Fertility Trend and Pattern in a Rural Area of South Africa in the Context of HIV/AIDS

Carol S. Camlin, University of Michigan
Michel Garenne, Institut de Recherche pour le Développement (IRD)
Tom A. Moultrie, University of Cape Town

This study presents trends and patterns of fertility observed in a rural South African population of 21,847 women under demographic surveillance, compared with patterns seen in another rural South African population and 1998 South Africa DHS data. Findings are interpreted in light of contraceptive use patterns and HIV prevalence estimates. In South Africa, the end of the fertility transition is in sight. In rural KZN, where national fertility levels are highest, fertility declined rapidly for about two decades and reached below-replacement level in 2003. While fertility declined rapidly among adults, fertility levels among adolescents have not changed in decades. High HIV seroprevalence appears to explain a small part of the fertility decline (12%); however, this effect is likely to grow in the near future as the HIV/AIDS epidemic continues. Should current trends continue, below replacement fertility, together with high AIDS-related mortality, could soon lead to negative natural population growth in rural South Africa.