Worldwide, marital sex is the leading cause of HIV infection in women, according to a new study by researchers at the Columbia University Mailman School of Public Health. The study, published in the June 2007 issue of the American Journal of Public Health, says that men’s “inevitable” infidelity across most cultures is now the single greatest HIV risk for women. Moreover, the authors warn that current monogamy and abstinence-based prevention programs are ineffective because infidelity is so deeply culturally-ingrained. Dr. Jennifer S. Hirsch, one of the study’s primary authors, said, “This study has direct implications for the types of prevention programs we should be supporting… It renders abstinence impossible and unilateral monogamy ineffective.”
The study drew from more than six months of anthropological research in rural Mexico, New Guinea, and Southeastern Nigeria, where high rates of labor migration and cultural norms of masculinity contributed to men’s infidelity. In Mexico, for instance, married men left home to seek work in the US or larger Mexican cities and often engaged in unsafe extramarital sex.
Studies conducted in Nigeria and New Guinea found that “looking for girls” — even among married men — is a socially ingrained phenomenon rooted in cultural anxieties about masculinity, and that it aggravates the existing risk of HIV transmission. “The result is that women are infected by their husbands…according to social convention…the only people with whom they are ever supposed to have sex,” writes Dr. Hirsch. Similar studies underway in Uganda and Vietnam are expected to produce comparable results.
The study suggests reframing HIV prevention dialogue within the context of these socially sanctioned behaviors: In cultures where men’s reputations are of the highest social importance, Hirsch recommends teaching men that it is their responsibility to protect their wives from infection.