Key Results Liberia Demographic and Health Survey

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Key Results 2013 Liberia Demographic and Health Survey

The 2013 Liberia Demographic and Health Survey (LDHS) was implemented by the Liberia Institute of Statistics and Geo-Information Services (LISGIS) from 10 March to 19 July, 2013. The Ministry of Health and Social Welfare (MOHSW) authorized the survey. Funding for the survey was provided by the United States Agency for International Development (USAID), the Global Fund, the United Nations Children s Fund (UNICEF), the United Nations Population Fund (UNFPA), and the Government of Liberia. ICF International supported the project through the MEASURE DHS project, a USAID-funded program providing support, technical assistance, and funding for population and health surveys in countries worldwide.

Objectives The primary objective of the 2013 Liberia Demographic and Health Survey (2013 LDHS) is to provide up-to-date estimates of basic demographic and health collected information on: indicators. Specifically, the 2013 LDHS fertility levels marriage, sexual activity fertility preferences awareness and use of family planning methods breastfeeding practices nutrition childhood and maternal mortality maternal and child health In addition, the 2013 LDHS provides information on: awareness and behavior regarding HIV/AIDS and other sexually transmitted infections (STIs). estimates on HIV prevalence among adult Liberians.

Sampling Design Sampling frame: 2008 National Population and Housing Census First stage: 322 clusters selected (119 urban and 203 rural) Second stage: systematic sampling of 9,677 households Selected households were visited and interviewed; all women age 15-49 were eligible to be interviewed. In half of selected households, men age 15-49 were eligible to be interviewed. In the same subsample, blood was collected from eligible men and women for HIV testing.

2013 Liberia Demographic and Health Survey (LDHS) The 2013 LDHS is a nationally representative sample. The 2013 LDHS provides estimates for the whole country, for urban and rural areas, and for each of the five regions. The 2013 LDHS provides estimates for each of the 15 counties for some, but not all indicators.

Questionnaires Household questionnaire: List all usual members and visitors Household characteristics Identify women and men eligible for individual interview and HIV testing Individual (Woman s and Man s) questionnaires: Background characteristics (age, education, religion, etc.) Knowledge, awareness and behavior regarding AIDS and other sexually transmitted infections (STIs) Many other topics

Biomarkers HIV testing All adults age 15-49 who were interviewed were asked to voluntarily provide a blood sample for testing for HIV. Blood samples from consenting respondents were collected by LDHS interviewers. The protocol for the blood specimen collection and analysis was based on the anonymous linked protocol developed by MEASURE DHS. This protocol allows for the merging of the HIV test results with the socio-demographic data collected in the individual questionnaires after all information that could potentially identify an individual is destroyed. Protocol for testing was approved by by the Liberia Institute for Biomedical Research, the Institutional Review Board of ICF International, and the Centers for Disease Control in Atlanta. HIV testing took place at the National Reference Laboratory at the Liberia Institute for Biomedical Research.

Results of the household and individual interviews Household Interviews Households selected 9,677 Households occupied 9,386 Households interviewed 9,333 Response Rate 99% Interviews with Women age 15-49 Eligible women 9,462 Women interviewed 9,239 Response Rate 98% Interviews with Men age 15-49 Eligible men 4,318 Men interviewed 4,118 Response Rate 95%

HIV Knowledge, Attitudes & Behavior 2013 Liberia Demographic and Health Survey

97% of women and 96% of men age 15-49 have heard of AIDS.

Knowledge of HIV Prevention Methods Percent who know HIV can be prevented by: Women 15-49 Men 15-49 75 75 79 78 68 68 Using condoms Limiting sex to one uninfected partner Using condoms AND limit sex to 1 partner

Trends in Knowledge of HIV Prevention Methods Percent who know HIV can be prevented by using condoms and limiting sex to one uninfected partner: 2007 LDHS 2013 LDHS 68 66 68 44 Women 15-49 Men 15-49

Knowledge of Mother to Child Transmission (MTCT) of HIV Percent of women and men age 15-49 who say that: Women Men HIV can be transmitted by breastfeeding 52 71 Risk of MTCT can be reduced by taking special drugs during pregnancy 35 58 HIV can be transmitted by breastfeeding AND reduced by taking special drugs during pregnancy 27 51

Trends in Knowledge of Prevention of Mother-to-Child Transmission Percent of women and men age 15-49 who know that HIV can be transmitted by breastfeeding and that the risk of MTCT can be reduced by the mother taking drugs during pregnancy 2007 LDHS 2013 LDHS 51 12 14 27 Women Men

76% of women and 62% of men age 15-49 know where to get an HIV test.

HIV Testing Percent of women and men age 15-49 Women Men 45 23 19 12 Ever tested and received results Tested in last 12 months and received results

Trends in HIV Testing Percent of women and men age 15-49 who have ever been tested for HIV in the last 12 months and received the results 2007 LDHS 2013 LDHS 19 2 2 12 Women Men

HIV Testing During Pregnancy Among women who gave birth in the two years before the survey, 53% were counseled and tested for HIV during antenatal care and received the results.

Key Findings 68% of women and men know that using condoms and limiting sex to one uninfected partner reduces the risk of contracting HIV. 51% of women and 27% of men know that HIV can be transmitted by breastfeeding and the risk of MTCT can be reduced by the mother taking special drugs during pregnancy. 19% of women and 12% of men age 15-49 were tested for HIV and received their results in the last 12 months.

HIV Prevalence 2013 Liberia Demographic and Health Survey

HIV Testing Response Rates Percentage of women and men age 15-49 tested for HIV in the 2013 LDHS 92 88 90 Women Men Total

HIV Prevalence by Residence Percent HIV-positive, women and men age 15-49 Women 15-49 Men 15-49 Total 15-49 2.0 1.7 1.9 2.7 2.5 2.6 1.0 0.7 0.8 Liberia Urban Rural

Trends in HIV Prevalence in Liberia Percent HIV-positive 2007 LDHS 2013 LDHS 1.5 1.9 1.8 2.0 1.2 1.7 Total 15-49 Women 15-49 Men 15-49

Difference in HIV Prevalence among Adults age 15-49 between Surveys is NOT Statistically Significant Percent HIV-positive women and men age 15-49 3 2.5 2 1.5 1.5 1.9 1.8 2.0 1.7 1 1.2 0.5 0 Total 2007 LDHS Total 2013 LDHS Women 2007 LDHS Women 2013 LDHS Men 2007 LDHS Men 2013 LDHS

Percent HIV positive HIV Prevalence by Age Women Men 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0.0 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Age

HIV Prevalence by Region Liberia 1.9% North Western 0.9% South Central 2.7% North Central 0.7% South Eastern A 1.3% South Eastern B 1.8%

HIV Prevalence by Marital Status Percent HIV-positive Women 15-49 Men 15-49 9.0 1.3 1.0 2.1 2.1 2.3 5.1 Too few cases Never Married Married/ living together Divorced/ separated Widowed

Key Findings 1.9% of Liberian adults age 15-49 are HIV-positive. 2.0% of women and 1.7% of men are HIV-positive. The change in HIV prevalence since 2007 is not statistically significant, which means we cannot say with confidence that HIV has truly changed. HIV prevalence is highest in South Central (2.7%) and lowest in North Central (0.7%). HIV prevalence is higher among women and men who are divorced, separated or widowed.