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

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Fertility Change in Response to HIVIn recent years, several authors have compiled excellent overviews of the mechanisms by whichfertility may respond to HIV. The Population Division of the U.N. (2002) provides a conciseoverview of the different mechanisms and the research supporting these mechanisms. Otheruseful overviews can be found in Gregson, Zaba, and Hunter (2002); Gregson and coauthors(1997); and Nöel-Miller (2003). The pathways through which HIV may affect fertility arenumerous, and they interact at a number of levels. While the reviews mentioned above providemuch-needed elucidation of the mechanisms, they generally do not provide empirical analysis ofhow these mechanisms may interact, or how they may affect large-scale trends. A relativelybrief overview of these mechanisms follows.1. Behavioral mechanismsThe behavioral mechanisms describe how women of child-bearing age intentionally respond toHIV. Behavioral responses are deliberate and in this sense distinguishable from biologicalmechanisms. Research has suggested both directions of fertility change as a behavioral responseto HIV, and effects may differ in relationship to knowledge of own HIV status versus perceivedthreat of HIV. This section outlines two behavioral mechanisms (see Figure 1 below) suggestinghow HIV can lead to various fertility responses.2
Figure 1: Fertility behavior responses to HIVKnowledge of HIVtransmission methodsand diseaseLearnof ownpositiveserostatusContractionof virusTested forvirusHeightened threat… To self (health,community standing) To children To partner(s) To availability of partnerDesire nomore childrenDesire morechildrenConstraints: Knowledgeand availability ofcontraception, ability tocontrol own fertilityConstraints: ability to control ownfertility, availability of partner that isable to conceiveIncreasecontraceptiveuse/sterilizationDecreasesexualactivityRemainor getmarriedDecreasecontraceptiveuse/sterilizationIncreasesexualactivityDivorce,remainsingleDecreasefertilityIncreasefertility3
Page 2 and 3: The DHS Working Papers series is an
Page 4 and 5: ACKNOWLEDGEMENTSWe have benefited f
Page 7: INTRODUCTIONRecent research has sug
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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