Encouraging monogamy is an ineffective way to combat the spread of HIV, since people will have extramarital sex and put themselves at risk even if they are warned against doing so, public health anthropologist Jennifer Hirsch '88 said in a lecture yesterday in Wallace Hall.
"Unilateral monogamy is about as successful as unilateral disarmament," she said.
Sponsored by the Wilson School's Princeton AIDS Initiative, Hirsch's lecture drew upon her research regarding intimacy and fidelity, which she uses to lobby for public health policy changes to fight the transmission of HIV.
"You cannot prevent heterosexual transmission [of HIV] by telling men not to have sex," she said yesterday. "It is a waste of our tax dollars."
Hirsch, an associate professor of sociomedical sciences at the Mailman School of Public Health at Columbia, argued for a "harm-reduction approach" to preventing the transmission of HIV. She said such an approach is superior to imposing a "crazy morality about extramarital sex" and encouraging universal monogamy.
To develop an anthropological approach toward fighting HIV cases spread by extramarital sex, Hirsch spent time in Puebla, Mexico, observing locals' attitudes toward sex and relationships.
There, she studied gender inequality changes across generations, noting changes in Mexican magazines, advertisements and websites. Her work focuses on how gender and sexuality shape sexual and reproductive health practices.
Conceptions of fidelity differ culturally, she claimed. "For men in rural Mexico," she said, "it doesn't count as infidelity if they don't love the woman [with whom they are having extramarital sex]." She also drew a distinction between socially safe sex — "sex that doesn't jeopardize men's obligations to their families" — and physically safe sex.
"What goes in what hole, and what they think it means," she said, "is historically and socially variable."
Hirsch said her studies were central to learning how to prevent HIV transmission between spouses. "For women in rural Mexico, the biggest risk of contracting HIV comes from having sex with their husbands," she said.
Additionally, Hirsch discussed the Mexican conception of love and said that women in love with their husbands are more susceptible to HIV. This phenomenon occurs because such women ignore evidence of their husbands' infidelity, employing the principle of "what you don't know won't hurt you," she said.
"Women and men collude in this illusion of fidelity," she added.
Hirsch is part of a larger project funded by the National Institutes of Health, titled "Love, Marriage and HIV: A Multisite Ethnographic Study of Gender and HIV Risk." The initiative also includes field research by anthropologists and ethnographers in four other countries — Nigeria, Uganda, Papua New Guinea and Vietnam.
Hirsch hopes the project's research will contribute to preventing HIV transmission and is optimistic that her research will be incorporated into the formulation of public policy.
"It's really a historical first for global health policy to respond to a social mobilization," she said.
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