Many young women dream about walking down the aisle at their wedding—they imagine the floral arrangements, the dress, the venue. Their visions may extend to include the honeymoon, children and retirement with their husband. But the dreams don’t typically include contracting HIV from their beloved. Unfortunately this is the reality for a growing number of women around the world. The spread of HIV in marriages is often driven by infidelity, but it can also result from people who are unaware of or who conceal their status before tying the knot.

In China, according to a report based on a 2011 study conducted in six mainland cities, at least 25 percent of the 48,000 newly diagnosed HIV cases resulted from heterosexual sex transmitted between spouses. The report, which was issued by the National Center for AIDS/STD Prevention and Control in conjunction with U.N. Women and UNAIDS, also found that women account for nearly 30 percent of the 740,00 people living with HIV, and that 62 percent of them were married when they were diagnosed positive. Similarly, in Argentina, University of Buenos Aires researchers found that 73 percent of women who contracted HIV through unprotected sex were infected by their allegedly monogamous partners.

In both countries, women who contracted HIV while betrothed said they felt less power than their male counterparts when it came to navigating their sexual relationships. Many reported histories of violence. Disempowerment and low self-esteem in the aftermath of abuse make women less able to negotiate condom use, which heightens their risk for contracting HIV. Also, lack of disclosure laws in these nations means that HIV-positive people don’t have to divulge their status to their spouses.

Clearly, women need protection from HIV in marriage. An option on the horizon is a vaginal microbicide, a topical gel containing HIV medication that a woman can apply without having to ask her partner to wear a condom, which can be construed as an admission of infidelity. Here’s to HIV having no place in “till death do us part.”