Malawi is a religious country. Open homosexuality is still a cultural taboo. Intravenous drug misuse is virtually unknown. Families go to church, listen to sermons, believe in God, chastity, the 10 Commandments, and then the men go to bars at the weekend and sleep with prostitutes. Sex is cheap.
Prostitution is casual, semi-open, and culturally acceptable.
After the weekend, the men go back and have unprotected sex with their wives. The virus spreads. Changing private sexual behavior is incredibly difficult. I asked Dr Bonongwe, the district hospital's sole physician if, in the midst of all this death, he was confident that Malawians would change and practise safer sex. There is no prospect that people will change their behavior.