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

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ACKNOWLEDGEMENTSWe have benefited from helpful discussions with Akila Weerapana, Adrienne Lucas, RandStoneburner, and Vinod Mishra, as well as anonymous reviewers from ICF Macro. The authorswould like to thank Tejaswi Velayudhan, Virginia C. Ritter, and Jing Chen for excellent researchassistance. All mistakes are solely our own.Suggested citation: Sneeringer, Stacy E., and Trevon Logan. 2009. A Closer Examination of theHIV/Fertility Linkage. DHS Working Papers No. 63. Calverton, Maryland: ICF Macro.
ABSTRACTRecent research on African countries suggests their fertility transitions are slowing or reversing.Authors have suggested that this trend change may relate to widespread HIV/AIDS, butspeculation abounds as to how the disease interacts with fertility. Different behavioral andmedical mechanisms can lead to positive or negative correlations between HIV and fertility, andthese correlations can be opposite on the individual and aggregate levels. This article provides asynopsis of the mechanisms relating HIV to fertility, attempting to describe their relativeimportance in affecting larger fertility trends. We discuss what outcome measures would beimpacted by the different mechanisms, and suggest methods on how to study whether HIV playsa significant role in fertility trends. Case studies of several variables from three countries(Uganda, Burkina Faso, and Zimbabwe) show that fertility declines appear to stall during theheight of the epidemics in these countries, and effects are larger depending on extremity of theepidemic. Indicators of other measures of fertility behavior suggest that women are attemptingto avoid HIV while maintaining high fertility. While these results show suggestive evidence offertility behavior changes in relation to the HIV epidemic, more rigorous empirical analyses arenecessary to control for conditional effects.
Page 2 and 3: The DHS Working Papers series is an
Page 7 and 8: INTRODUCTIONRecent research has sug
Page 9 and 10: Figure 1: Fertility behavior respon
Page 11 and 12: worry about passing the virus to an
Page 13 and 14: Changes in fertility outcomes: Whet
Page 15 and 16: of the increased likelihood of pass
Page 17 and 18: 12 percent. Reductions in fertility
Page 19 and 20: Actions to put fertility desires in
Page 21 and 22: Zimbabwe1. Trends in HIV prevalence
Page 23 and 24: Figure 3: Trend in ideal number of
Page 25 and 26: Figure 5: Trends in sexual activity
Page 27 and 28: Finally, to understand whether wome
Page 29 and 30: Uganda1. Trends in HIV prevalence a
Page 31 and 32: 3. Trends in fertility action: mari
Page 33 and 34: Modern contraceptive use is growing
Page 35 and 36: Figure 15: Trends in number of mont
Page 37 and 38: 2. Trends in fertility desiresWomen
Page 39 and 40: Figure 19: Trends in sexual activit
Page 41 and 42: 4. Summary for Burkina FasoIn many
Page 43 and 44: CONCLUSIONSThis paper has investiga
Page 45 and 46: REFERENCESCasterline EL. 2003. Fert

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

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