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How subjective beliefs about HIV infection affect life-cycle fertility : evidence from rural Malawi

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  • Shapira, Gil
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    Abstract

    This paper studies the effect of subjective beliefs about HIV infection on fertility decisions in a context of high HIV prevalence and simulates the impact of different policy interventions, such as HIV testing programs and prevention of mother-to-child transmission, on fertility and child mortality. It develops a model of women's life-cycle, in which women make sequential fertility decisions. Expectations about the life horizon and child survival depend on women's perceived exposure to HIV infection, which is allowed to differ from the actual exposure. In the model, women form beliefs about their HIV status and about their own and their children's survival in future periods. Women update their beliefs with survival to each additional period as well as when their HIV status is revealed by an HIV test. Model parameters are estimated by maximum likelihood with longitudinal data from the Malawi Diffusion and Ideational Change Project, which contain family rosters, information on HIV testing, and measures of subjective beliefs about own HIV status. The model successfully fits the fertility patterns in the data, as well as the distribution of reported beliefs about own HIV status. The analysis uses the model to assess the effect of HIV on fertility by simulating behavior in an environment without HIV. The results show that the presence of HIV reduces the average number of births a woman has during her life-cycle by 0.15. The paper also finds that HIV testing can reduce the fertility of infected women, leading to a reduction of child mortality and orphan-hood.

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    Bibliographic Info

    Paper provided by The World Bank in its series Policy Research Working Paper Series with number 6343.

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    Date of creation: 01 Jan 2013
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    Handle: RePEc:wbk:wbrwps:6343

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    Related research

    Keywords: Population Policies; Gender and Health; Disease Control&Prevention; Gender and Law; Adolescent Health;

    This paper has been announced in the following NEP Reports:

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    1. Wolpin, Kenneth I, 1984. "An Estimable Dynamic Stochastic Model of Fertility and Child Mortality," Journal of Political Economy, University of Chicago Press, vol. 92(5), pages 852-74, October.
    2. James J. Heckman & Robert J. Willis, 1974. "Estimation of a Stochastic Model of Reproduction: An Econometric Approach," NBER Working Papers 0034, National Bureau of Economic Research, Inc.
    3. Sebnem Kalemli-Ozcan, 2006. "AIDS, "Reversal" of the Demographic Transition and Economic Development: Evidence from Africa," NBER Working Papers 12181, National Bureau of Economic Research, Inc.
    4. Dick Durevall & Annika Lindskog, 2011. "Uncovering the impact of the HIV epidemic on fertility in Sub-Saharan Africa: the case of Malawi," Journal of Population Economics, Springer, vol. 24(2), pages 629-655, April.
    5. Sebnem Kalemli-Ozcan & Belgi Turan & Chinhui Juhn, 2009. "HIV and Fertility in Africa: First Evidence from Population Based Surveys," 2009 Meeting Papers 650, Society for Economic Dynamics.
    6. Jane G. Fortson, 2009. "HIV/AIDS and Fertility," American Economic Journal: Applied Economics, American Economic Association, vol. 1(3), pages 170-94, July.
    7. Jane G. Fortson, 2009. "HIV/AIDS and Fertility," Mathematica Policy Research Reports 7082, Mathematica Policy Research.
    8. Rebecca L. Thornton, 2008. "The Demand for, and Impact of, Learning HIV Status," American Economic Review, American Economic Association, vol. 98(5), pages 1829-63, December.
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