Soon after, Anna had to leave when her husband started getting violent and aggressively demanding that she consents to his pleas for unprotected sex.

“I had to leave for the sake of the children. I have seen how much children without parents suffer and I vowed that I would rather make it alone than put my children’s future at stake,” she says.

“Women who experience violence often have low self esteem. To validate themselves they are more likely to have multiple sexual partners. It allows them to think of a future for themselves,” Kithika says.

Sometimes, even when women discover their positive status, they would rather face re-infection than come clean to their spouses fearing abandonment or financial withdrawal.

“I know this woman at the clinic who takes ARV’s in secret because she says she would rather die than tell her husband. We have tried to counsel her but she is adamant that she would rather put herself at risk than risk the man not paying the bills,” Donata says.

Closely linked to violence is the fact that in many cases, since sex is regarded as a taboo, rarely do women get adequately prepared in the bedroom. This means that they are rarely in the right mood to enjoy consensual sex.

“For a lot of women, sex is a duty. It’s what you give your husband in exchange for financial favours or affection. I don’t ever remember when I was psychologically prepared to get ready for the act. Often he came home late and he asked to get his dues. And since I had never really known another man before I married my husband I didn’t know how to go about the whole thing,” confesses Kate.

Evidence shows that it is easier for a woman to contract HIV from a man than vice versa, due to a greater surface area of the vagina that comes into contact with semen, while lack of lubrication during encounters increases tears and abrasions that are an automatic inlet for the virus.

“The truth is, if every unsafe encounter with a positive person meant infection, we would have alarming infection rates. Abrasions during sex is one of the reason women and uncircumcised men are more likely to contract the virus,” observes Dr Njiru.

Sexologist and marriage counsellor Roseline Achar says that if couples talked more about their sexual expectations and worked on pleasing each other, women would be less susceptible to the HIV virus.

“It’s about understanding how each gender operates. For a woman, sex is about emotional connection with her spouse, while for men, sex is mostly physical. What happens is that if a woman doesn’t feel emotionally taken care of by her man, she is not going to warm up in the bedroom,” advises Achar.

But many more experts call for complex solutions for many women who face complex encounters with HIV.

“It calls for a multi-faceted approach. While the ABC’s can work at some individual’s levels, there is need for communities to play a part in HIV prevention, including destigmatisation of the virus and support for those infected. Plus, the health care system and legal framework need to aid those who are at risk of contracting HIV, or infecting others,” says Carol of COVAW. That, and empowering women not only economically but emotionally, notes Dr Njiru, will aid the already prevention measures.