Because sub-Saharan African society is characterized by extended families, the horrendous effects of the HIV/AIDS pandemic are felt at individual, household, community, and national levels. The pandemic has been spreading rapidly in rural and urban areas, reversing previous achievements in reducing mortality and increasing life expectancy since the 1950s. It appears to strike at the most productive and reproductive segments of the population. But underlying socio-economic and cultural environments appear to favour the perpetuation of high fertility. This implies that the reproductive power of the African population will remain superior to the effects of HIV/AIDS during the foreseeable future, except in certain hard-hit small sub-national areas of some countries. National survival campaigns against HIV/AIDS are needed to sensitize and raise individual awareness and behavioural change, to improve institutional capacities, to undertake continuing analysis of demographic, socio-economic and epidemiological processes. Research on fertility in particular should question prior assumptions and consider antecedent variables other than HIV/AlDS.
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