Contrary to what some may think, marriage poses significant risk of HIV infection for women in many parts of the world. In fact, more than eighty percent of new HIV infections in women occur in marriage or in long-term relationships. Despite global recognition of the unique vulnerabilities of women and girls to HIV infection, U.S. HIV prevention policy continues to emphasize abstinence education ahead of tools, like condom use, that would better safe-guard women’s health. Tragically, it also has all but abandoned its 40 year leadership of support for international family planning. The vast amount of funding for HIV/AIDS prevention are rarely, if ever, integrated with family planning and reproductive health programs that provide desperately needed services to women and their families.