1. 1 HIV and AIDS in Nairobi Urban Informal Settlements Nyovani Madise, Matilu Mwau, John Kebaso, Abdallah Ziraba, Samoel Khamadi, Vincent Okoth

2. 2 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

3. 3 Process  Ethical clearance (January-May 06)  Community mobilization (April- August 06)  Drawing of random sample  Pilot (Sept - Dec 2006)  Main study (from January 07)

4. 4 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).

5. 5 Results: Lessons from Pilot 66% of 800 were contacted 53% bled - 80% of those contacted 10% refused to give blood, but interviewed 10% refused both

6. 6 Results: Lessons from Pilot 11% out of 800 not traced but believed to be in the area 15% had out-migrated 1.3% had died 4% temporarily away

7. 7 Pilot Results: Characteristics of acceptors Age Sampled % (N=800) Contacted % (N=529) Bled % (N=423) 15-19151719 20-24242322 25-34322928 35-44202122 45+910

8. 8 Pilot Results: Characteristics of acceptors Sex % Sampled (N=800) % Contacte d (N=529) % Bled (N=423) Male504647 Female505453 Total100

9. 9 Main Study- Preliminary Results Korogocho  32% males bled (sampled has 36%) Viwandani 27% males bled (sample has 40%) Age differences between sample & those bled are small

10. 10 HIV Prevalence (%) by Sex Korogocho Slum, 2006-7 (N=1304) Viwandani Slum, 2007 (N=620) Both slums Nairobi, 2003 KDHS N=667 Males149128 Femal es 14111312 Total14101310

11. 11 HIV Prevalence (%) by Age

12. 12 HIV Prevalence (%) by Ethnicity Ethnicity KorogochoViwandaniNairobi Kamba16812 Kikuyu10117 Luhya1587 Luo222719 Other11106

13. 13 Concluding Remarks  Male and female prevalence rates similar  Higher HIV prevalence among older people in Korogocho (especially men)  Ethnic differences; influence of other kin?

14. 14 Acknowledgement  DSS Community members  Fieldworkers and Phlebotomists  The Rockefeller Foundation  Colleagues from Africa Centre and Kisumu DSS sites