Demographic impact of AIDS in a low-fertility urban African setting: projection for Addis Ababa, Ethiopia
Mekonnen, Y.; Jegou, R.; Coutinho, R.A.; Nokes, J.; Fontanet, A.
Journal of Health Population and Nutrition 20(2): 120-129
2002
ISSN/ISBN: 1606-0997 PMID: 12186192 DOI: 10.2307/23498933Document Number: 243668
The potential demographic impact of acquired immune deficiency syndrome (AIDS) in a low-fertility urban setting in sub-Saharan Africa was estimated. The prevalence of human immunodeficiency virus (HIV) infection projected using a deterministic mathematical model was put into the AIDS Impact Model (AIM) of the SPECTRUM Policy Modelling System to estimate the potential demographic impact of AIDS in Addis Ababa, Ethiopia. Demographic indicators from 1984 (the start of the HIV epidemic in Ethiopia) to 2024, including and excluding the HIV epidemic, were compared. Addis Ababa is experiencing a demographic transition in which the total fertility rate has declined from 3.8 to below replacement level over the last 20 years. The prevalence of HIV is predicted to stabilize at 10% in adults, resulting in a total number of people living with HIV at 200 000 and a cumulative number of deaths due to AIDS at 50 000. About 60% of adult deaths can be attributable to AIDS by 2000. The epidemic is predicted to reduce life expectancy by 10 and 17 years in 2000 and 2024, respectively, and to turn to negative the rate of natural increase after 2009. Accordingly, the rate of natural increase will be -0.18%, -0.35%, and -0.71% per annum by 2009, 2014 and 2024, respectively. Population growth is expected to continue with or without HIV, as a result of high net in-migration, although data for migration are scanty. In a low-fertility urban society of Africa, this study shows the potential for the HIV/AIDS epidemic to turn the rate of natural increase to negative.