Abstinence and faithfulness are often promoted as the only and best forms of protection against HIV infection. If the theory is true, in the real world abstinence and faithfulness have shown an impressive rate of failure. In a couple it takes two for it to work, and when single it takes an extremely powerfull mind to resist the call of nature, particularly under 30 (or more for some).

In a study published in Plos One, Keren Landman and colleagues examined the association between the number of sexual partners and HIV infection amongst men and women in a community in Northern Tanzania to determine the “protective” effect of monogamy.

Of the 6,104 participants in their study, they found that 25% of the women were seropositive whereas 10% of the men were infected with HIV. The difference is a reflection of the inherent higher risk for women to be infected by HIV than men. Their second observation was that the higher the number of sexual partners, the higher the risk to be infected. Again, this is a reflection of engaging in an activity where there is a risk of getting infected by HIV.

Interestingly, if not completely unexpected, Landman observed that “having a partner who had other sexual partners or not knowing whether the partner had other partners was associated with seropositivity among monogamous females but was not associated with monogamous men.”

Therefore, being a monogamous woman does not protect against HIV if your partners “muck around” with other chicks (or chicken for what matters). The researchers did not really came up to term with this and say this as bluntly only noting that: “we found significantly higher rates of HIV infection among women reporting certain or possibly polygynous partners.”

Strikingly, this association was not observed with men for whom poligyny was not associated with increased infection rates. Men with 5 or more sexual partners have a lower rate of HIV infection than monogamous women (figure above).

The researchers concluded that “efforts to promote abstinence, to reduce the number of sexual partners, and to promote mutual monogamy should be coupled with methods which empower women to better control their exposure risk” and recommended “increased efforts to educate and empower women with respect to condom use” amongst other relevant strategies.

This is a rather surprising, but conventional, recommendation when it is clear that it is the men who drives the epidemic, not the women. Shouldn’t the increased efforts be invested in educating men and empowering them to use condoms?

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