PSTC Research: Fertility and hiv/aids
This thematic area pairs the oldest of demographic topics – fertility – with a topic – HIV/AIDS – that has taken on great importance in the demographic world over the past decade. What links the two at the PSTC are a series of perspectives and approaches that are distinctive. Among these are: (1) research that, while incorporating the micro-level, systematically theorizes about and empirically investigates meso-level influences; (2) an emphasis on the collection of original data; (3) multi-method research designs incorporating both quantitative and qualitative methods; (4) a significant international focus covering Africa, East and South Asia, Eastern and Western Europe, and Latin America; (5) a focus on life course and longitudinal approaches; and (6) an interest in the impact of intergenerational social and economic relations on behavior. These, in turn, reflect the fact that the PSTC is unusual among population centers in the balance achieved in integrating anthropological, sociological, and economic demography in demographic research.
Fertility. Although PSTC researchers utilize international standard surveys such as the DHS, the distinctive feature of PSTC fertility research is its commitment to achieving deep understanding of the social, cultural, and economic contexts in which reproduction occurs, something that cannot be done through standard survey research alone. This commitment is based on the premise that fertility behavior cannot be understood simply by the analysis of individual-level traits but requires adequate knowledge of family and kinship systems, changing gender systems, religious institutions, and the impact of the state, to mention only some of the foci of PSTC study.
HIV/AIDS. Research on HIV/AIDS has expanded dramatically at the PSTC in recent years, with particular focus on sub-Saharan Africa, where the epidemic is most severe. The PSTC is at the forefront in developing a distinctive interdisciplinary approach to understanding behavioral aspects of the spread of HIV/AIDS in Africa. The links across themes are again evident as work here ties into PSTC work on households, health behavior, and spatial inquiry.
Projects in the Fertility and HIV/AIDS thematic area include:
Project Title: The Cultural Context of Infertility in Southern Nigeria: Meanings, Consequences and Coping Mechanisms
PSTC Investigators: Marida Hollos (Ulla Larsen, PI)
Funding: NSF
Other Research Areas: Families and Households, Social Behavior and Health, African Demography
Description: This research seeks to advance understanding of the cultural perceptions and social consequences of infertility in sub-Saharan Africa among the Ijo and Yakurr communities of southern Nigeria. It examines structural differences between these populations in order to analyze the link between descent and gender ideology on the one hand, and the perception of infertility and the treatment of infertile women on the other. The study is important for understanding the cultural perceptions and social consequences of infertility in sub-Saharan African societies.
Project Title: Explaining Very Low Fertility in Italy
PSTC Investigators: David Kertzer, Michael White
Funding: NSF
Other Research Areas: Social Behavior and Health
Description: This project employs innovative multidisciplinary methodology and cutting-edge theory to seek a better explanation for very low fertility by focusing on Italy, a country that in the 1990s had the lowest fertility in the world, and which today has among the very lowest.Project Title: Using Relationship Calendars to Improve Sexual Behavior Data among Kenyan Couples
PSTC Investigators: Nancy Luke
Funding: NIH
Other Research Areas: Social Behavior and Health, African Demography
Description: This project will provide researchers with proven data collection methods so information can be analyzed to understand how relationship histories and couple dynamics affect the sexual risk behaviors and reproductive health of young women and men in Kisumu, Kenya, a low-income urban setting where young women and their male partners are affected by high rates of unintended pregnancy and STIs, including HIV.Project Title: The Public Health Impact of Antiretroviral Therapy in South Africa
PSTC Investigators: Mark Lurie
Funding: NIH / NIMH
Other Research Areas: Social Behavior and Health, African Demography
Description: This project, conducted in collaboration with colleagues at the University of KwaZulu-Natal in Durban, South Africa, collects data on sexual behavior and incidence of sexually transmitted infections among people who are co-infected with TB and HIV and who are on antiretroviral therapy within an existing randomized controlled trial. This and other data will be used to develop maResearchal models to estimate the public health impact of HIV treatment in terms of secondary transmission averted.
Project Title: Collaborative AIDS Programme of Research in South Africa (CAPRISA)
PSTC Investigators: Mark Lurie (S. Abdool Karim, PI)
Funding: NIH
Research Areas: Social Behavior and Health, African Demography
Description: The project will undertake globally relevant and locally responsive research that contributes to understanding HIV pathogenesis and epidemiology as well as the nexus between tuberculosis and AIDS care; to build local research infrastructure through cores of expertise; and to provide training through research fellowships tenable both in South Africa and the USA.Project Title: Microcredit and Health Services Experiment in Bangladesh
PSTC Investigators: Mark Pitt (S. Becker, PI)
Funding: NIH (Subcontract with Johns Hopkins University)
Other Research Areas: Families and Households, Population and Environment
Description: The project seeks to assess the relative impact of three program interventions targeted at poor women in Bangladesh on a variety of health and family planning attitudes and behaviors, including contraceptive use, health care utilization, prenatal care, and infant and child care. Micro-credit, health, and family planning programs will be experimentally introduced in three treatment areas, with a fourth group of villages serving as a control group, where existing government health and family planning programs will operate without the presence of micro-credit programs. Pre-intervention and post-intervention data will be collected from all four groups.Project Title: Love, Marriage, and HIV: A Multi-site Study of Gender and HIV Risk
PSTC Investigators: Daniel J. Smith (Jennifer Hirsch, PI)
Funding: NIH (Subcontract with Columbia Univ.)
Research Areas: Social Behavior and Health, African Demography
Description: Smith is one of five investigators from five universities in this comparative ethnographic study that explores the relationship between changing conceptions and practices of marriage, gender inequality, and HIV risk in five countries (Nigeria, Mexico, Vietnam, Uganda, and Papua New Guinea). Smith is responsible for the Nigeria research. This research explores the proposition that married women living in social contexts of persistent gender inequality and economic contexts of under- or unemployment and labor migration are placed uniquely at risk for HIV infection by the worldwide diffusion of an ideology of marriage as a relationship based on romantic love and companionship between equal partners. The project's specific aims are: 1) to compare, across five developing country sites, the relative penetration of ideas and practices associated with compassionate marriage and the specific forms of marital and extramarital relationships; 2) to understand and explain the ways in which these ideas about and practices of intimacy are shaped and constrained by gender-unequal structures and ideologies, local forms of economic organization, and cultural change; and 3) to evaluate the implications of these ideas and practices for HIV prevention within and outside of marriage. The project’s methodology promises to demonstrate value of a comparative ethnographic approach in which qualitative research is used not just to uncover data in one particular context in greater depth, but to enable cross-cultural comparisons based on ethnographic research.
Project Title: Household-Level Effects on HIV/AIDS Mortality
PSTC Investigators: Nicholas Townsend (Sangeetha Madhavan, PI)
Funding: NIH
Research Areas: Families and Households, Social Behavior and Health
Description: This proposal addresses the effects of HIV/AIDS-related morbidity and mortality on household structure, composition, power dynamics and children's living arrangements. HIV/AIDS has attained epidemic proportions in sub-Saharan Africa over the past 10 years with particularly high prevalence rates in southern Africa.Project Title: Potential Economic Benefits of Reductions in Fertility
PSTC Investigators: David Weil
Funding: MacArthur Foundation
Other Research Areas: Families and Households
Description: The goal of this research project is to analyze quantitatively the economic effects of interventions that reduce fertility in developing countries. Our analysis and results will speak to long-standing, yet still unresolved debates about the relation between demographic dynamics and the trajectory of economic development.