The link between HIV/AIDS and fertility patterns in Kenya

Monica A. Magadi, City University London
Alfred A. Otieno, Population Studies and Research Institute

This study examines the effect of individual and contextual community-level HIV/AIDS factors on fertility in Kenya. Multilevel models are applied to the 2003 KDHS, introducing various proximate fertility determinants in successive stages, to explore possible mechanisms through which HIV/AIDS may have influenced fertility. The results corroborate findings from earlier studies of the fertility inhibiting effect of HIV/AIDS among infected women. HIV/AIDS infected women have 40 per cent lower odds of having had a recent birth than their uninfected counterparts of similar background characteristics and child mortality experience. Further analysis suggests that the effect of HIV/AIDS on fertility is partly through proximate fertility determinants relating to sexual exposure, breastfeeding duration, and foetal loss. Whilst HIV/AIDS may have contributed to reduced fertility, mainly through reduced sexual exposure, there is also evidence that it has contributed to increased fertility through increased desire for more children, mainly resulting from increased infant and child mortality.