Men's sexual and intimate relationships with women vary tremendously within and between countries. Some men and women live their lives in respectful and mutually faithful relationships. Other men have a regular woman partner and also engage in occasional sex with other women -- or men. In some parts of the world, formal or informal polygamy -- in which a man has more than one wife or regular woman partner -- is common.
In many cultures, women are expected, and sometimes forced, to be sexually faithful to a husband or male partner while he is permitted or even encouraged to also have sex with other women. This means men are more likely than women to have extramarital sex partners, which increases their own and their partners' risk of contracting HIV. In one study from Rwanda, 45% of women contracted the virus from their husbands.
Two factors greatly compound the risk to wives and long-term women partners. One is the secrecy surrounding male infidelity. Most men do not talk openly about their outside encounters to their wife or partner, and may react with anger or even violence if questioned about them or asked to use condoms. Risk is also increased by the stigma and shame that surround AIDS. Both factors stifle discussion within couples about preventing transmission of HIV.
Discussions with groups of men in Thailand have shown that even where men are expected to have many partners, many are reluctant to acknowledge that they contracted the virus outside their marriage or primary relationship -- which makes them unwilling to protect their wives through condom use. A recent UNAIDS study in India showed that husbands who acquired HIV were not blamed in the same way as women were. It was somehow expected that 'as men' they would seek sex outside of marriage (although paradoxically wives were often blamed). There is a clear double standard in the way in which families and the community responded to women and men with HIV.
Given existing economic and gender inequalities, as well as dominant cultural expectations, women who seek occasional or regular non-committed sexual relationships with men may also find it difficult to obtain protection. Research from all over the world shows that men are more able than women to influence how sex takes place. Women who seek sex on their own terms may thereby find themselves seriously disempowered when it comes to prevention. All this must change if women and men are to achieve greater equality in their sexual relationships, and if both are to be able to contribute to HIV prevention and care.
This article was provided by UNAIDS. It is a part of the publication Men and AIDS -- A Gendered Approach, 2000 World AIDS Campaign. Visit UNAIDS' website to find out more about their activities, publications and services.