Bifurcated fertility in areas with higher HIV prevalence? Evidence from the 2001-2002 DHS of Zambia

Laurie DeRose, University of Maryland

While the impact of HIV on mortality is rather uniform, its impact on fertility may vary across women, thus concealing any effects on fertility. For instance, while HIV-positive women may have fewer children because of their own frailty, the fertility of HIV-negative women may increase due to hoarding effects inspired by high levels of childhood mortality in their community. These competing effects are likely to offset each other, leaving no difference in fertility by community level HIV prevalence. Multi-level logistic regressions estimating the determinants of recent fertility in Zambia confirm that the prevalence of HIV in the community does not have an effect on individual fertility. However, there is a strong positive relationship between the level of HIV in the community and the variance in community fertility: areas where HIV infection rates are higher have greater variability in fertility behavior across women than those where infection rates are lower.