The Effect of HIV/AIDS on Fertility: What Role Do Proximate Determinants Play?

J. Alice Nixon-Thompson, University of Maryland

This study examines interactions between HIV/AIDS and the proximate determinants of fertility (age at first marriage, condom use, & postpartum insusceptibility) at the national level for 31 countries during two time periods representing phases of the epidemic (1993-2002 and 2003-2010). This analysis found HIV/AIDS and some proximate determinants of fertility (age at first marriage, and postpartum insusceptibility) were significantly associated with fertility. The separate components of postpartum insusceptibility (amenorrhea and abstinence) were also analyzed. While these determinants had the same directional influence on the effect of HIV, they have variable impacts in different countries, which could suggest country-specific strategies for improving HIV/AIDS and family planning programs. Based on the findings of this study, the effect of HIV and some proximate determinants on fertility has increased as the epidemic has evolved. This research suggests that both HIV/AIDS & family planning programs will need to more consciously address this overlap in impact.