Effects of fertility preferences on HIV prevention behaviors in a high prevalence setting

This paper examines the effects of fertility preferences on self-reported HIV prevention behaviors among married, reproductive age women and men in Zimbabwe. Ideal family sizes are generally high in Zimbabwe but so too is HIV prevalence. However, to date, there has been little quantitative research on the population-level effects of fertility preferences on HIV prevention behaviors in this setting. Given that men and women who desire a pregnancy are often also at significant risk of HIV infection, reproductive decision making can be complex for those who consider themselves at risk. Because the contraceptive choices that could best help couples attain their fertility preferences may not also provide protection against HIV, it can be hypothesized that couples prioritize their potentially conflicting reproductive health needs. A more through understanding of the relationship between fertility motivations and HIV prevention behaviors could help explain the limited success of some HIV prevention programs and improve their effectiveness by providing further insight into reproductive decision making.

The effects of fertility preferences on whether individuals make contraceptive choices that provide protection against HIV infection will be examined at the individual level. Additionally, the effect of fertility preferences on monogamy and receipt of HIV testing will be assessed. Bivariate analyses will be used to examine these HIV prevention behaviors by fertility preference. The contribution of fertility preferences to HIV prevention behaviors will then been assessed using logistic regression. Data come from the 2005-2006 Zimbabwe DHS survey.