Nicholas Kristof has an excellent column today on the disturbing role that marriage has come to play in southern Africa's AIDS epidemic.

One key passage:

President Bush is focusing his program against AIDS in Africa on sexual abstinence and marital fidelity, relegating condoms to a distant third...

The stark reality is that what kills young women here is often not promiscuity, but marriage. Indeed, just about the deadliest thing a woman in southern Africa can do is get married.

Take Kero Sibanda, a woman I met in a village in Zimbabwe. Mrs. Sibanda is an educated woman and lovely English-speaker who married a man who could find a job only in another city. She suspected that he had a girlfriend there, but he would return to the village every couple of months to visit her.

"I asked him to use a condom," she said, "but he refused. There was nothing I could do."

Four years ago I spent a few days in the Livingston/Vic Falls border region where Kero Sibanda lives, and unfortunately I can testify to just how common her story is. While there I had conversations with several articulate young women who -- even though they were still adolescents -- already seemed to have given up on life. All listed the same reason for their resignation: the cultural obligations of marriage. Though it remained unspoken, it was no secret that the main obligation in question was the sexual subservience that marriage entailed.

Where America is concerned, the shame of this situation is that its policy is exacerbating the problem rather than alleviating it. For instance, when I was in Zimbabwe, Bush had only just signed into law the bill that barred federal funding from any foreign medical clinics which offered abortion counseling. Alas, what everyone feared then has now, it seems, come true: that bill has served more to intensify the AIDS crisis than reduce abortions. In emphasizing marriage and fidelity so heavily, our remaining medical clinics have simply lent tacit approval to disastrous social norms.

As a result, if I could give one piece of advice to President Bush, it would be this: "even though abstinence remains the one foolproof countermeasure to AIDS, sometimes you need to go with what works rather than what's ideal."

Bush clearly recognizes the wisdom of that latter part when it comes to foreign policy; if would be nice if he did so when it came to foreign aid, too.