"the men are forced to confront the fact..." No they aren't, they simply never confront it. People go to their graves denying that they have HIV, denying that they ever tested positive, denying that a positive HIV test has anything to do with illness.

"Otherwise the men are setting themselves up for a lose:lose scenario regardless of what the wife does." - Of course.

I mean, the most rational win:win thing to do is to get an HIV test and get treated if positive. They then both don't get sick and die and can't pass along HIV. Many people don't do that either. What's the mindset that explains this behavior? You can't work backwards from the most rational thing to do to what people actually do.