The same Journal that brought you Teens and Condoms also carried a paper from the Columbia University of Public Health titled The Inevitability of Infidelity: Sexual Reputation, Social Geographies, and Marital HIV Risk in Rural Mexico. This article shows that the Bush doctrine of abstinence only HIV programs has wasted a billion dollars in our tax money on a quixotic moral quest.
The article also has data from Nigeria and New Guinea. The abstract in part:
Marriage presents the single greatest risk for HIV infection among women in rural Mexico. We found that culturally constructed notions of reputation in this community lead to sexual behavior designed to minimize men’s social risk (ones that endanger one’s social status), rather than viral risks and that men’s desire for companionate intimacy may actually increase women’s risk for HIV infection. We propose that, because of the structural nature of men’s extramarital sexual behavior, intervention development should concentrate on sexual geographies (i.e. the social spaces that shape sexual behavior) and risky spaces rather than risky behaviors or identities.
Most of the men became infected when they left their family to travel to the US for work. Long periods away from home led to extra-marital and often unsafe sex. Returning home brought a "new honeymoon" and the wife may become infected. In Nigeria and New Guinea it is usually the men living away from home for economic reasons and becoming infected that makes marital sex so dangerous for wives. But the point is made that the male behavior is so much a part of each culture that the abstinence only programs are not only a waste of money but are positively deadly for both husband and wife.
The sooner that the puritanical idiots are kicked out of the US sponsored international health programs the sooner realistic programs can start preventing HIV infection and saving saving lives.