How Does Communal HIV/AIDS Affect Fertility? - Evidence from Malawi

Abstract

Recently there has been a surge in interest on how HIV/AIDS affects fertility in countries hit by the disease. In this study, the effect of communal HIV/AIDS on fertility in rural Malawi is estimated using individual data from the 2004 Malawi Demographic and Health Survey on fertility and the ideal number of children. The survey includes individual HIV status, making it possible to distinguish between behavioural and physiological effects. The main indicator of communal HIV/AIDS is the district-level prime-age mortality rate, obtained from the 1998 Population Census. The paper first tests the overall behavioural fertility response due to the epidemic, and then tests for differences in response due to gender-specific communal mortality and HIV rates, as well as individual age and knowledge about mother-to-child HIV transmission. The main findings are: communal HIV/AIDS has a negative but small impact on fertility; actual fertility and women’s ideal number of children is more negatively affected by HIV/AIDS among women than among men; and a woman’s age and knowledge about mother-tochild transmission of HIV are important determinants of her fertility response to the disease.