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

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.