Fertility and HIV Status: Sub-Saharan African Women in France

The aim of our study was to analyse the association between HIV status and fertility among migrant women who arrived in France from sub-Saharan Africa. We used data from the PARCOURS survey conducted by the French National Agency for Research on AIDS and Viral Hepatitis (ANRS, Agence Nationale de Recherche sur le Sida et les hépatites virales), based on a sample of 954 women who arrived in France during their reproductive years (aged 15 to 49). To assess the impact of demographic, socioeconomic, and health factors on fertility rates, a Poisson regression model was applied. The analysis showed that women who arrived in France before the age of 30 had a significantly lower fertility rate than those who arrived between 30 and 34. Additionally, HIV-negative migrant women had a significantly higher total fertility rate than HIV-positive women (4.09 children per woman versus 3.20). The period of arrival in France was also significantly associated with fertility rates. Women arriving aged 15–49 before 1996 had significantly lower fertility rates than those arriving between 2005 and 2013, reflecting the influence of French migration policies and socio-economic context. Fertility decisions are influenced by factors at both micro-levels (such as education and autonomy in decision-making) and macro-levels (including media influence and place of residence), highlighting the complexity of reproductive behaviour, especially within the migration context. Our study emphasises the associations between HIV status, age at arrival, abortion history, and other factors in understanding the determinants of fertility among sub-Saharan African migrant women. These findings provide valuable insights for the development of health policies and services tailored to the specific reproductive health needs of this population.