Examining the Relationship between HIV and Fertility in Rural South Africa

Christie Sennott, Purdue University
Jill Williams, University of Colorado, Boulder
Benn Sartorius, University of the Witwatersrand
Jane Menken, University of Colorado, Boulder
Nicole Angotti, American University
Kerstin Klipstein-Grobusch, University of the Witwatersrand

Research from sub-Saharan Africa has demonstrated lower fertility among HIV+ women compared to same-age HIV- women, except among teens where the pattern reverses. These differences have been explained by earlier sexual debut among HIV+ women. This study uses HIV prevalence data collected in the Agincourt Health and Socio-Demographic Surveillance System to examine differences by HIV status in women’s likelihood of having a birth in 2010 and several sexual risk behaviors associated with HIV status and fertility. Results show a lower likelihood of birth among HIV+ women, except for those in their twenties who experience the opposite pattern. HIV+ women also experience significantly more sexual risk behaviors; however, the association between HIV+ women in their twenties and higher odds of birth is robust to these factors. The unique combination of changing fertility and marriage patterns, high HIV prevalence, and condom use among HIV+ women may help explain these associations.