She refused, afraid that he would only cripple her. It was 2002, and Ou Chanta, 33, recalls that before that day she joked with her husband, saying "I think you have AIDS", after he began falling ill with diarrhea and headaches.

Two years later he died and she was failing, one of a startling large number of married Cambodian women infected with the virus by their husbands.

"The infection of monogamous married women is one of the real tragedies of the epidemic here," says Matthew Warner-Smith, acting country coordinator for

"The real injustice is women cannot do anything about it. The power dynamics are so heavily tilted in the favor of men. (Married women) are a very difficult group to reach," he says.

Cambodia continues to have the highest prevalence of HIV/AIDS in Asia, with 1.9 percent, or approximately 123,000 people, infected.

While health officials have beaten back the epidemic in its most obvious places, among sex workers and their clients, it has exploded in Cambodian families, passed along from cheating husbands to their wives.

The highest number of new HIV infections -- about 40 percent -- occur in married women, according to United Nations and government statistics.

An estimated 96 percent of the 57,500 Cambodian women with HIV are likely married and not engaged in sex work, according to statistics compiled at the end of 2003.

Prevention and treatment should be easy enough; to some extent Cambodia has dealt successfully with the virus for more than a decade, with workshops, better healthcare and safe sex media blitzes halting a spiraling infection rate in the impoverished country's sex industry.

But health workers, and the women themselves, say they are struggling to check the epidemic's spread among wives who are largely closed off to them by the taboos and prejudices of a male-dominated society.

Negotiating something as basic as condom use, a key factor in reining in the epidemic amongst sex workers, is nearly impossible for most married women, who have little power over their husband's actions -- even behaviour they know could be deadly to them as well.

"There is the whole association of condoms with sex workers. If either the husband or wife requests to use a condom, it would either interpreted as a sign of infidelity or disease," says Ingrid Fitzgerald, a consultant with the UN Development Fund for Women (UNIFEM).

As few as one percent of married Cambodian couple use condoms, according to a study by UNIFEM and the Ministry of Women's Affairs.

Many women "do not understand that they get infected from their husbands, or they do not have any power to ask their husbands to use a condom," says Pheng Pharozin of the Positive Women Sector, part of the Cambodian People Living with HIV/AIDS Network.

Housewife Soeung Samnang says she never spoke with her husband about preventing the disease.

"I didn't dare talk to my husband about condoms because I felt embarrassed ... I knew nothing about AIDS," says the 29 year-old.

Eventually she plucked up courage to ask her husband to take a test, but he repeatedly refused.

It was only when their six month-old daughter fell deathly ill and both she and Soeung Samnang were diagnosed with HIV that he acknowledged he might also be infected.

"I begged him many times. He denied he had AIDS. After his daughter started getting more and more sick he finally agreed ... the three of us had another test and a week later the results came back positive," she says.

But still, it was only moments before he died in 1999 that Soeung Samnang's husband admitted to sleeping around. Their daughter, who was infected through her, died in 2002.

"Some women trust their husbands too much," Soeung Samnang says.

Ou Chanta says her husband also refused to be tested for HIV/AIDS after he became sick. In the end she had to trick him into having blood drawn, telling him he was only being tested for malaria.

"My husband always denied he had AIDS, that's why I had to lie to him," the housewife says. She has been taking antiretrovirals to prevent her HIV developing into AIDS since coming to the capital Phnom Penh earlier this year.

She supports herself working alongside Soeung Samnang, stitching together purses and handbags.

Deceit, or denial is not uncommon in a culture where women risk physical violence for challenging their husbands.

"It's very difficult to tackle masculinity, but with an issue such as this it's something we have to do," UNIFEM's Fitzgerald says.

"I don't know if we know enough about how to do that effectively in the Cambodian context."

But Warner-Smith of UNAIDS says that despite the alarming spike in HIV among wives, Cambodia is not likely to see the devastation wrought by the disease in parts of Africa.

"There's not the same sexual networking," he says.

Beyond the husband "it is only one life and one or two children ... if that is translated into numbers you're not going to see a huge dent in the population.

"But even if you're only talking about two percent of the population, that's one person in 50 -- at least one or two people in each village, one child in each classroom ... it's still absolutely a tragedy," Warner-Smith says.