A Closer Examination of the HIV/Fertility Linkage ... - Measure DHS

period before HIV, and by dying in the epidemic they would leave lower-fertility women as agreater share of the population. These potential effects could only be witnessed at the aggregatelevel when comparing age-specific fertility rates before and after a period of epidemic. In orderto estimate which effect dominates, it would be necessary to compare age-specific birth ratesbefore and after an epidemic, netting out any concurrent effects on fertility rates, such aseducation and income.A somewhat different mechanism by which AIDS-related deaths could influence fertilityis via availability of male partners. If more men are dying of AIDS than before, the availabilityof partners may decrease. However, HIV prevalence rates are generally higher for women thanfor men, suggesting that AIDS-related mortality will lead to a disproportionate number of men,not women.3. Which mechanisms would matter most to aggregate fertility trends?Which effects would have the largest impacts, when considering fertility transition? Given thesmall percentage of people who know about their sero-status, any behavioral response to ownstatus would likely not be large enough to impact aggregate trends. If any behavioral response toHIV impacts larger trends, it would be the community threat response. The magnitude of anycommunity threat response would be constrained by availability and effectiveness of methods tocontrol fertility.A lower fertility rate due to HIV-contraction will affect the age groups where HIVprevalence is highest. The estimates suggest that the biological constraints due to HIVcontraction lower fertility rates by 25 to 40 percent (UNPD 2002). At a maximum, 30 percent ofwomen in a country have HIV; therefore the total fertility rate (TFR) could be lowered by 7.5 to10