Zambia Demographic and Health Survey 2001-2002 - Measure DHS

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13.11.3 Payment for Sexual RelationsTable 13.22 shows that among men who ever had sex, 10 percent reported having paid for sexin the 12 months prior to the survey. Payment for sex is more common among the divorced/separated/widowed, and those in North-Western province. This phenomenon is less common among marriedmen, men living in Eastern province, and men with secondary or higher education.Men who paid for sex were asked whether they used a condom the last time they had such anencounter. More than two in five men used a condom in such sexual activities. The reported use of acondom in paid sex increases with increasing education, is more common in urban areas, particularly inLusaka, and among those who have ever been married.Table 13.22 Payment for sex and condom use during last paid sexAmong men who have ever had sex, the percentage who paid for sex in the 12months preceding the survey and the percentage who used a condom during lastpaid sexual intercourse, by background characteristics, Zambia 2001-2002––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––Paid Number Used Number whofor sex who condom paid for sexBackground in past 12 ever at last in pastcharacteristic months had sex paid sex 12 months––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––Age15-19 17.1 291 24.2 5020-24 17.7 319 56.1 5725-29 10.7 356 (42.1) 3830-39 7.7 520 (63.2) 4040-49 4.8 286 * 1450-59 0.9 171 * 1Marital statusNever married 17.2 579 38.9 100Married/living together 5.4 1,248 50.6 67Divorced/separated/widowed 28.3 116 (51.0) 33ResidenceUrban 10.7 793 62.5 85Rural 10.0 1,150 31.6 114ProvinceCentral 12.1 148 (50.0) 18Copperbelt 8.5 415 * 35Eastern 5.1 246 * 13Luapula 6.1 149 * 9Lusaka 12.3 289 (70.4) 35Northern 7.5 250 * 19North-Western 22.5 83 (41.7) 19Southern 12.0 207 * 25Western 17.2 156 (32.0) 27EducationNo education 11.3 97 * 11Primary 13.0 975 39.4 127Secondary or higher 7.1 871 62.7 62Total 10.3 1,943 44.8 200––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––Note: Figures in parentheses are based on 25-49 unweighted cases. An asteriskindicates that a figure is based on fewer than 25 unweighted cases and has beensuppressed.224 | AIDS/HIV/STI-Related Knowledge and Behaviour
PREVALENCE OF HIV AND SYPHILIS 14Kumbutso DzekedzekeZambia has used the antenatal care (ANC) sentinel surveillance data as a principal means ofmonitoring the spread of HIV for almost a decade (Fylkesnes et al., 1998). The ANC sentinel surveillancesystem includes both urban and rural sites with at least two sites in each of the country’s nine provinces.Over time, there has grown a need to expand the tools for monitoring HIV trends in the generalpopulation with population-based surveys.UNAIDS recommends carrying out population-based surveys in catchment areas of ANC sentinelsurveillance sites to calibrate the results of routine surveillance systems (UNAIDS/WHO Working Groupon Global HIV/AIDS and STI Surveillance, 2000). A number of population-based surveys have been carriedout in specific catchment areas of the ANC sentinelsurveillance system in Zambia to calibrate the results ofthe ANC system to the general population and to monitorHIV trends in the general population. (For a comparisonof ANC surveillance estimates and the ZDHS rates, seeSection 14.4.) However, the 2001-2002 ZDHS is the firstnationally-representative population-based survey to estimatethe prevalence of HIV in Zambia. In addition to HIVtesting, syphilis was included from among other sexuallytransmitted infections (STIs) because it is an importantbio-marker of the prevalence of STIs which are a majorrisk factor in the heterosexual transmission of HIV in theZambian population.In the ZDHS, all women and men interviewed inthe one-half of households selected for the men’s surveywere asked to volunteer for a syphilis and HIV test of theirvenous blood. Consent was sought separately for thesyphilis and HIV tests such that respondents could refuseor agree to take one or both of the two tests. Test resultsfor syphilis have been linked to other variables collectedduring the survey while those for HIV are unlinked. A fulldescription of the sample collection, testing, and syphilistreatment procedures is discussed in Chapter 1.14.1 COVERAGE FOR HIV AND SYPHILIS TESTING14.1.1 Coverage for Syphilis Testing by ResidenceTables 14.1 and 14.2 summarise coverage rates forthe syphilis testing component of the ZDHS by residence.Among the women and men eligible for testing, 76 percentconsented to the syphilis test, 15 percent refused to betested, and 6 percent were absent from the household whenTable 14.1 Coverage for syphilis testing by urbanruralresidence (unweighted)Percent distribution of de facto women and meneligible for syphilis testing by testing status, accordingto urban-rural residence, Zambia 2001-2002ResidenceTesting status Urban Rural TotalWomen 15-49Tested 79.6 79.1 79.2Refused 15.1 15.6 15.4Absent/other 3.2 3.0 3.0Interviewed in DHS 1.7 0.7 1.0Not interviewed in DHS 1.5 2.3 2.0Result missing 2.1 2.4 2.3Total 100.0 100.0 100.0Unweighted number 873 1,816 2,689Men 15-59Tested 66.5 76.5 73.1Refused 15.6 14.5 14.8Absent/other 13.3 5.4 8.1Interviewed in DHS 3.6 0.9 1.8Not interviewed in DHS 9.7 4.6 6.3Result missing 4.7 3.6 4.0Total 100.0 100.0 100.0Unweighted number 814 1,604 2,418Total 15-49Tested 73.4 77.8 76.4Refused 15.3 15.1 15.1Absent/other 8.1 4.2 5.5Interviewed in DHS 2.6 0.8 1.4Not interviewed in DHS 5.5 3.4 4.1Result missing 3.2 2.9 3.0Total 100.0 100.0 100.0Unweighted number 1,631 3,297 4,928the nurse/nurse counselor visited. The 2001-2002 ZDHS household record did not include a syphilis resultcode for the remaining individuals (3 percent). Most of the latter individuals were not interviewed inthe 2001-2002 ZDHS, so it is likely they were also absent at the time the household was visited for thetesting.Prevalence of HIV and Syphilis | 225
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ZambiaDemographic andHealth Survey2
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This report summarises the findings
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Page3.6 Women’s Employment ......
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Page11.3.2 Micronutrient Intake amo
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PageA.7 Sample Selection ..........
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PageTable 3.11 Decision on use of e
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Table 7.7 Wanted fertility rates ..
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PageTable 13.5 Discussion of HIV/AI
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PREFACEThe Zambia Demographic and H
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FAMILY PLANNINGKnowledge of contrac
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According to mothers’ reports, ar
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ZAMBIALake TanganyikaLake MweruTanz
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The 1980s marked the start of the f
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the peripheral structures. An impor
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ing in private households in the co
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subjects agreed) received a referra
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confidentiality.Finally, in additio
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CHARACTERISTICS OF HOUSEHOLDS AND2R
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Figure 2.2 Distribution of De Facto
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2.4 EDUCATIONAL LEVEL OF HOUSEHOLD
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Figure 2.3 Percent Distribution of
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Figure 2.4 Net and Gross Attendance
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2.5 HOUSING CHARACTERISTICS ANDHOUS
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Thirty percent of households own a
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CHARACTERISTICS OF RESPONDENTS3AND
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enrolment ratios suggest that educa
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3.3 LITERACYThe ability to read is
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Figure 3.1 Youth Literacy100 Percen
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3.5 MEN’S EMPLOYMENTMale responde
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Table 3.6 Occupation: menPercent di
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Table 3.8 Employment status: womenP
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non-agricultural occupations, since
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Table 3.12 Women’s control over e
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Table 3.14.1 Women’s participatio
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Table 3.14.2 Women’s participatio
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Table 3.15.1 Women’s attitudes to
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3.7.3 Attitudes toward Refusing Sex
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Table 3.16.2 Men’s attitudes towa
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Table 3.17.1 Smoking of tobacco: wo
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FERTILITY4Richard Banda and Margare
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As the comparison in Figure 4.1 ind
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Figure 4.3 Total Fertility Rate by
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Table 4.4 Trends in fertility by ba
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Results from the 2001-2002 ZDHS ind
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The median birth interval is 33 mon
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4.6 TEENAGE FERTILITYAdolescent chi
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FERTILITY REGULATION5Mika Bwembya a
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Table 5.1.2 Knowledge of contracept
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Seventy percent of currently marrie
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Table 5.4 Current use of contracept
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Table 5.7 Number of children at fir
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Table 5.10 Source of contraceptionP
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The pattern is slightly different f
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5.14 EXPOSURE TO FAMILY PLANNING ME
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Table 5.16.1 Exposure to specific r
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Table 5.17 shows that 18 percent of
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Table 5.19 Attitudes of couples tow
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Table 6.1 shows that one-fourth of
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Table 6.3 Age at first marriagePerc
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Table 6.5 Age at first sexual inter
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Table 6.7.1 Recent sexual activity:
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Almost four in ten (38 percent) of
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FERTILITY PREFERENCES AND UNMET NEE
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The above results show an increase
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7.3 UNMET NEED FOR FAMILY PLANNINGW
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Figure 7.4 Unmet Need for Spacing a
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The mean ideal number of children f
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Table 7.7 shows the total wanted fe
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Fifty-nine percent of all neonatal
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Table 8.3 Early childhood mortality
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Table 8.5 Early childhood mortality
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Only 27 percent of births are in a
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MATERNAL AND CHILD HEALTH9Miriam Ch
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Expectant mothers should beginanten
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There are particularly sharp differ
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Table 9.5 Place of deliveryPercent
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Table 9.7 shows that only 2 percent
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Table 9.8 Postnatal carePercent dis
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Table 9.9 Visits by health workersP
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Table 9.10.2 Neighbourhood Health C
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No major variations were observed w
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Table 9.13 Vaccinations by backgrou
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Table 9.14 Prevalence of injections
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Eastern province has the highest pr
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Table 9.18 Diarrhoea treatmentPerce
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Table 9.20 Household knowledge and
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10.1.1 Use of Bednets by Children a
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Table 10.4 Use of antimalarial drug
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Luapula province has the highest pe
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INFANT FEEDING, NUTRITIONAL PRACTIC
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than half (51 percent) of the infan
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tamination after cleaning, the nipp
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11.2 COMPLEMENTARY FEEDING11.2.1 Ty
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Few children under two years of age
Page 193 and 194: Table 11.6 Iodisation of household
Page 195 and 196: 11.3.2 Micronutrient Intake among C
Page 197 and 198: 11.3.3 Micronutrient Supplementatio
Page 199 and 200: 11.4 HOUSEHOLD FOOD SECURITYFood se
Page 201 and 202: Table 11.12 Nutritional status of c
Page 203 and 204: Table 11.12 indicates that children
Page 205 and 206: VIOLENCE AGAINST WOMEN 12Mary Kazun
Page 207 and 208: Table 12.2 Experience of beatings o
Page 209 and 210: Results show that almost eight out
Page 211 and 212: Table 12.5 Experience of sexual vio
Page 213 and 214: More than four out of ten never-mar
Page 215 and 216: AIDS/HIV/STI-RELATED KNOWLEDGE AND1
Page 217 and 218: Table 13.2 Knowledge of ways to avo
Page 219 and 220: Knowledge of HIV prevention methods
Page 221 and 222: Table 13.5 Discussion of HIV/AIDS w
Page 223 and 224: The view that HIV status of a famil
Page 225 and 226: Table 13.8 Knowledge of “Trendset
Page 227 and 228: Figure 13.1 Unmet Need for HIV Test
Page 229 and 230: Table 13.10 Men's attitudes toward
Page 231 and 232: Men in sales and services and skill
Page 233 and 234: Table 13.13 Alcohol consumption by
Page 235 and 236: Table 13.14.2 Knowledge of symptoms
Page 237 and 238: The peak age for having STI symptom
Page 239 and 240: used condoms, 34 percent took medic
Page 241 and 242: The practice of having multiple par
Page 243: Table 13.21 Use of condoms by type
Page 247 and 248: 14.1.2 Coverage for HIV Testing by
Page 249 and 250: 14.1.3 Approach to Weighting Syphil
Page 251 and 252: 14.2 SYPHILIS PREVALENCE RATES 1Tab
Page 253 and 254: Table 14.8 Syphilis prevalence by a
Page 255 and 256: The 2001-2002 ZDHS data can be used
Page 257 and 258: Figure 14.2 illustrates the distinc
Page 259 and 260: Figure 14.3 HIV Prevalence AmongWom
Page 261 and 262: ADULT MORTALITY15Ann A. WayData col
Page 263 and 264: Table 15.2 Adult mortality ratesDir
Page 265 and 266: While again not definitive, the res
Page 267 and 268: 124 | ReferencesGaisie, K., A. Cros
Page 269 and 270: SAMPLE DESIGNAppendix AA.1 INTRODUC
Page 271 and 272: Table A.2. Expected number of selec
Page 273 and 274: Similarly, a total of 2,658 potenti
Page 275 and 276: Table A.5 Sample implementation: me
Page 277 and 278: where h represents the stratum whic
Page 279 and 280: Table B.2 Sampling errors for selec
Page 287 and 288: Table B.10 Sampling errors for sele
Page 289 and 290: Table B.12 Sampling errors for sele
Page 291 and 292: DATA QUALITY TABLESAppendix CTable
Page 293 and 294: Table C.3 Completeness of reporting
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Table C.6 Reporting of age at death
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Provincial CoordinatorsMr Martin Nj
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Data Processing StaffMr Mathews Muv
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286 | Appendix E
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HOUSEHOLD SCHEDULENow we would like
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LINENO.USUAL RESIDENTSAND VISITORSR
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NO. QUESTIONS AND FILTERS CODING CA
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INFORMED CONSENT FOR SYPHILIS AND H
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September 28, 20012001 ZAMBIA DEMOG
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SECTION 1. RESPONDENT’S BACKGROUN
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SECTION 2: REPRODUCTIONNO. QUESTION
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212 213 214 215 216 217IF ALIVE:218
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NO QUESTIONS AND FILTERS CODING CAT
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NO. QUESTION AND FILTERS CODING CAT
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NO. QUESTION AND FILTERS CODING CAT
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407AWhere did the first antenatal v
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NAMELAST BIRTHNEXT-TO-LAST-BIRTHNAM
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NAMELAST BIRTHNEXT-TO-LAST-BIRTHNAM
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SECTION 4B. IMMUNIZATION, HEALTH AN
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LAST BIRTHNEXT-TO-LAST BIRTHNAMENAM
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LAST BIRTHNEXT-TO-LAST BIRTH474B CH
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LAST BIRTHNEXT-TO-LAST BIRTH480 Wha
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NO QUESTIONS AND FILTERS CODING CAT
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SECTION 5. MARRIAGE AND SEXUAL ACTI
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SECTION 6. FERTILITY PREFERENCESNO.
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SECTION 7. HUSBAND'S BACKGROUND AND
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SECTION 9. MATERNAL MORTALITYNO. QU
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904 What wasname given toyour oldes
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NAME OF EDITOR:____________________
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SUPERVISOR FIELD EDITOR OFFICE EDIT
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14 Have you heard of any other ways
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SECTION 5. FERTILITY PREFERENCESNO.
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SECTION 7. AIDS AND OTHER SEXUALLY
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