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The Economic, Health, and Social Context of HIV infection in Informal Urban Settlements of Nairobi

KENYA, 2006 - 2007
Health and Well-Being (HaW)
African Population and Health Research Center
Last modified November 25, 2014 Page views 202304 Documentation in PDF Metadata DDI/XML JSON

Identification

IDNO
APHRC-HIV-2006.1.1
Title
The Economic, Health, and Social Context of HIV infection in Informal Urban Settlements of Nairobi
Translated Title
ENGLISH
Country
Name Country code
KENYA KEN
Abstract
According to the 2003 Kenya Demographic and Health Survey, about 9% of adult women and 5% of men are infected with HIV. Urban areas are disproportionately affected (10%) compared to rural areas (6%) but these averages mask the huge inequalities in HIV prevalence rates and also the growing vulnerability and disadvantage among the urban poor. Research by the African Population and Health Research Center (APHRC, 2002) has shown that the urban poor have the worst health indicators compared with the rural poor and other urban dwellers.. The urban poor population is growing very rapidly so that unfavorable health outcomes among this sub-group will have adverse implications for the achievement of many of the Millennium Development Goals. We conducted a study on the economic, social, and health context of HIV/AIDS in informal urban settlements. To achieve this, population-based HIV testing was conducted annually in Korogocho and Viwandani slums in Nairobi City to estimate the prevalence and incidence of HIV/AIDS. APHRC has been conducting a demographic surveillance system (DSS) in these two slums since 2002. Data on HIV status was linked to individual data from the DSS to determine the social, health, economic, and demographic factors associated with HIV positive status. The project also assessed the impact of HIV/AIDS by following up a cohort of HIV positive and negative subjects for a period of two years. Being the first study of its nature in these communities, it was proposed to start with a study to assess acceptance rates for participation into the study and to estimate a baseline HIV prevalence rate. This feasibility phase took approximately 6-8 months and it informed the procedures for the main study. HIV prevalence among the urban poor was higher than the estimate of 10% for Nairobi, there were higher refusal rates in the urban slums, and that the impacts of HIV/AIDS was greater than those documented in the literature from rural studies. The findings had significance for the design of policies and programs for the urban poor and also for assessing the impact of HIV/AIDS.

Version

Version Notes
Version 1.1, November 2014. Anonymized with DOI and Recommended Citation added.

Scope

Keywords
Keyword
HIV

Coverage

Geographic Coverage
The study was conducted in the two NUHDSS areas namely, Korogocho and Viwandani slums where APHRC runs a longitudinal demographic surveillance system (DSS).
Unit of Analysis
Individuals
Universe
The study population consisted of all residents of Korogocho and Viwandani slums who met the eligibility criteria thus: residents are registered by the Nairobi Urban Demographic Surveillance System (NUHDSS); aged between 15 to 54 years for men and 15 to 49 years for females and were in relatively good health to respondent to the interview.

Producers and sponsors

Authoring entity/Primary investigators
Agency Name Affiliation
African Population and Health Research Center APHRC
Producers
Name Affiliation
Dr Nyovani Madise APHRC
Dr Matilu Mwau KEMRI
Eliya Zulu APHRC
Zewdu Woubalem APHRC
Chi-Chi Undie APHRC
Abdhalah Ziraba APHRC
John Kebaso APHRC
Elizabeth Kimani APHRC
Samoel Khamadi KEMRI
Michael Kiptoo KEMRI
Raphael Lihana KEMRI
Funding Agency/Sponsor
Name Abbreviation Role
Rockefeller Foundation RF Funder
Other Identifications/Acknowledgments
Name Affiliation Role
Rockefeller Foundation RF Funder
Field Team FT Data collection
Population of Koroghocho and Viwandani Survey subjects

Sampling

Sampling Procedure
For the pilot phase of the project a sample of 800 was estimated to be adequate to answer the key question of prevalence of HIV and acceptability of community based testing of HIV in the slums. A computer assisted random sample of eligible individuals was selected. Following a successful pilot phase, an extra 3,380 sample was selected to try and characterize the HIV situation further including carrying out analyses to establish risk factors for HIV. This resulted into a total sample size of 4180 individuals to be drawn.
Response Rate
Total population interviewed = 6237 (3,876 women and 2,354 men).



Due to unforeseen circumstances, some the individuals who were initially sampled could not be interviewed for various reasons including death, and out migration. Therefore, a replacement random sample similar to those missed was drawn to make up the sample initially targeted.
Weighting
The data are not weighted.

Data Collection

Dates of Data Collection (YYYY/MM/DD)
Start date End date
2006-01-05 2007-12-14
Mode of data collection
Face-to-face [f2f]
Type of Research Instrument
The questionnaire captured data on knowledge of HIV transmission and prevention, knowledge of HIV/AIDS related services and their availability in the community, behaviors associated with risks of HIV infection, attitudes and perceptions related to support and care of people living with AIDS.



More specifically, the themes covered by the questionnaire included :

1. Background

2. Knowledge about HIV/AIDS

3. Testing history

4. Marriage and Sexual activity

5. Practices

a. Male circumcision this section to be administered to males only

b. Questions on pubic hair removal practice

6. Referral

Data Processing

Cleaning Operations
Completed and edited questionnaires were returned to the office for data entry on a regular basis. About 10% of all questionnaires were manually re-checked by an office edit before data entry could be carried out.
Other Processing
The survey data was entered into a computer using SQL Server software at the APHRC offices. HIV status data were stored in secure password protected data base at KEMRI laboratories. Only authorized personnel had access to HIV status data.

Data access

Contact
Name Affiliation Email URI
African Population and Health Research Center APHRC info@aphrc.org www.aphrc.org
Conditions
DATA ACCESS CONDITIONS

All non-APHRC staff seeking to use data generated at the Center must obtain written approval to use the data from the Director of Research. This form is developed to assess applications for data use and facilitate responsible sharing of data with external partners/collaborators/researchers. By entering into this agreement, the undersigned agrees to use these data only for the purpose for which they were obtained and to abide by the conditions outlined below:

1. Data Ownership: The data remain the property of APHRC; any unauthorized reproduction and sharing of the data is strictly prohibited. The user will, therefore, not release nor permit others to use or release the data to any other person without the written authorization from the Center.

2. Purpose: The provided data must be used for the purpose specified in the Data Request Form; any other use not specified in the form must receive additional or separate authorization.

3. Respondent Identifiers: The Center is committed to protecting the identity of the respondents who provide information in its research. All analytical data sets (both qualitative and quantitative) released by the Data Unit MUST are stripped of respondent identifiers to protect the identity of the respondents. By accepting to use APHRC data, the user is pledging that he/she will not, under any circumstance, regenerate the identifiers or permit others to use the data to learn the identity of any individual, household or community included in any data set.

4. Confidentiality pledge: The user will not use nor permit others to use the data to report any information in the data sets that could identify, directly or by inference, individuals or households.

5. Reporting of errors or inconsistencies: The user will promptly notify the Head of the Statistics and Survey Unit any errors discovered in the data as soon as the errors are discovered.

6. Publications resulting from APHRC data: The Center requires external collaborators to work with APHRC staff on all publications resulting from its data. In order to facilitate this, lead authors should send a detailed concept note of the paper (including the background, rationale, data, analytical methods, and preliminary findings) to the Principle Investigator (or Theme Leader) for the project (with a copy to the Director of Research), who will circulate the abstract to concerned researchers for possible expression of interest in participating in the publication as co-authors. Any exception to the involvement of APHRC staff should be approved by the Director of Research, APHRC.

7. Security: The user will take responsibility for the security of the data by ensuring that the data are used and stored in a secure environment where access is password protected. This will ensure that non-authorized people should not have access to the data.

8. Loss of privilege to use data: In the event that APHRC determines that the data user is in violation of the conditions for using the data, or if the user wishes to cancel this agreement, the user will destroy the data files provided to him/her. APHRC retains the right to revoke this agreement or informs publishers to withhold publication of any work based wholly or in part on its data if the conditions for using the data are violated.

9. Acknowledgement: Any work/reports from this data must acknowledge APHRC as the source of these data. For example, the suggested acknowledgement for NUHDSS data is:

“This research uses livelihoods data collected under the longitudinal Nairobi Urban Health and Demographic Surveillance System (NUHDSS) since 2006. The NUHDSS is carried out by the African Population and Health Research Center in two slums settlements (Korogocho and Viwandani) in Nairobi City.”

Additionally all funders, the study communities that provided the data, and staff who collected and analyzed or processed the data should be acknowledged.

10. Deposit of Reports/Papers: The user should submit electronic and paper copies of all publications generated using APHRC data to the Policy Engagement and Communications Department, with copies to the Director of Research.

11. Change of contact details: The user will promptly inform the Director of Research of any change in your personal details as contained on this data request form.
Citation requirement
African Population and Health Research Center, The Economic, Health, and Social Context of HIV infection in Informal Urban Settlements of Nairobi, October 2013. APHRC, Nairobi - Kenya. doi:11239/176-2006-002-1.1

Contacts

Contact
Name Affiliation Email
Head, Statistics and Surveys Unit APHRC datarequests@aphrc.org

Metadata production

Document ID
APHRC-HIV-2006.1.1
Producers
Name Abbreviation Affiliation Role
African Population and Health research Center APHRC APHRC Metadata Producer
Date of Production
2013-10-23
Document version
Version 1.1