From HBO’s hit series Big Love to the police raid on the Yearning for Zion Mormon ranch in Texas, polygamy has proved a titillating ratings draw recently. The practice—having multiple spouses—would seem to encourage the transmission of such sexually transmitted diseases as HIV.

Researchers have yet to find evidence supporting such a link in the United States. But studies show that polygamy has boosted HIV infection rates in India and developing countries in sub-Saharan Africa.

“Polygamy has a [significant] influence on the high level of infections among couples,” says Feliciano dos Santos, an activist who works for Estamos, a Mozambique organization. One of its goals is to promote monogamy—a challenge, because polygamy is often based on economic survival. The more wives a man has, the more wealth he accumulates—not only from the women’s dowries but from the work of all of the children he has with them.

But dos Santos is optimistic. “In the 10 years that I have been doing this work. I can say that although people still practice polygamy, many things are changing,” he says. “There are more open discussions about sex and condom use.”