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The Role of HIV Detection on Reproductive Health: Outcomes in Cameroon

The paper compares fertility outcomes and preferences between women enrolled in HIV clinics and the DHS sample, both administered in Yaounde contemporaneously. Using propensity score matching, we show that fertility outcomes are contingent on age at which women are detected HIV positive. By splitting the sample in two, above and below the median (30), younger women self-select into HIV during their antenatal VCT but their preference for total number of lifetime children and desire for additional pregnancy is not statistically different from average population. On the reverse, compared to the DHS sample, women detected positive in older ages have a relative 29% lower births, 26.5% higher propensity to desire additional pregnancy and a 15% higher ideal number of lifetime children. They are also less likely to be using any contraceptive method at the time of the survey, giving suggestive evidence of unmet need. These results are consistent when we use the 2007 fee exemption policy as a natural experiment. In an era where UHC and health equity are at the center of the post 2015 development agenda, our findings highlight any potential added-value from providing age specific family planning counselling.