Differences in fertility preferences and contraceptive behaviors by HIV status among women and men in 17 sub-Saharan African countries

Akinrinola Bankole, Guttmacher Institute
Ann E. Biddlecom, Guttmacher Institute
Kumbutso Dzekedzeke, Independent Consultant

HIV and unintended pregnancy prevention is a priority in Sub-Saharan Africa, where HIV prevalence and unmet need for contraception are the highest in the world. At the same time, availability of anti-retroviral therapy is enhancing the health of people living with HIV and raising hopes for a normal life. This improvement has potential effects on the relationship between HIV status and fertility preferences and behavior. New evidence is needed to better understand the implications of this relationship for service needs. Using data from the Demographic and Health Surveys (DHS) with HIV biomarker testing conducted between 2003 and 2007 in 17 Sub-Saharan African countries, this paper examines the extent to which fertility desires and contraceptive behaviors differ by HIV status. Bivariate and multivariate, including multilevel, analyses are conducted to explore the relationships between HIV status and desire for additional children, unmet need for contraception and use of condom at last sex.