HIV status and fertility intention: what does knowledge have to do with it?

Sara E. Yeatman, University of Colorado, Denver

Despite the extent of the AIDS epidemic in sub-Saharan Africa, one of the remaining regions with high actual and desired fertility, little is known about how it influences fertility preferences. In this paper, I employ a quasi-experimental design to explore how learning one’s HIV status influences thinking about childbearing. Drawing on the case of rural Malawi, I use data over a unique period where no one “knew” their HIV status until HIV testing and counseling was offered door-to-door as part of a longitudinal study. However, in the absence of an HIV test, people are not oblivious to their HIV status; thus, I explore how “local” knowledge—or speculation—about one’s HIV status interacts with biomedical knowledge to influence fertility preferences. I find a large depressive effect of learning one is HIV positive on the desire to continue childbearing, an effect that is greatest among those who are surprised by their HIV result.