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

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    1. James J. Heckman & Robert J. Willis, 1976. "Estimation of a Stochastic Model of Reproduction: An Econometric Approach," NBER Chapters, National Bureau of Economic Research, Inc, in: Household Production and Consumption, pages 99-146 National Bureau of Economic Research, Inc.
    2. Delavande, Adeline & Gine, Xavier & McKenzie, David, 2009. "Measuring Subjective Expectations in Developing Countries: A Critical Review and New Evidence," Policy Research Working Paper Series 4824, The World Bank.
    3. Chinhui Juhn & Sebnem Kalemli-Ozcan & Belgi Turan, 2008. "HIV and Fertility in Africa: First Evidence from Population Based Surveys," NBER Working Papers 14248, National Bureau of Economic Research, Inc.
    4. Rebecca L. Thornton, 2008. "The Demand for, and Impact of, Learning HIV Status," American Economic Review, American Economic Association, American Economic Association, vol. 98(5), pages 1829-63, December.
    5. Jane G. Fortson, 2009. "HIV/AIDS and Fertility," Mathematica Policy Research Reports, Mathematica Policy Research 7082, Mathematica Policy Research.
    6. 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.
    7. Wolpin, Kenneth I, 1984. "An Estimable Dynamic Stochastic Model of Fertility and Child Mortality," Journal of Political Economy, University of Chicago Press, University of Chicago Press, vol. 92(5), pages 852-74, October.
    8. 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, Springer, vol. 24(2), pages 629-655, April.
    9. Jane G. Fortson, 2009. "HIV/AIDS and Fertility," American Economic Journal: Applied Economics, American Economic Association, American Economic Association, vol. 1(3), pages 170-94, July.
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