1

HIV and AIDS in Nairobi Urban Informal Settlements

Nyovani Madise, Matilu Mwau, John Kebaso, Abdallah Ziraba, Samoel Khamadi, Vincent Okoth

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Objectives

To assess feasibility of conducting community-based HIV testing in informal urban settlements.

Magnitude of HIV problem in slums and how it varies by age, sex, sexual behaviour, socio-economic status etc

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Process

Ethical clearance (January-May 06)

Community mobilization (April-August 06)

Drawing of random sample Pilot (Sept - Dec 2006) Main study (from January 07)

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Methods

Simple random sample of 800 men and women for pilot DSS framework, women 15-49; men 15-

54 years Additional 3,400 men and women

(ratio of 40% men and 60% women) for main study.

Allowed for non-response & attrition (50% larger sample).

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Results: Lessons from Pilot

66% of 800 were contacted53% bled - 80% of those

contacted10% refused to give blood,

but interviewed10% refused both

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Results: Lessons from Pilot

11% out of 800 not traced but believed to be in the area

15% had out-migrated1.3% had died4% temporarily away

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Pilot Results: Characteristics of acceptors

AgeSampled% (N=800)

Contacted%(N=529)

Bled%(N=423)

15-19 15 17 19

20-24 24 23 22

25-34 32 29 28

35-44 20 21 22

45+ 9 10 10

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Pilot Results: Characteristics of acceptors

Sex% Sampled(N=800)

%Contacted(N=529)

% Bled(N=423)

Male 50 46 47

Female 50 54 53

Total 100 100 100

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Main Study- Preliminary Results

Korogocho 32% males bled (sampled has 36%)

Viwandani27% males bled (sample has 40%)

Age differences between sample & those bled are small

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HIV Prevalence (%) by SexKorogocho Slum, 2006-7 (N=1304)

ViwandaniSlum, 2007 (N=620)

Both slums

Nairobi, 2003 KDHSN=667

Males 14 9 12 8

Females

14 11 13 12

Total 14 10 13 10

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HIV Prevalence (%) by Age

HIV Prevalence in two Nairobi Slums and Nairobi City by age-group

0

5

10

15

20

25

15-19 20-24 25-34 35-44 45+

Age group (years)

Pre

vale

nce

Korogocho Viwandani Nairobi City

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HIV Prevalence (%) by Ethnicity

EthnicityKorogocho Viwandani Nairobi

Kamba 16 8 12

Kikuyu 10 11 7

Luhya 15 8 7

Luo 22 27 19

Other 11 10 6

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Concluding Remarks

Male and female prevalence rates similar

Higher HIV prevalence among older people in Korogocho (especially men)

Ethnic differences; influence of other kin?

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Acknowledgement

DSS Community members Fieldworkers and Phlebotomists The Rockefeller Foundation Colleagues from Africa Centre and Kisumu DSS sites