HIV and Fertility: Long-Term Evidence from Sub-Saharan Africa

Guenther Fink, Harvard University
Sebastian Linnemayr, Harvard University

The emergence of HIV/AIDS constitutes the single largest negative health shock to the international health system over the last 50 years that has resulted in a sharp disruption of the global upward trend in life expectancy, and thus provides a natural study ground for the interactions between health and socioeconomic behavior. In this paper, we focus on the effect of HIV as a health shock on family size. Combining historical micro data from the World Fertility Surveys with the most recent rounds of the Demography and Health Surveys we find little relation between the onset of HIV and the average changes in fertility on the regional level. These results, however, mask important heterogeneity in fertility responses at the individual level that are human-capital-specific: while women with primary school or less increase their fertility in the presence of HIV, the opposite is true for women with secondary or higher education.