Prevention of Mother-to-Child Transmission of HIV and Reproductive Behavior in Zambia
Prevention of mother-to-child transmission of HIV (PMTCT) is the single most effective HIV prevention intervention in practice today. Nonetheless, little reliable empirical evidence exists on the behavioral effects of PMTCT. This paper documents the rapid expansion of access to PMTCT in Zambia during the period 2000-2007 and provides some of the first evidence on the change in reproductive behavior associated with PMTCT scale-up. The results of a primarily descriptive analysis suggest that PMTCT may have generated increases in knowledge about PMTCT and MTCT, large reductions in child mortality and pregnancy rates, and smaller changes in breastfeeding rates. However, additional research is required to address the potential endogeneity of PMTCT availability.
I would like to thank Quamrul Ashraf, William Dow, Lucie Schmidt, Lara Shore-Sheppard, Jeffrey Stringer, Anand Swamy, Waly Wane, Tara Watson, David Weil, seminar participants at the University of California, Berkeley, NBER Africa Project Zanzibar Conference, University of California, Santa Cruz, and Williams College, and an anonymous referee for many excellent comments. Special thanks to Elisa Pepe for tremendous support throughout this project. Madeleine Watson and Wentao Xiong provided superb research assistance. The NBER Africa Project provided generous financial and institutional support. This research would not be possible without the assistance of the Network of Zambian People Living with HIV/AIDS (NZP+). All errors are my own. The findings, interpretations, and conclusions expressed in this paper are those of the author and do not necessarily represent the views of the aforementioned individuals or the agencies that employ them.