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Happily Ever After? A Cross-Cultural Exploration of Love, Inequality, and Risk

For many women around the world, their greatest risk of HIV infection comes from having sex with their husbands. The Secret: Love, Marriage, and HIV, a new book co-authored by Jennifer Hirsch, PhD, associate professor of Sociomedical Sciences, draws on fieldwork in Mexico, Nigeria, Papua New Guinea, Vietnam and Uganda to examine this seeming contradiction and provide a nuanced analysis of marital and extramarital sexuality.

Dr. Hirsch and her coauthors, including Constance A. Nathanson, PhD, professor of clinical Sociomedical Sciences, illustrate how an increasingly widespread ideal of monogamous companionate marriage is honored mostly in the breech.

Careful ethnographic study demonstrates how social, cultural, and economic factors intertwine to facilitate extramarital sex and produce marital HIV risk.

With a Little Help from Society
It seemed at times almost a secret that entire communities were trying to keep from themselves, insisting on the ideal of marital fidelity even though the conditions that promote infidelity were so clearly woven into the fabric of everyday life.                               
-  The Secret: Love, Marriage, and HIV

The notion that extramarital sex is something men do because their bodies demand it and women can’t stop them is upended by this book.  In each of the societies examined, extramarital sex, while officially a secret, is actually a widespread (and widely acknowledged) social practice.

Drawing on rich data from marital case studies, the authors show extramarital sex to be a fundamental aspect of gendered social organization.

Each of the case studies, as well as the syntheses with which the book opens and concludes, traces out specific ways in which extramarital opportunity structures, sexual geographies, and concerns about social risk facilitate men’s participation in extramarital sex. 

What Every Girl (and Policymaker) Should Know
At heart, the book sheds light on the potential negative consequences of public health prevention policies that imply that marital sex is safe(r) sex.

This exploration of how cultural, social and economic factors shape intimate – and usually hidden – aspects of everyday life around the world  is timely in its relevance to global HIV prevention policies.  From a programmatic viewpoint, the authors’ findings suggest that the “B” (be faithful) in ABC programs will not be achievable via exhortations to fidelity, given the many social, cultural, and economic factors that facilitate men’s access to extramarital sex.

With its insightful look at marital relations, The Secret is an excellent addition to the reading lists of scholars of gender, sexuality, kinship, or the anthropology of public health, as well as for policymakers and public health practitioners.

The Secret: Love, Marriage, and HIV
Jennifer S. Hirsch, Holly Wardlow, Daniel Jordan Smith, Harriet M. Phinney, Shanti Parikh and Constance A. Nathanson