Advocates say that gender inequality and a “culture of silence” around the issue of sex and sexuality have contributed to more than 1.5 million women in Asia contracting HIV and continue to put 50 million more at risk of infection, reports Agence France-Presse.

According to a UNAIDS report titled “HIV Transmission in Intimate Partner Relationships in Asia,” married women and those in long-term relationships with men were once perceived as having a low risk of contracting the virus, However, women are increasingly at risk because of male partners who have sex with other men, inject drugs or are the clients of sex workers. While women accounted for 17 percent of adult HIV infections in 1990, that number has risen to 35 percent in 2008.

“[It’s] a problem of great magnitude that the countries have largely ignored [and] a challenge that we may no longer ignore,” said Prasada Rao, UNAIDS regional director.

UNAIDS is calling for the removal of punitive laws that prevent intravenous drug users from accessing clean injecting equipment; the group also recommends increased prevention efforts among men who have sex with men (MSM) and interventions with sex workers and their clients.