Perception of HIV risk and the quantity and quality of children: the case of rural Malawi

The empirical literature on the impact of HIV on the quality (Q) and quantity (N) of children provides limited and somewhat mixed evidence. This study introduces individual HIV risk perceptions, as a predictor of mortality, into a Q–N investment model. In this model, higher maternal mortality predicts lower N, while higher child mortality predicts lower Q. Thus, the two effects together make likely negative associations between HIV and both Q and N. Based on longitudinal micro-data on mothers and their children in rural Malawi, our results suggest that higher mothers’ reported HIV risk reduces both child quality, as reflected in children’s schooling and health, and child quantity, when the perceived risk is already moderate or high. The effects are sizable and, in the case of Q (schooling and health), are found for children and teenagers, both boys and girls, while in the case of N, they are found for young and mature women.