HIV/AIDS and Fertility

Abstract

This paper studies the response of fertility to the HIV/AIDS epidemic in sub-Saharan Africa. I use repeated cross sections of the Demographic and Health Surveys for 12 countries in sub-Saharan Africa to examine this question empirically. Using individual birth histories from these data, I construct estimates of the regional total fertility rate over time. In a difference-in-differences approach, I compare regional HIV prevalence to changes in total fertility rates from the 1980s to the present. My results suggest that HIV/AIDS had very little impact on fertility, both overall and in a sample of HIV-negative women. (JEL I12, J13, O12)

Economic booms and risky sexual behavior: Evidence from Zambian copper mining cities

“…Gersovitz et al (1998) show that females under-reporting sexual activity and/or males over-reporting sexual activity is more likely to explain these gender differences in sexual behavior than is the existence of a small group of high sexual frequency women not captured by the survey. Second, 32% of females report being pregnant in the 12 months prior to the survey date, a figure that seems slightly high compared to the estimate total fertility rate in Zambia, 5.91 (Fortson 2009). This suggests that respondents may interpret the "12 months" prior to the survey as a period longer than 12 months.…”

“…This approach is virtually identical to that in Ruhm (2000), Ruhm (2003), Dehejia and Lleras-Muney (2004), and Ruhm (2005), studies that examine the effects of state-level unemployment rates on health in the United States. Likewise, this approach is similar in spirit to the difference-in-differences approaches in Bleakley (2007), Fortson (2009), Fortson (2010, and Lucas (2010), approaches that focus on estimating the effects of health shocks using variation in the shock on the intensive margin. 18 The primary regression equation is:…”

“…Existing studies of the relationship between economic growth and HIV/AIDS focus on the effect of HIV/AIDS on economic growth (Young 2005) or its determinants (Fortson 2009, Fortson 2010, Juhn et al 2009). In the current study setting, I find that a large and sustained positive shock to aggregate production appears to have reduced particularly risky sexual behaviors where the intensity of the shock was the greatest.…”

HIV, wages, and the skill premium

“…AIDS -by changing population composition, risks, and decision-making -has potential spillovers on other sectors, including education and fertility (e.g., Fortson, 2011, Fortson, 2009, Juhn, Kalemli-Ozcan and Turan, 2008. The economic effects of the epidemic are potentially staggering, and economists have devoted considerable effort to estimating and forecasting the economic effects of HIV/AIDS.…”

“…In the first case, the effective negative labor supply shock would be bigger than what is captured by AIDS mortality, while in the second case the reverse would hold. However, empirical evidence on the issue suggests that there has been no fertility response to the HIV epidemic (Fortson, 2009, Kalemli-Ozcan, 2010, Juhn, Kalemli-Ozcan and Turan, 2008, KalemliOzcan and Turan, 2010. We can therefore neglect this channel.…”