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

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Normalisation of weightsNormalised weights were used to avoid generating incorrect standard errors and confidenceintervals and were valid for estimation of proportions and means at any aggregation level.They were not valid for estimation of totals, however. Weights were normalised to the KAISsample size and had a mean of 1.0Population estimates (Reference needs to be updated to 2006 projections)Estimation of adult population sizes through extrapolation provided a useful measure of thenumber of adults affected by a particular infection or accessing particular HIV services. Inthis report, we calculated estimates of populations sizes by multiplying weighted parameterestimates from the 2007 KAIS (proportions or percentages) by national and provincial‐levelpopulation projections. We used national and provincial population projections from the1999 Analytical Report on Population Projections, Volume VII, KNBS (2002) to determinepopulation sizes at the national and province level, and by sex for analyses requiringestimates for women (e.g. PMTCT). The projections for the 2007 population in the report arebased on findings from the 1999 Census. While a national projection for the number ofwomen and men aged 15‐64 years was not explicitly provided in the report, we were able toconstruct a national projection by summing province‐level projections for 2007 for womenand men aged 15‐64 years as shown in Table A6.e. The report provides projections by fiveyearage category; we summed all categories from 15‐19 years through 60‐64 years to arriveat a total.Due to variations between the Census population distributions by province compared to thethe 2007 KAIS population distributions by province, the total sum across provinces (or sex)may not equal the national estimate. The number of HIV‐infected persons summed acrossprovinces, for example, may not equal the number obtained by multiplying the nationalprojected population by the weighted national KAIS HIV prevalence estimate. Analystsopted to utilize national level estimates and confidence intervals around national estimateswhenever possible, rather than summing across provinces or sex, because national estimateswere more precise than provincial estimates given the larger sample size. In many analysesby province, population estimates for North Eastern province were not presented becausethe parameter estimate was derived from a sample size too small to generate valid estimates.Similarly, where possible, a “one‐step” process for calculating population estimates wasemployed. To estimate the number of pregnant women who were HIV‐infected, forexample, we multiplied the projected number of women in Kenya by the weighted percentof women in the 2007 KAIS who were both pregnant and HIV‐infected. In a two‐stepprocess, we would have had to first estimate the number of pregnant women and secondly,the number HIV‐infected among those pregnant. The one‐step process was both simpler andmore appropriate given that the 2007 KAIS sampling and weighting design producednationally representative 2007 KAIS estimates.KAIS 2007 300
Table A6.e Estimated number of women and men aged 15-64 years by province,based on 1999 Census projections.Province Women Men TotalNairobi 938,743 1,009,484 1,948,227Central 1,337,054 1,159,867 2,496,921Coast 962,636 758,756 1,721,392Eastern 1,452,514 1,380,006 2,832,520North Eastern 449,901 361,358 811,259Nyanza 1,443,225 1,408,356 2,851,581Rift Valley 2,365,472 2,241,801 4,607,273Western 1,039,861 999,633 2,039,494Total 9,989,406 9,319,261 19,308,667For this report, population projections were rounded to the nearest 1,000 adults. That is, weused a national population projection of 19,309,000. The 2009 KAIS estimates were roundedto two decimal points. The final population estimates presented were also rounded to thenearest 1,000 adults. Confidence intervals around population estimates were calculated bymultiplying the same base population (rounded to the nearest 1,000 adults) by the lower andupper bounds of the 95% confidence interval around the 2007 KAIS point estimate (roundedto two decimal points).Data processing and statistical analysisData processing included a number of steps to prepare data collected in the field foranalysis. The initial steps included editing questionnaires, both in the field and at KNBS, anddouble‐data entry of all questionnaire responses to minimise errors. Data were doubleentered using Census and Survey Processing System (CSPro) version 3.3. 31 Once all surveyresponses were electronically entered, the double entered databases were compared forconcordance, using paper questionnaires to resolve any discrepancies in transcription. Aseries of internal consistency and range checks helped to identify any illogical responses andto verify that responses adhered to skip patterns in the questionnaire. Data validationprograms for data cleaning were written in Stata version 8.0 32 and corrections were entereddirectly in CSPro at KNBS.A concurrent process for cleaning raw laboratory data was conducted at the NHRL. Thefinal, cleaned questionnaire database at KNBS was merged with the laboratory resultsdatabase at the NHRL using unique survey identification numbers to ensure accuratematches (>99.9% of identification numbers were matched). After successfully merging thequestionnaire and laboratory results databases, cluster and household identificationnumbers were serialized from 1‐402 and from 1‐25, respectively. Original cluster andhousehold numbers, barcodes, and individual survey identification numbers were strippedfrom the database prior to weighting and analysis to ensure anonymity of surveyparticipants.31U.S. Census Bureau, Washington, DC. USA.32Stata Corporation, College Station, Texas. USA.KAIS 2007 301
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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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14.5 PREVALENCE OF HIV-AFFECTED HOU
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Page 261 and 262: Overall, 52.3% percent of children
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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-
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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 298 and 299: Documentation. Results counsellors
Page 302 and 303: This report presents the results of
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