| Table of contents |
Figures and Tables ………........................................................................................................................................VII
Abbreviations ........................................................................................................................................................XIV
Foreword .................................................................................................................................................................XVI
Map of Kenya .......................................................................................................................................................XVII
Executive Summary ............................................................................................................................................XVIII
CHAPTER 1 Introduction, Overview of Methods and Response Rates
1.1 Background .....................................................................................................................................1
1.2 National policy on HIV/AIDS .......................................................................................................2
1.3 Purpose and objectives of the survey ...........................................................................................2
1.4 Survey design and sample frame ..................................................................................................3
1.5 Data collection tools .......................................................................................................................4
1.6 Return of test results to participants ............................................................................................6
1.7 Survey implementation ..................................................................................................................7
1.8 Laboratory logistics ........................................................................................................................8
1.9 Data processing and analysis ........................................................................................................8
1.10 Comparison of the 2003 KDHS and the 2007 KAIS ....................................................................9
1.11 Response rates ...............................................................................................................................11
1.12 Chapter summary ..........................................................................................................................14
CHAPTER 2 Prevalence of HIV
2.1 Key findings ..................................................................................................................................15
2.2 Introduction ..................................................................................................................................15
2.3 HIV prevalence by age group and sex ........................................................................................16
2.4 HIV prevalence among youth ......................................................................................................17
2.5 HIV prevalence among older adults (50–64 years old) ............................................................18
2.6 HIV prevalence by rural/urban residence ..................................................................................18
2.7 HIV prevalence by province .........................................................................................................20
2.8 HIV prevalence by marital status ................................................................................................22
2.9 HIV prevalence by education level ............................................................................................23
2.10 HIV prevalence by wealth index and employment status .......................................................24
2.11 HIV prevalence by time away from home .................................................................................26
2.12 HIV prevalence by religious affiliation ......................................................................................27
2.13 Male circumcision and association with HIV infection ...........................................................28
2.14 Gaps and unmet needs ..................................................................................................................31
CHAPTER 3 Comparison of HIV Prevalence in the 2003 KDHS and 2007 KAIS
3.1 Key findings ..................................................................................................................................32
3.2 Introduction ..................................................................................................................................32
3.3 Sex ..................................................................................................................................................34
3.4 Age Group .....................................................................................................................................35
3.5 Youth ..............................................................................................................................................36
3.6 Residence .......................................................................................................................................37
3.7 Province .........................................................................................................................................38
3.8 Marital status .................................................................................................................................38
3.9 Education level ............................................................................................................................40
3.10 Wealth index ................................................................................................................................40
IV PRELIMINARY
3.11 Age of sexual debut .....................................................................................................................41
3.12 Gaps and unmet needs ................................................................................................................42
CHAPTER 4 HIV Testing
4.1 Key findings ................................................................................................................................43
4.2 Introduction ................................................................................................................................43
4.3 HIV testing behavior ..................................................................................................................44
4.4 Testing experiences among persons who had ever been tested for HIV ..............................50
4.5 Reasons for not testing ................................................................................................................51
4.6 Attitudes toward home testing ...................................................................................................53
4.6 Gaps and unmet needs ................................................................................................................53
CHAPTER 5 Knowledge and Disclosure of HIV Status
5.1 Key findings .................................................................................................................................55
5.2 Introduction ................................................................................................................................55
5.3 Knowledge of HIV infection ......................................................................................................56
5.4 Disclosure of HIV status to sexual partners ............................................................................59
5.5 Knowledge of HIV infection in partnerships .........................................................................60
5.6 HIV-concordance and -discordance among married and cohabiting couples .....................64
5.7 Gaps and unmet needs ...............................................................................................................67
CHAPTER 6 Sexual Partners, Sexual Debut and Circumcision
6.1 Key findings .................................................................................................................................68
6.2 Introduction ................................................................................................................................68
6.3 Number of lifetime sexual partners ..........................................................................................69
6.4 Condom use .................................................................................................................................73
6.5 Age at first sex among youth aged 15-24 years .........................................................................76
6.6 Male circumcision ........................................................................................................................79
6.7 Gaps and unmet needs ................................................................................................................81
CHAPTER 7 Knowledge, Attitudes and Beliefs about HIV/AIDS
7.1 Key findings ................................................................................................................................82
7.2 Introduction ................................................................................................................................82
7.3 Knowledge of HIV/AIDS ...........................................................................................................83
7.4 Stigma and accepting attitudes toward HIV-infected persons .............................................91
7.5 Perceived risk of HIV infection ................................................................................................93
7.6 Attitudes toward women’s roles in sexual decision making ................................................96
7.7 Gaps and unmet needs ...............................................................................................................99
CHAPTER 8 Prevention of Mother-to-Child Transmission and Family Planning
8.1 Key findings ...............................................................................................................................100
8.2 Introduction ...............................................................................................................................100
8.3 Antenatal clinic attendance, 2003 – 2007 ................................................................................102
8.4 Knowledge of mother-to-child transmission and antiretroviral therapy for PMTCT …....103
8.5 HIV counseling and testing at ANC clinics, 2003 – 2007......................................................105
8.6 Breastfeeding practices .............................................................................................................109
8.7 Currently pregnant women: ANC clinic attendance ..............................................................109
8.8 Currently pregnant women: HIV testing, HIV status and CD4 cell counts ......................110
8.9 Currently pregnant women: HIV, HSV-2 and syphilis ........................................................110
8.10 HIV status and sexual partnerships ........................................................................................112
8.11 Fertility desires ..........................................................................................................................113
8.12 Contraceptive use ......................................................................................................................115
8.13 Gaps and unmet needs .............................................................................................................118
PRELIMINARY V
CHAPTER 9 Blood and Injection Safety
9.1 Key findings ...............................................................................................................................119
9.2 Introduction ...............................................................................................................................119
9.3 Blood donations ..........................................................................................................................120
9.4 Blood transfusions ......................................................................................................................126
9.5 Medical injections .......................................................................................................................127
9.6 Gaps and unmet needs ..............................................................................................................130
CHAPTER 10 Care and Treatment of Adults Infected with HIV
10.1 Key findings ...............................................................................................................................131
10.2 Introduction ...............................................................................................................................131
10.3 Cotrimoxazole prophylaxis for HIV-infected adults ............................................................132
10.4 ARV eligibility, coverage and access .......................................................................................136
10.5 Gaps and unmet needs ..............................................................................................................141
CHAPTER 11 Health Care Utilization, Tuberculosis and Preventive Services among HIV-infected Adults
11.1 Key findings ...............................................................................................................................142
11.2 Introduction ...............................................................................................................................143
11.3 Health care utilization ...............................................................................................................144
11.4 Co-infection with tuberculosis and HIV .................................................................................146
11.5 Preventive services for people with HIV: clean water ............................................................149
11.6 Preventive services for people with HIV: bednets ..................................................................151
11.7 Preventive services for people with HIV: nutritional supplements ......................................153
11.8 Gaps and unmet needs ..............................................................................................................154
CHAPTER 12 Prevalence of Herpes Simplex Virus-2 (HSV-2) and Co-infection with HIV and HSV-2
12.1 Key findings ...............................................................................................................................155
12.2 Introduction ...............................................................................................................................155
12.3 HSV-2 prevalence .......................................................................................................................156
12.4 Acquiring and transmitting HSV-2 ...........................................................................................161
12.5 Co-infection with HIV and HSV-2 ............................................................................................161
12.6 HSV-2 prevalence and perceived risk of HIV, STI symptoms, STI treatment-seeking
behavior, and condom use ........................................................................................................163
12.7 Gaps and unmet needs ..............................................................................................................165
CHAPTER 13 Prevalence of Syphilis and Co-infection with HIV and Syphilis
13.1 Key findings ...............................................................................................................................166
13.2 Introduction ...............................................................................................................................166
13.3 Syphilis prevalence ................................................................................................................... 168
13.4 Acquiring and transmitting syphilis ........................................................................................171
13.5 HIV and HSV-2 prevalence by syphilis status ........................................................................172
13.6 Gaps and unmet needs ...............................................................................................................173
CHAPTER 14 Household Characteristics and Impact of HIV on Households
14.1 Key findings ................................................................................................................................174
14.2 Introduction ................................................................................................................................174
14.3 Household composition .............................................................................................................175
14.4 Birth registration .........................................................................................................................177
14.5 Prevalence of HIV-affected households .................................................................................178
14.6 Drinking water and toilet facilities ..........................................................................................180
14.7 Household ownership of mosquito bednets and insecticide-treated nets ............................184
14.8 Children’s living arrangements and orphanhood ....................................................................188
14.9 Care and support for orphans and vulnerable children ...................................................190
VI PRELIMINARY
14.10 Care and support for chronically ill adults ..........................................................................192
14.11 Gaps and unmet needs ................................................................................................................194
CHAPTER 15 Returning Test Results
15.1 Key findings ...............................................................................................................................195
15.2 Introduction ................................................................................................................................195
15.3 Participants who returned for test results by socio-demographic characteristics ................197
15.4 Returning to receive test results by HIV testing behaviour and HIV status ...................201
15.5 Uptake of results by pregnancy status .....................................................................................202
15.6 Gaps and unmet needs ............................................................................................................203
GLOSSARY OF TERMS ...................................................................................................................................204
APPENDIX A Methods of the 2007 KAIS
A.1 Survey methods .........................................................................................................................209
A.2 Field methods .............................................................................................................................211
A.3 Human subjects ..........................................................................................................................214
A.4 Laboratory methods ...................................................................................................................214
A.5 Returning laboratory test results to participants ................................................................217
A.6 Weighting, non-response adjustment and statistical analysis ............................................223
APPENDIX B Chapter Data Tables
B.1 Background Characteristics of KAIS Respondents ……..............………...............................228
B.2 Chapter 2 - Prevalence of HIV ...............................................................................................230
B.3 Chapter 3 - Comparison of HIV Prevalence of 2003 KDHS and 2007 KAIS ....................234
B.4 Chapter 4 - HIV Testing .........................................................................................................237
B.5 Chapter 5 - Knowledge and Disclosure of HIV Status ....................................................240
B.6 Chapter 6 - Sexual Partners, Sexual Debut and Circumcision ............................................244
B.7 Chapter 7 - Attitudes, Knowledge & Beliefs .........................................................................247
B.8 Chapter 8 - Prevention of Mother-to-Child Transmission and Family Planning ..................251
B.9 Chapter 9 - Blood and Injection Safety .................................................................................257
B.10 Chapter 10 - Care and Treatment of Adults Infected with HIV ..............................................261
B.11 Chapter 11 - Health Care Utilization, Tuberculosis and Basic Prevention among
HIV-infected Persons ................................................................................................................. 266
B.12 Chapter 12 - Prevalence of Herpes Simplex Virus-2 (HSV-2) ................................................271
B.13 Chapter 13 - Prevalence of Syphilis and Co-Infection with HIV & HSV-2 .................…274
B.14 Chapter 14 - Household Characteristics and Impact of HIV on Households ....................276
B.15 Chapter 15 - Collection of Test Results ................................................................................280
APPENDIX C Estimates of Sampling Errors ...................................................................................................282
APPENDIX D Persons Involved in the 2007 KAIS .......................................................................................295
APPENDIX E 2007 KAIS Household Questionnaire .......................................................................................299
APPENDIX F 2007 KAIS Individual Questionnaires ...................................................................................324 |
