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The link between HIV and reduced fertility among women in Sub-Saharan Africa: Implications for treatment and contraceptive choice.    
  • Virginia Reid
Virginia Reid
Undergraduate Student at Duke University, Departments of Biology and Global Health
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Abstract

The effect of viral infections on female fertility is an essential relationship to research in order to properly conduct health interventions and predict population dynamics.  Particularly in Sub-Saharan Africa, a relationship between HIV positive status and fertility will have ramifications for how HIV patients are treated and what contraceptive methods they should choose.  This paper investigates the hypothesis that viral infections reduce fertility in women due to life history trade-offs and increased susceptibility for co-infections.  To investigate this hypothesis, I made the prediction that there is a significant negative correlation between HIV seropositive status and fertility rate among women of reproductive age. In addition, due to key recent studies on the association of injectable contraceptive methods with increased HIV susceptibility, I investigated if injectable contraceptive use modifies this relationship between HIV positive status and fertility.  Using linear regression methods, a significant negative correlation between HIV positive status and fertility was found.   Additionally, when the modifier of injectable contraceptive use was included in the multiple linear regression analysis, the relationship between HIV positive status and fertility was no longer found to be significant.  These results support the hypothesis that viral infections may decrease fertility; however, the inclusion of the modifier of use of injectable contraceptives signals a confounding relationship between injectable contraceptives and HIV risk.  The results of this study show that additional research on the effect of HIV and women's fertility is needed, and that contraceptive choice cannot be ignored when examining this relationship.