24 International Family Planning Perspectives Condom

use by married or cohabiting couples in popula-tions with high rates of HIV infection has become a signif-icant public health issue. The HIV pandemic has prompt-ed massive efforts to promote condom use, but these efforts have targeted high-risk behaviors and focused on premar-ital and extramarital sexual relationships. A fair degree of success in increasing condom use in these circumstances has been achieved.1 By comparison, the needs of married and cohabiting couples have been neglected despite the fact that, in generalized HIV epidemics, many infections occur within marital and cohabiting unions because of ei-ther prior infection by one partner or infidelity.2 Research in diverse settings has shown that condoms are often regarded as more appropriate for nonmarital than marital relationships.3 In countries with generalized HI