Imagine you're a woman living in a country where your husband can physically and sexually abuse you without fear of punishment. Now imagine trying to convince your husband to use condoms to protect you from HIV infection.

This predicament faced by women in India and South Africa is one of the many cultural challenges that UCLA AIDS Institute faculty encounter when collaborating with other countries on national programs to prevent the spread of HIV infection.

But it's a challenge they readily accept.

"We're in it for the long haul," said John Fahey, the institute's director of international activities. "That means the entire research team works within the country's language, cultural norms and political system to create positive change from the inside out."

In New Delhi, India, a physician educates train porters on the prevention of HIV and sexually transmitted diseases (STDs).

To do that, 26 of the AIDS institute's 140 scientists travel the globe to work with colleagues at government and academic institutions. UCLA teams train researchers and introduce AIDS research and vaccine trials in 27 developing countries.

-- In China, behavioral scientist Mary Jane Rotheram-Borus trains migrant workers to deliver HIV-prevention messages to their peers in outdoor markets. She also studies how homeless youth in the United States and Australia -- often at high risk for HIV when they trade sex for drugs -- access health and social services.

-- In the Philippines, public-health expert Donald Morisky developed HIV-intervention programs for female bar workers and a peer-counseling program for their male clients. He also has worked to reduce HIV risk among teenagers in Belize.

-- In four Brazilian cities, pediatricians Yvonne Bryson and Karin Nielsen launched studies to reduce mother-to-infant HIV transmission and prevent sexual transmission of the disease.

-- Epidemiologist Roger Detels, behavioral scientist Gail Wyatt and psychologist Dorothy Chin will be instructing researchers in China and Vietnam on medical ethics and human subjects protection. The two Communist countries must demonstrate the practice of informed patient consent in order to obtain research grants from U.S. agencies.

-- In India, Fahey, Detels and clinician Ronald Mitsuyasu recently helped train 110 government and medical leaders on clinical trial design and conduct.

On the streets of Bombay, a youth peddles condoms along with betel nuts. As an incentive, he receives a portion of the sale of every condom he sells from the local STD clinic.

Angolan soldiers, homeless teens in Uganda and HIV-positive women in Rio de Janeiro are just some of the other groups whom UCLA researchers and clinicians are preparing to help as they team up with international partners against AIDS.

While UCLA researchers funded by the National Institutes of Health travel the world to work on international projects, the UCLA/Fogarty AIDS International Training and Research Program has brought more than 120 public health professionals from Southeast Asia, China, India, Brazil and Hungary to UCLA.

Fogarty graduates then return home to implement their new expertise -- often heading up AIDS-control programs, leading research or becoming co-investigators on projects with UCLA.

"I can't convey how exciting it is to help Asia's best and brightest become positive public-health forces in their own countries," said Detels, who created the Fogarty program in 1988.

So important is global outreach to the UCLA AIDS Institute that scientists here secure about $4 million per year in direct grants from the National Institutes of Health and other agencies for AIDS-related research overseas. The institute allocates roughly $300,000 per year in unrestricted funding to faculty conducting international research.

To battle HIV internationally, UCLA researchers often have to devise creative solutions to social dilemmas that are seamlessly woven into the country's cultural and economic fabric.

In the late 1980s, for example, Chinese health officials grew alarmed by a rise in injection drug use and subsequent HIV infection among young men in the Golden Triangle -- a region notorious for its drug trade. Detels worked with UCLA colleague Virginia Li and Fogarty graduate Zunyou Wu to create a drug-intervention project with local village leaders.

"Unlike in the United States, Asian drug users remain part of their family and their community," said Detels. "That sparked the idea of using the village as part of our drug-prevention program."

Village leaders organized youths into teams to tackle community-improvement projects to build their self-esteem. They also provided informal hangouts where youngsters could socialize without pressure to use drugs.

In the Phillipines, pedicab drivers serve two purposes. They provide transportation and peer counseling on HIV and STD prevention as they convey passengers to the country's commercial sex bars.

Working in India and South Africa, Wyatt discovered that improving the plight of HIV-infected women first meant educating their husbands, who frequently leave their families for years in order to make a living abroad. The men often support two families and enjoy multiple sexual partners, including prostitutes. Yet if a man infects his wife with HIV, society blames her.

"Indian and South African women share no power in their marriage's sexual decisions," said Wyatt. "They have no right to speak about condoms or their husband's extramarital affairs. So the 'safe sex' messages we use in the States are inappropriate in these cultures. We must imbed them in the context of family health."

The exchange benefits both sides, UCLA faculty point out. They learn valuable lessons on how to craft culturally sensitive messages on AIDS prevention to reach immigrant communities in the United States.

Withholding judgment on how some countries treat women and persons with HIV is essential, Wyatt said.

"There's always a reason that people do what they do," said Wyatt. "If I judged them, I'd never understand their decision-making process. I'd only be studying myself."

To learn more about the UCLA AIDS Institute, see www.uclaaidsinstitute.org.