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How Subjective Beliefs about HIV Infection Affect Life-Cycle Fertility : Evidence from Rural Malawi

AGE GROUPS AGE OF MARRIAGE AGED ANTENATAL CLINICS ANTIVIRAL DRUGS AVERAGE AGE BIRTH OUTCOMES BIRTH SPACING BLOOD TESTS CHILD MORTALITY CHILD MORTALITY RATES CHILD SURVIVAL CHILDBEARING CHILDHOOD CLINICS CONSECUTIVE PREGNANCIES CONTRACEPTION CONTRACEPTIVES DEMOGRAPHIC TRANSITION DEVELOPING COUNTRIES DEVELOPMENT POLICY DISEASE DISSEMINATION DRUGS DYING ECONOMIC GROWTH EDUCATED WOMEN EDUCATIONAL ATTAINMENT EPIDEMIC EPIDEMICS EU FACT SHEETS FAMILY SIZE FERTILITY FERTILITY BEHAVIOR FERTILITY LEVELS FERTILITY PATTERNS FERTILITY RATE FERTILITY RATES FEWER BIRTHS FEWER PREGNANCIES FEWER WOMEN FREQUENCY OF INTERCOURSE HAZARD HAZARDS HEALTH SURVEYS HIV HIV INFECTION HIV POSITIVE HIV TESTING HIV/AIDS HOMES HOUSEHOLD INCOME HOUSEHOLD LEVEL HOUSEHOLD SIZE HUMAN CAPITAL HUMAN DEVELOPMENT HUSBAND HUSBANDS IMPACT OF POLICIES INFANT INFANT MORTALITY INFECTION RATES INFECTIOUS DISEASES INFORMATION CAMPAIGNS INTERCOURSE INTERNATIONAL FOOD POLICY RESEARCH INSTITUTE LEVELS OF EDUCATION LIFE EXPECTANCY LITERACY LIVING STANDARDS LOWER FERTILITY MARITAL STATUS MARRIAGE AGE MARRIAGES MARRIED WOMEN MEDICINE MIGRATION MORTALITY RISK MOTHER MOTHER TO CHILD MOTHER TO CHILD TRANSMISSION MOTHER-TO-CHILD MOTHER-TO-CHILD HIV TRANSMISSION MOTHER-TO-CHILD TRANSMISSION MOTHERS NUMBER OF BIRTHS NUMBER OF CHILDREN NUMBER OF WOMEN NUTRITION OLDER WOMEN OPPORTUNITIES FOR WOMEN ORPHANS PLAGUE POLICY DISCUSSIONS POLICY RESEARCH POLICY RESEARCH WORKING PAPER POLYGAMY PREGNANCIES PREGNANCY PREGNANCY OUTCOMES PREGNANCY STATUS PREVALENCE PREVENTION OF MOTHER PREVENTION OF MOTHER-TO-CHILD TRANSMISSION PRIOR TO MARRIAGE PROBABILITY OF CONCEPTION PROGRESS PUBLIC SERVICES RELIGIOUS GROUPS REPRODUCTION REPRODUCTIVE CHOICES REPRODUCTIVE DECISIONS RESIDENCE RESPECT RISK OF INFECTION RURAL AREAS SECONDARY EDUCATION SECONDARY SCHOOL SEX SEXUAL ACTIVITY SEXUAL BEHAVIOR SEXUALLY TRANSMITTED INFECTIONS STDS SURVIVAL OF CHILDREN SYMPTOMS TB THERAPY TREATMENT UNEDUCATED WOMEN UNPROTECTED INTERCOURSE UNPROTECTED SEXUAL ACTIVITY URBAN AREAS VOLUNTARY COUNSELLING WIFE WILL WOMAN YOUNG CHILDREN
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World Bank, Washington, DC
Africa | Malawi
2013-04-10T18:37:06Z | 2013-04-10T18:37:06Z | 2013-01

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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