted to NASCOP at the end of the four to six week period that the testresults were available.Monitoring and supervision. Supervision teams monitored procedures for returning testresults to participants and supported results counsellors in the field. Supervision teamsvisited the field three times during the survey and verified adherence to the protocol forreturning test results, ensured supplies were sufficient, and addressed any acute issuesreported by results counsellors. After each supervisory visit, all supervisors submitted astatus report on the progress of the exercise. Supervisors also met to discuss outcomes of thesupervision visits and address unresolved issues. Feedback was provided to resultscounsellors as necessary.Data management and analysis A Microsoft Access database was created to captureinformation on the activity for returning test results to participants. The database was prepopulatedwith cluster numbers, participant identification numbers, laboratory test results,and reasons for any missing test results. A team of six data managers at NASCOP wastrained on data editing and entry. Upon receiving completed results forms, the team loggedin the cluster numbers to keep track of counsellors who had filed their results forms. Theresults forms were photocopied to provide a backup copy in case of loss and were thenmanually edited and double entered into two separate datasets.The two datasets were compared for consistency and discrepancies were resolved byreferring to the results forms and making changes to the databases accordingly. Once the twodatasets were equivalent, the team ran a series of consistency and range checks to ensure thedata were accurate. Descriptive analyses were performed on the final, cleaned dataset.Fndings from these analyses are reported in Chapter 15 of this report.A.6 WEIGHTING, NON-RESPONSE ADJUSTMENT AND STATISTICALANALYSISSampling weightsSampling weights were incorporated into all statistical analyses. The purpose of weightingwas to correct for unequal probability of selection and to adjust for non‐response to produceresults that were representative of the larger population from which the sample was drawn.We used standard weighting procedures similar to methods used in the 2003 KDHS toincrease comparability of results between surveys.KAIS 2007 298
Design weightsThe 2007 KAIS sample was not self‐weighted and thus a weighting adjustment was requiredto provide estimates representative of the target population. The design weightsincorporated the probabilities of selection of the 1800 clusters into the NASSEP IV sampleframe and the probabilities of selection of the 402 clusters into the KAIS sample from theNASSEP IV clusters. The probabilities of selection of clusters into NASSEP IV were takenfrom the documentation of the NASSEP IV master sample, which was available throughKNBS.Post-stratification adjustmentThe allocation of clusters among the urban and rural areas in each province was based onthe distribution of households across the districts. The allocation resulted in 34 districts withno clusters in their urban strata. Consequently, an adjustment to the weights was made toincrease the representation of urban areas within the affected provinces.Table A6.a shows the ratios of the weighted number of households according to NASSEP IVto the weighted numbers using the base KAIS weights. There was reasonably closeagreement between the two samples by province for Nairobi and for rural areas, but anunder‐representation for other urban areas except Central Province. Thus, we multipliedthe original weights (for the urban areas outside of Nairobi) by the ratios shown in TableA6.a.Table A6.a Ratio of NASSEP IV to original KAIS using sampling fractions at thedistrict level, KAIS 2007.Province Rural Urban TotalNairobi na 1.033 1.033Central 1.037 0.807 1.002Coast 1.084 1.019 1.053Eastern 1.086 1.397 1.104North Eastern 0.950 1.169 0.975Nyanza 1.055 1.183 1.066Rift Valley 1.013 1.762 1.105Western 1.064 1.766 1.113Total 1.047 1.149 1.070Non-response adjustmentBase weights were adjusted for cluster non‐response, household non‐response, andindividual non‐response (both for the interview and the blood draw). Ultimately, eachcluster had three cluster‐specific weights: household, individual interview, and blood draw.All household members captured in the household questionnaire were assigned the samehousehold weight. All individuals within a cluster who participated in the individualinterview or blood draw were assigned the same cluster‐specific weights for individualinterview or blood draw.KAIS 2007 299
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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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13.6 GAPS AND UNMET NEEDS• Patien
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Household Characteristics andImpact
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Figure 14.3a Sex of head of househo
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Figure 14.3d Household population,
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Page 257 and 258: Figure 14.7b HIV-affected and HIV-u
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Page 261 and 262: Overall, 52.3% percent of children
Page 263 and 264: 14.9 CARE AND SUPPORT FOR ORPHANS A
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Page 267: Returning Test Results15.1 KEY FIND
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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 294 and 295: Recruitment and training of results
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Page 300 and 301: Normalisation of weightsNormalised
Page 302 and 303: This report presents the results of
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