The impact of HIV on family size preference in Zambia.

This paper examines the way in which concerns about HIV infection are affecting thinking in Zambia about preferred number of children. It draws on research on the impact of HIV/AIDS in peri-urban and rural households in 1995, based mainly on in-depth interviews with 65 of 300 people who were initially surveyed. In spite of high levels of anxiety about AIDS in these communities, risk from HIV was not always associated with the act of conceiving children, nor did this association necessarily influence actual behaviour or family size preferences. In some cases, however, the threat of contracting HIV had led to a decision to have fewer children. Many also worried about leaving orphans for others to look after and the costs which might be incurred in taking over the care of orphans left by others. A related reason for limiting fertility was the hope that orphaned children would be better cared for if there were fewer of them. Greater access to contraceptives, and specifically to condoms, is an important element in supporting women's efforts to protect themselves, and men also need to be involved in strategies for mutual protection. In both communities, however, there was a shared sense of limited control, not just over fertility, but also over the wider economic and health environment. An understanding of the complexity of these factors is essential for intervention programmes intended to enhance women's reproductive rights and support their fertility choices so as to ensure greater protection against HIV/AIDS.