Abstract
This chapter examines the relationship between HIV infection and fertility among women in eight countries in Sub-Saharan Africa. The two most recent rounds of the Demographic and Health Surveys, which links women to their HIV test results, were used to distinguish between potential mechanisms linking HIV and fertility. HIV positive women had significantly lower fertility. The magnitude of the association between HIV status and fertility was consistent for women over the entire childbearing age and with different years of education. While HIV positive women desired fewer children compared to HIV negative women, the preference for smaller family sizes was not driving the relationship between HIV status and fertility. The relationship between HIV status and fertility held even after controlling for several indicators of risky sexual behavior, suggesting that changes in these indicators were not driving the observed relationship. HIV positive women had significantly lower fertility even after restricting the sample to respondents who had never been tested for HIV prior to the survey i.e. were presumed to be unaware of their HIV status and, thus, unlikely to be changing their behavior in response to their HIV infection. This provides evidence for a direct physiological effect of HIV infection on fertility.
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Acknowledgments
Support for this research was provided by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (grant #5R24HD047879) and from the National Institutes of Health (training grant #5T32HD007163).
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Mahmud, A. (2017). Behavioral or Biological: Taking a Closer Look at the Relationship Between HIV and Fertility. In: Hoque, M., Pecotte, B., McGehee, M. (eds) Applied Demography and Public Health in the 21st Century. Applied Demography Series, vol 8. Springer, Cham. https://doi.org/10.1007/978-3-319-43688-3_20
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DOI: https://doi.org/10.1007/978-3-319-43688-3_20
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