HIV Reduces a Woman's Childbearing

HIV/AIDS is obviously a health and mortality issue, so there has been relatively little discussion about its impact on fertility. The conventional wisdom would be that as HIV affects a community, the higher death rate will cause women to have more children in order to combat the high mortality. A paper just published in the Journal of Population Economics (and available for free download) draws a different set of conclusions. The authors use data from Demographic and Health Surveys in African countries where HIV testing is part of the survey to look at both individual and community effects of HIV infections on fertility.

The data allow us to distinguish the effect of own positive HIV status on fertility (which may be due to lower fecundity and other physiological reasons) from the behavioral response to higher mortality risk, as measured by the local community HIV prevalence. We show that although HIV-infected women have significantly lower fertility, local community HIV prevalence has no significant effect on noninfected women’s fertility.

Overall, the study suggests that the effects of HIV infections are that the infected women wind up with fewer children (probably a good thing for her and the community), along with reduced human capital and lower prospects for a good life (not a good thing either for her or her community).