EMPIRICAL-EVIDENCE FOR THE SEVERE BUT LOCALIZED IMPACT OF AIDS ON POPULATION-STRUCTURE

Despite considerable speculation on the demographic impact of AIDS, th ere has been, until now, little scientific evidence to establish its e xistence or scale. Because of the widespread implications of these pre dictions, methods to combine demography and epidemiology to study empi rical situations have been an urgent priority. This study derives the extent and mechanisms of demographic impacts of AIDS from routine data (the 1991 census) in a severely affected country, Uganda. Three chara cteristics are of particular note: first, the emergence of demographic impacts much earlier than previously estimated; second, their localiz ation with negative population growth at parish but not at district or national scales; third, a greater impact on the number of children th an previously predicted(1,2), due as much to changes in population fer tility as mortality. The emergence of demographic impacts at this stag e highlights original aspects of the interdependence of HIV infection and demographic growth not previously recorded and the need to target preventive interventions to youth in developing countries.