HIV and Fertility in Sub-Saharan Africa: Are Adolescents Different?

David A. Sánchez Páez , Universidad de Valladolid
Sophia Chae, Université de Montréal
Bruno D. Schoumaker, UCLouvain

Although regional estimates from sub-Saharan Africa show that HIV-positive women generally have lower fertility than HIV-negative women, the opposite pattern is observed among adolescents. This discrepancy is likely due to previous studies not accounting for exposure to sexual activity. Controlling for sexual activity is particularly relevant for HIV-negative adolescents because many of them have not yet initiated sexual activity and are therefore not at risk of childbearing. Except for mother-to-child transmission of HIV, they are also not at risk of HIV infection. In this paper, we use Demographic and Health Surveys data from 31 countries to examine age-specific fertility patterns by HIV status and to understand the extent to which these patterns differ between adolescent girls and women in other age groups. We first compare age-specific fertility rates by HIV status, accounting and not accounting for exposure to sexual activity. We then analyze whether fertility patterns by serostatus differ according to HIV prevalence in the country and select socio-demographic variables. With the exception of the 15–19 age group, we find that HIV-negative women have higher fertility than HIV-positive women in all age groups. The opposite pattern is observed among adolescents. However, when we account for sexual activity, HIV-positive adolescents have fertility levels similar to those of HIV-negative adolescents. Our results suggest that the fertility patterns of HIV-positive adolescent girls are not so different from their HIV-negative counterparts when exposure to sexual activity is taken into account.

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 Presented in Session 24. Fertility and Health