Reproductive decision making and the HIV/AIDS epidemic in Zimbabwe

The fertility-stimulating effect of high rates of child mortality on reprod uctive decision making (RDM) is a central tenet of population studies, yet the effects of the HIV/AIDS epidemic on RDM have not been thoroughly explor ed in the literature. This paper investigates how RDM is articulated in the context of high HIV/AIDS prevalence in Zimbabwe. Using qualitative methods (35 focus groups and 46 in-depth interviews), we found that childbearing i s extremely important in the lives of adult Zimbabweans and that children a re needed to cement the couple's relationship, whether it is the first or s ubsequent marriage. Most respondents said that the rates of both adult and child mortality were greatly increasing due to the AIDS epidemic. However, contrary to expectations based upon the insurance strategy, most respondent s said that they would have fewer children as a result of the perceived inc rease in child mortality. They were also hesitant to continue childbearing after a child death, indicating only weak replacement motivation. Instead, many respondents expressed the desire to limit family size due to concerns about their own mortality and its negative effects on their children. Furth ermore, new reproductive strategies seem to be emerging, which focus upon t he health of parents and child and are based upon perceptions of 100 per ce nt maternal-infant HIV transmission. Adult HIV status is linked to child su rvival as respondents explained that having a healthy child who survives to age five indicates that the parents are also free of the virus and, at thi s point, they can safely continue childbearing. Additionally, couples who h ave experienced the death of a child are hesitant to give birth again becau se they believe future children would die. Finally, there was some talk of having children early in an attempt to avoid contracting HIV. This study pr esents evidence that Zimbabweans are altering their reproductive strategies in order to protect both parents from the threat of AIDS.