A recent study has found that a hubby’s extramarital sex life is the single greatest HIV risk for women around the world.

The study, conducted by Columbia University’s Mailman School of Public Health, demonstrated that marital disloyalty by men is so intensely deep-seated across many cultures, that existing HIV prevention programs are putting an increasing number of women at risk of developing the HIV virus.

The findings, signifying that worldwide prevention programs that undertake a "just say no" approach and persuade men to be monogamous are not likely to be of use, highlight the need for programs that make extramarital sex safer, rather than idealistically trying to exterminate it.

These findings are published in the June 2007 issue of the American Journal of Public Health.

The article’s lead author, Jennifer S. Hirsch, PhD, associate professor of Sociomedical Sciences at Columbia University Mailman School of Public Health, is the foremost researcher on a large comparative study showing that the certainty of men’s infidelity in marriage is true across cultures.

This was confirmed in the research conducted in rural Mexico as well as in similar studies she is supervising in rural New Guinea and southeastern Nigeria. Two additional studies in progress, in Uganda and Vietnam, are expected to show similar results.

The Mexico study was based on six months of anthropological research, including participant inspection, 20 marital case studies, 37 key informant interviews, and document analysis to investigate the factors that outline HIV risk among married women in Degollado, one of the Mexico’s rural communities.

In rural Mexico, status is a vital facet of sexual identity, and attention to reputation provides insight into why people act in ways that are communally safer, but physically risky.

"What we found in our research was that culturally constructed notions of reputation in this community led to sexual behaviour designed to minimize men’s social, rather than viral, risks," said Dr. Hirsch. "We also saw that men’s desire for companionate intimacy actually increases women’s risk for HIV infection."

A major aspect in the study was that married men in the community left their homes to travel to the United States or large Mexican cities for jobs. While away for long periods, they engaged in extra-marital and unsafe sex, which can lead to HIV infection. When men return home, they infect their wives with the deadly virus during sexual intercourse.

"The result is that women are infected by their husbands, the very people with whom they are supposed to be having sex and, according to social conventions of Mexico, the only people with whom they are ever supposed to have sex," said Dr. Hirsch. "This challenges existing approaches to HIV prevention. It renders abstinence impossible and unilateral monogamy ineffective. Marital condom use is also not a serious option, because of women’s deep, culturally supported commitment to the fiction of fidelity."

In New Guinea, researchers also saw labour relocation as a major contributor to infidelity. In addition, many men did not view sexual fidelity as an essential factor for achieving a happy marriage, but they viewed drinking and "looking for women" as central for male friendships.

In the Nigerian study, the social organization of infidelity was shaped by economic inequality, aspirations for modern lifestyles, gender disparities, and contradictory moralities. There, it is men’s apprehensions and ambivalence about masculinity, sexual morality, and social status in the context of seeking modern lifestyles, rather than immoral sexual behaviour and traditional culture that worsen the risks of HIV/AIDS.

"This study has direct implications for the types of prevention programs we should be supporting. We might find men’s persistent and widespread participation extramarital sex to be troubling – but it’s a deeply rooted aspect of social organization, and one that is unlikely to be easily changed. Public health programs alone can’t stop extramarital sex, so we need to think about how to reduce the risk. Saying that ‘be faithful’ will protect married women is not true – unilateral monogamy is not an effective prevention strategy," Dr. Hirsch said.

Via Times of India