The rise in mortality is concentrated among young adults. In most countries, men have been affected worse so far, but in Uganda adult women's mortality has risen most. Data can be collected in household surveys and censuses to monitor the mortality impact of HIV in African populations. The available data begin to document the differential impact of the epidemic. In countries where HIV became prevalent by the late 1980s and for which data exist, massive rises in mortality occurred by the mid 1990s.
Support needs to be provided for the collection of further such data.
Using this result, we compare fertility rate ratios observed in cohort studies with indirectly calculated fertility rate ratios based on comparisons of cross-sectional HIV prevalence in pregnant women and the general female population in the same area. The plausibility of reported differentials is examined in the light of the statistically significant results obtained from case-control studies and the theoretical predictions from a model of the proximate determinants of fertility and HIV incidence. Estimates of population attributable change are made. Selection for early start of unprotected sexual activity explains the reverse pattern at young ages. Other factors being equal, HIV prevalence estimates based on ante-natal surveillance underestimate true prevalence in women in the childbearing ages.