Multiple Indicator Cluster Surveys Survey Design Workshop

1. Multiple Indicator Cluster SurveysSurvey Design Workshop Questionnaire for Individual Women: HIV/AIDS MICS4 Survey Design Workshop

2. Purpose • To measure knowledge and attitudes about HIV and AIDS among women • To monitor progress and achievements in national goals and targets on HIV information and education • To monitor progress and achievements in international goals and commitments – e.g. MDG 6, UNGASS, Universal Access MICS4 Survey Design Workshop

3. Goals • MDG 6: Combat HIV/AIDS, Malaria and other diseases • Target 6.A: Have halted by 2015 and begun to reverse the spread of HIV/AIDS • UNGASS: Ensure that by 2010 at least 95 per cent of young people aged 15-24 years have access to information, education and services necessary to develop the life skills to reduce their vulnerability to HIV MICS4 Survey Design Workshop

4. Eligibility • Questions are asked of all women aged 15-49 years in the household MICS4 Survey Design Workshop

5. MICS Indicators # 9.1 - Comprehensive knowledge about HIV prevention Percentage of women age 15-49 years who correctly identify two ways of preventing HIV infection, know that a healthy looking person can have HIV, and reject the two most common misconceptions about HIV transmission # 9.2 - Comprehensive knowledge about HIV prevention among young people Percentage of women age 15-49 years who correctly identify two ways of preventing HIV infection, know that a healthy looking person can have HIV, and reject the two most common misconceptions about HIV transmission (MDG 6.3) MICS4 Survey Design Workshop

6. Comprehensive knowledge Comprehensive knowledge is constructed from the following set of prompted questions: • Can people reduce their chance of getting the AIDS virus by having just one uninfected sex partner who has no other sex partners? [HA2] • Can people reduce their chance of getting the AIDS virus by using a condom every time they have sex? [HA4] • Is it possible for a healthy-looking person to have the AIDS virus? [HA7] • Can people get the AIDS virus from mosquito bites? [HA5] • Can people get the AIDS virus by sharing food with a person who has AIDS? [HA6] • Can a person get HIV through supernatural means? [HA3] MICS4 Survey Design Workshop

7. Comprehensive knowledge • The first three questions [HA2 - HA4 - HA7] should not be altered; the correct answers are “Yes” • The next three questions [HA5 - HA6 – HA3] ask about local misconceptions; the correct answers are “No” and additional questions about local common misconceptions can be added in your country MICS4 Survey Design Workshop

8. Comprehensive knowledge • Example of other misconceptions: • “Can a person get HIV by hugging or shaking hands with a person who is infected?” MICS4 Survey Design Workshop

9. Comprehensive knowledge • Those who have never heard of HIV and AIDS should be excluded from the numerator, but included in the denominator • An answer of “Don’t know” will be regarded as an incorrect answer MICS4 Survey Design Workshop

10. MICS Indicators # 9.3 - Knowledge of mother-to-child transmission of HIV Percentage of women age 15-49 years who correctly identify all three means (transmission during pregnancy, during delivery and by breastfeeding) of mother-to-child transmission of HIV # 9.5 - Women who know where to be tested for HIV Percentage of women age 15-49 years who state knowledge of a place to be tested MICS4 Survey Design Workshop

11. MICS Indicators # 9.4 – Accepting attitudes towards people living with HIV Percentage of women age 15-49 years expressing accepting attitudes on all four questions towards people living with HIV Notes: Numerator is calculated by first asking survey respondents if they have ever heard of HIV If yes, then they are asked a series of questions about people living with HIV MICS4 Survey Design Workshop

12. Accepting attitudes towards people living with HIV • 4 Questions: • HA9 - In your opinion, if a female teacher has the AIDS virus but is not sick, should she be allowed to continue teaching in school? • HA10 - Would you buy fresh vegetables from a shopkeeper or vendor if you knew that this person had the AIDS virus? • HA11 - If a member of your family got infected with the AIDS virus, would you want it to remain a secret? • HA12 - If a member of your family became sick with AIDS, would you be willing to care for her or him in your own household? MICS4 Survey Design Workshop

13. Accepting attitudes towards people living with HIV • Only respondents who report an accepting or supportive attitude on all four of these questions is counted in the numerator • An accepting attitude for the respective questions is considered to be (HA9) yes, (HA10) yes; (HA11) no; and (HA12) yes • Denominator: All women 15-49 who have heard of HIV MICS4 Survey Design Workshop

14. MICS Indicators # 9.6 - Women who have been tested for HIV and know the results Percentage of women age 15-49 years who have been tested for HIV in the 12 months preceding the survey and who know their results (UNGASS additional #7) -[HA16-17 & HA20-21] # 9.7 - Sexually active young women who have been tested for HIV and know the results Percentage of young women age 15-24 years who have had sex in the 12 months preceding the survey, who have been tested for HIV in the 12 months preceding the survey and who know their results MICS4 Survey Design Workshop

15. MICS Indicators # 9.8 - HIV counseling during antenatal care Percentage of women age 15-49 years, who gave birth in the 2 years preceding the survey and received antenatal care, reporting that they received counseling on HIV during antenatal care [HA15] # 9.9 - HIV testing during antenatal care Percentage of women age 15-49 years, who gave birth in the 2 years preceding the survey and received antenatal care, reporting that they were offered and accepted an HIV test during antenatal care and received their results [HA17] MICS4 Survey Design Workshop

16. Methodological issues • Interviews must be conducted in private • Check translation in previous MICS or other national survey questionnaires to ensure consistency and comparability • Questions H15 –H18 require a check in the child mortality module (CM13) and maternal and newborn health module (MN1) • HA20-H27 require a check in maternal and newborn health module (MN17) MICS4 Survey Design Workshop

17. Methodological issues • Most of the indicators derived from this module are dependent on each other; care should be taken not to delete questions that contribute to the calculation of related indicators • Trends in indicators can also be obtained by comparing age cohorts (15-19, 20-24, 25-29…) if only one data point exists MICS4 Survey Design Workshop

18. Summary of Module • Knowledge of HIV or AIDS • Knowledge of HIV prevention • Misconceptions about HIV and AIDS • Attitudes towards people living with HIV • Knowledge of mother-to-child transmission of HIV • Knowledge of HIV testing services • HIV testing for the general population • HIV testing for pregnant women at antenatal clinics MICS4 Survey Design Workshop

19. Acknowledgements Prepared by: Priscilla Akwara, PhD Statistics & Monitoring Section UNICEF, New York Email: pakwara@unicef.org Telephone: +1 212 326 7573 MICS4 Survey Design Workshop