{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T04:08:32Z","timestamp":1786766912008,"version":"build-2736575974"},"reference-count":21,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,10,24]],"date-time":"2017-10-24T00:00:00Z","timestamp":1508803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["085477\/Z\/08\/Z"],"award-info":[{"award-number":["085477\/Z\/08\/Z"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R03AI125001"],"award-info":[{"award-number":["R03AI125001"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To describe regional differences in the relative fertility of <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010positive <jats:italic>vs<\/jats:italic>. <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010negative women and changes as antiretroviral treatment (<jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content>) is scaled up, to improve estimates of predicted need for and coverage of prevention of mother\u2010to\u2010child transmission services at national and subnational levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analysed 49 nationally representative household surveys in sub\u2010Saharan Africa between 2003 and 2016 to estimate fertility rate ratios of <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010positive and <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010negative women by age using exponential regression and test for regional and urban\/rural differences. We estimated the association between national <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> coverage and the relationship between <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> and fertility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Significant regional differences exist in <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> and fertility relationships, with less <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010associated subfertility in Southern Africa. Age patterns of relative fertility are similar. <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> impact on fertility is weaker in urban than rural areas. For women below age 30, regional and urban\/rural differences are largely explained by differences in age at sexual debut. Higher levels of national <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> coverage were associated with slight attenuation of the relationship between <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> and fertility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Regional differences in <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010associated subfertility and urban\u2013rural differences in age patterns of relative fertility should be accounted for when predicting need for and coverage of <jats:styled-content style=\"fixed-case\">PMTCT<\/jats:styled-content> services at national and subnational level. Although <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> impacts on fertility are somewhat reduced at higher levels of national <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> coverage, differences in fertility between <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> positive and negative remain, and fertility of women on <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> should not be assumed to be the same as <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010negative women. There were few data in recent years, when <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> has reached high levels, and this relationship should continue to be assessed as further evidence becomes available.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12983","type":"journal-article","created":{"date-parts":[[2017,10,7]],"date-time":"2017-10-07T01:32:42Z","timestamp":1507339962000},"page":"1542-1550","source":"Crossref","is-referenced-by-count":23,"title":["The relationship between <scp>HIV<\/scp> and fertility in the era of antiretroviral therapy in sub\u2010Saharan Africa: evidence from 49 Demographic and Health Surveys"],"prefix":"10.1111","volume":"22","author":[{"given":"M.","family":"Marston","sequence":"first","affiliation":[{"name":"London School of Hygiene and Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Zaba","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. W.","family":"Eaton","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Epidemiology Imperial College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,10,24]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"UNAIDS.Global Plan Towards the Elimination of New HIV Infections Among Children by 2015 and Keeping Mothers Alive. Geneva: Joint United Nations Programme on HIV\/AIDS (UNAIDS) 2011."},{"key":"e_1_2_6_3_1","unstructured":"UNAIDS.On the fast\u2010track to an AIDS free generation. Geneva: 2016."},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001330"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2010.043620"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00126334-200012010-00008"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200406002-00005"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001305"},{"issue":"1","key":"e_1_2_6_9_1","first-page":"S41","article-title":"Measuring the impact of HIV on fertility in Africa","volume":"12","author":"Zaba B","year":"1998","journal-title":"AIDS"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-199903110-00011"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200403260-00012"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1353\/dem.2004.0025"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200203080-00017"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0151877"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.12747"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000000963"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.2989\/16085906.2015.1093512"},{"key":"e_1_2_6_18_1","unstructured":"ICF International.The DHS Program Calverton Maryland: ICF International; [2017]. Available from:http:\/\/dhsprogram.com\/."},{"key":"e_1_2_6_19_1","unstructured":"UNAIDS.Global AIDS Update 2016. Geneva Switzerland: UNAIDS 2016."},{"key":"e_1_2_6_20_1","unstructured":"RutsteinSR.Guide to DHS statistics. Calverton Maryland Demographic and Health Surveys ORC Macro; 2006."},{"key":"e_1_2_6_21_1","unstructured":"UNAIDS.AIDSinfo: UNAIDS; [2016 17\/12\/2016]. Available from:http:\/\/aidsinfo.unaids.org\/."},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2012.03005.x"}],"container-title":["Tropical Medicine &amp; International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Ftmi.12983","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.12983","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T11:13:28Z","timestamp":1695986008000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tmi.12983"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,10,24]]},"references-count":21,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2017,12]]}},"alternative-id":["10.1111\/tmi.12983"],"URL":"https:\/\/doi.org\/10.1111\/tmi.12983","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"value":"1360-2276","type":"print"},{"value":"1365-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,10,24]]}}}