Zar Zar’s husband was a womanizer. Throughout their five years of marriage he was a regular in the brothels around the city of Rangoon in Burma, drank heavily, was violent, and more than once gave her a sexually transmitted infection.

She tried telling his parents, but they had never approved of the marriage and sided with their son; to make matters worse, the couple lived under their roof. In the end, fed up, she packed her bags and left for neighbouring Thailand as a migrant worker, but did not get away scot-free.

Now aged 30, Zar Zar lives in a shelter for HIV-positive women from Burma in the Thai town of Mae Sot near the Burmese border. She is concerned that many more are at risk of infection because there is so little awareness about AIDS in her home country. “Women in Myanmar [Burma] don’t know anything about how to protect themselves,” she said.

HIV prevention campaigns inside military-ruled Burma are underfunded; across the border in Thailand, they struggle to reach, and make sure the estimated 1.5 million migrant workers from Burma understand the messages.

Public health professionals fret that even when women from Burma are taught how to prevent HIV infection, deeply conservative attitudes towards women’s sexuality prevent them from negotiating condom use with their partners.

“In Burma, every sex relationship is up to the man,” said Mie Mie, 30, a Burmese health educator working with migrant workers in Thailand. “So a woman keeps feeling that she cannot openly ask a partner, ’please use a condom’, or else he will look down on her.”

Brian Williams, the head of UNAIDS in Rangoon, says the difficulties women face in negotiating condom use, especially in a marriage or stable relationship, are not unique to Burma. But according to recent projections, up to 25 percent of people now living with AIDS in Burma are thought to be ’low-risk’ married women who most likely contracted the virus from their husbands.

Until a few years ago the authorities considered the mere possession of a condom sufficient evidence to convict the carrier of prostitution. Many women still feel that owning condoms, or insisting on their use by their husbands or partners, raises doubts about their own sexual morality.

“They think this [a condom] is very dirty—used by criminals or very sexually active people,” said Mie Mie. “So they think, ’this is not for us’.”

Traditionally a women’s chastity was carefully guarded until marriage. The mass migration to labour-hungry Thailand has undermined those social controls, handing young people from Burma far greater sexual freedom, but also reinforcing gender roles that tend to frustrate prevention strategies.

Who’s fooling whom?

Dr Ei Ei Khin, technical advisor to an HIV prevention project targeting Burmese workers in Thailand, notes that traditional attitudes deter most young, unmarried women from being upfront with boyfriends about their sexual histories, and from requesting condom use.

The result is that many young Burmese men, who may use condoms when visiting brothels, underestimate the risks of unprotected sex with their girlfriends, usually assuming—sometimes wrongly—that the young women, often factory workers, are virgins.

“The boys believe their girlfriends are innocent and have no previous experience,” Khin said. “Even if girls have experience before, they don’t tell, or try to hide it. The boys want virgins, and if they know the girls had sex before, they won’t marry, or may leave them. So if the girlfriend requests condom use, maybe the boyfriend will think ’oh, she knows too much’.”

Tha Zin, 30, a married factory worker trained as an informal AIDS peer counselor, says her efforts to encourage younger colleagues to use condoms have floundered due to the girls’ shame at admitting they were sexually active before marriage.

“Most of the girls have boyfriends, and mostly they have sex, but I never heard that they used a condom,” she said. “In three factories, after training, I gave condoms but the girls ran away. They are very shy and they are very ashamed.”