President Bush's Africa plan doesn't acknowledge that often it's husbands who infect wives.

Religious groups are fixated on the need to stop HIV transmission through premarital and extramarital sex, but what's killing African women by the millions is http:///unprotected sex with their husbands. Yet the United States spends more on promoting abstinence and fidelity programs ($198 million in fiscal 2007) than on promoting condom use ($147 million in 2007). Roughly 10 million African girls under the age of 18 are married each year, many to older men who seek HIV-free brides. To those wedded to HIV-positive men, marriage often means a death sentence. They have little power to control their husbands' condom use or extramarital behavior; they are more likely than young men to contract HIV; and those who know they're infected and do not want to bear children often have no access to contraception.

By providing life-saving drugs to HIV-positive pregnant women, the president's program claims to have prevented 157,000 infants from becoming infected. This is a huge accomplishment. What the U.S. funding hasn't done is reduce unwanted pregnancies. In a clinic in Uganda where pregnant HIV-positive women were receiving anti-retroviral treatment, 93% reported that their pregnancies were unintended. It's no surprise that many HIV-positive women do not wish to bear children whom they might infect with the virus or leave orphaned. It's cruel to deny contraception to such poor and sick women should they desire it. And as a public health matter, it's far cheaper to prevent unwanted pregnancies than to prevent mother-child HIV transmission. Yet U.S. funding for family planning has flat-lined.