Behavioral or Biological: Taking a Closer Look at the Relationship between HIV and Fertility

Ayesha Mahmud, Princeton University

This paper examines the relationship between HIV and fertility at the individual level, using data from eight countries in Sub-Saharan Africa. I utilize the two most recent rounds of the Demographic and Health Surveys, which links women to their HIV test results, to distinguish between potential mechanisms linking HIV and fertility. I find that HIV positive women have significantly lower fertility. I argue that this relationship predominantly reflects the biological consequences of the disease, rather than a behavioral response. The relationship between HIV status and fertility holds even after controlling for several indicators of risky sexual behavior, and after restricting the sample to women who have never been tested for HIV prior to the survey. While HIV positive women have smaller ideal family sizes and want fewer children in the future, this does not appear to be driving the relationship between HIV and fertility.

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 Presented in Session P3. Fertility Intentions and Behaviors