Fertility in Times of Crisis: The Case of the AIDS Epidemic

Sara Yeatman, University of Texas at Austin

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. However, as the epidemic matures, earlier infections are felt, and HIV testing spreads, there is reason to believe that fertility intentions might change considerably. This paper uses mixed methods to explore this relationship. Specifically, I draw on longitudinal data and in-depth interviews from rural Malawi to investigate how learning one’s HIV status alters childbearing intentions. Particular attention is paid to how AIDS-related changes in fertility preferences differ by sex and across the reproductive life course and how such changes are mitigated by local knowledge about antiretroviral medicines. Identifying the size and nature of these changes will be critical for anticipating the demographic and epidemiological future of the region as well as the specific reproductive health requirements created by the disease.