Pope, Condoms and AIDS

THIS CATHOLIC’S VIEW By Thomas J. Reese Even before he got off the plane in Africa, Pope Benedict XVI caused … Continued

THIS CATHOLIC’S VIEW

By Thomas J. Reese

Even before he got off the plane in Africa, Pope Benedict XVI caused controversy by his comments on condoms. “One cannot overcome the problem with the distribution of condoms,” he told reporters on the plane. “On the contrary, they increase the problem.”

The pope was not caught off guard by this question since the reporters submitted questions in advance and he chose which ones he would answer. By choosing to answer the question about condoms, the pope unintentionally guaranteed that what he said about condoms would overshadow everything else he said about refugees, war, political corruption and poverty in Africa.

Nor did he choose his words well in the view of the Vatican, which revised his response in the official transcript. According to the revised text, he said, “the scourge can’t be resolved with the distribution of condoms: on the contrary, there is a risk of increasing the problem.”

The condom controversy once again shows that the pope and the Vatican do not know how to deal with the media. Anyone with any experience with Western media knew that a condom quote would dominate the headlines. The need to revise the response made matters worse.

All of this controversy over condoms hides a fact that both the Vatican and the media do not want to acknowledge: What the pope says about condoms will have little impact on whether men will use them in Africa or anywhere else. If a man is sleeping with multiple partners and thus violating the Sixth Commandment, do you really think he is going to say to his partners, “Sorry, I can’t use a condom because the pope won’t let me”? Get real. Cultural factors limit the use of condoms not papal pronouncements.

Blaming the pope for the spread of AIDS is a bum rap. Much more culpable are African politicians who refused to acknowledge its reality or proposed ineffective remedies. The president of South Africa, along with some “traditional healers,” claimed AIDS could be cured with herbs. Worse yet were those who said it could be cured by sleeping with a virgin. Meanwhile the Catholic Church has provided more medical care to African AIDS victims than any other organization.

Some experts are even coming to the pope’s defense. In “The Pope May Be Right” in the Washington Post, Edward C. Green reports “in truth, current empirical evidence supports him.” As a self-described liberal and senior research scientist at the Harvard School of Public Health, he has no brief for the Vatican.

While Green acknowledges that condom promotion has worked in countries like Thailand and Cambodia where most HIV is transmitted through commercial sex, it has not proven successful in Africa where most HIV infections are found in the general population, not in high risk groups. Nor can condoms “address challenges that remain critical in Africa such as cross-generational sex, gender inequality and an end to domestic violence, rape and sexual coercion.”

According to Green, one explanation why an emphasis on condoms has not worked is that “when people think they’re made safe by using condoms at least some of the time, they actually engage in riskier sex.” This is the point the pope was trying to make.

In Africa, the risky behavior is evident where significant proportions of the population have two or more regular sex partners at the same time. Multiple partners at the same time is much more likely to spread HIV than multiple partners over time. One study in Botswana, according to Green, found that “43 percent of men and 17 percent of women surveyed had two or more regular sex partners in the previous year.”

“These ongoing multiple concurrent sex partnerships resemble a giant, invisible web of relationships through which HIV/AIDS spreads” writes Green. “A study in Malawi showed that even though the average number of sexual partners was only slightly over two, fully two-thirds of this population was interconnected through such networks of overlapping, ongoing relationships.”

So what has been effective in Africa? Green points to Uganda’s program that focuses on “Sticking to One Partner.” But Green is not an anti-condom purist. Although he does not mention abstinence, Green’s position is similar to the ABC anti-AIDS program used in Uganda and elsewhere: Abstain, Be faithful, use Condoms. He says that “condoms should always be a backup strategy for those who will not or cannot remain in a mutually faithful relationship.” Condoms are the third choice, not the first.

The Vatican does need a better way of talking about condoms, and it could learn from what the U.S. bishops said over 20 years ago in their 1987 statement “The Many Faces of AIDS.” After clearly stating that the best and most morally acceptable way to combat AIDS is confining sexual activity to marriage, they went on to say:

Because we live in a pluralistic society, we acknowledge that some will not agree with our understanding of human sexuality. We recognize that public educational programs addressed to a wide audience will reflect the fact that some people will not act as they can and should; that they will not refrain from the type of sexual or drug-abuse behavior that can transmit AIDS. In such situations, educational efforts, if grounded in the broader moral vision outlined above, could include accurate information about prophylactic devices or other practices proposed by some medical experts as potential means of preventing AIDS.

That is close to Green’s position that “condoms should always be a backup strategy for those who will not or cannot remain in a mutually faithful relationship.” If the Vatican could say something similar to what was said by the U.S. bishops, then African bishops could support an ethically responsible ABC program that made clear that condoms were the third choice for those who will not follow A or B.

But while this makes sense for those who are not yet infected, what about those who have AIDS? Even people in the Vatican are concerned about innocent spouses who would have sex with an infected spouse. Saying that such couples could use condoms would be helpful.

Others would go further. “Someone who is infected with the HIV virus and decides to have sex with an uninfected person has to protect his partner by using a condom,” said Cardinal Godfried Danneels of Mechelen-Brussels in 2004. Not using a condom would be a violation of the Fifth Commandment: Thou shall not kill. In this case a condom is not used as a birth control device but to avoid passing on an infection.

Thomas J. Reese, S.J., is Senior Fellow at Woodstock Theological Center at Georgetown University.

By Thomas J. Reese | 
March 31, 2009; 9:19 AM ET

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  • dwickert51

    You guys need new leadership. A new perspective on clerical sexuality. To renounce the subjugation of women. You need to start right away. There isn’t much time before you completely lose your constituency.These are big things. The longer you wait, the harder it gets.

  • fishcrow

    dwickert51:Nah. We’ve survived upheaval and controversy, barbarians, the Crusades, the Romans and being tossed to the lions, the Protestants, even corrupt Popes and clergy. We’re here to stay. If anything we’ll just lose the half-hearted Catholics who dilute the faith anyway.Certainly nothing to fear from the NYT, bloggers and twitterers! Give it your best shot!

  • ebleas

    Condoms are extremely effective against the spread of the HIV virus when used properly and consistently – this is an undisputable fact. Under these conditions, they are more than 95% effective. That’s nothing to sneeze at. But as this article (and others) and the Pope point out, some people will feel invincible when using a condom, and will thus engage in riskier than normal behavior, thus negating the beneficial effects of using the condoms in the first place. But this only clearly illustrates the need to have education go along with condom dispersement. The combination of condoms, consistent use and education would quickly eradicate HIV even in places like Africa. So why take the approach that condoms are not effective when the total solution is not being properly deployed?An analogy would be the use of air bags in cars. One could take the stance that since they have an air bag to protect them, they can engage in riskier than normal driving behavior. But does this mean we should not include air bags in cars as part of standard safely equipment?

  • Chagasman

    The pope is guilty of murder. By condemning the use of condoms and by implying that condoms increase the spread of AIDs, the pope is telling his congregation not to protect themselves. What a cruel and shameful thing to do. The pope and the Catholic church continue to live in the dark ages, and are becoming more and more irrelevant as time goes on, just like most religions. Religion will be downfall of mankind.

  • lcarter0311

    I knew exactly what the Pope meant when he made his initial comments. What I interpreted the Pope to say, is that you can hand out millions of condoms to folks; however, there will be a large percentage of folks who will not use them, regardless. And an even larger percentage of these same people are not in committed relationships, even though some may be married. Everyone knows that most human beings, especially men, regardless of their culture, socio-economic backgrounds allows their natural human tendencies to cloud their best judgment when it comes to physical fulfillment. Most people, especially men would rather experience those natural tendencies without some form of restriction. For many men, that level of relief is much more enjoyable without certain restrictions being placed on them. This is not just an issue in Africa, but around the world. This is truly unfortunate, because man chooses and some women will also choose to value the physical act above their own health and well-being.

  • mrobertb

    This episode demonstrated Benedict’s lack of understanding of the situation in Africa, as well as the root causes of the spread of HIV. It’s too bad there’s no legal mechanism in Canon Law to allow for the resignation or impeachment of the Pope. The Church needs competent, compassionate leadership in our troubled times, not a narrow-minded, out of touch dogmatist like Benedict.

  • LeszX

    The Church approves of the use of periodic abstinence in marriage – according to the cycle of the woman’s fertility – for grave reasons. Certainly avoiding the transmission of AIDS to one’s spouse is a grave reason. So it would be possible to use condoms against the disease during the woman’s infertile time, and yet not be in violation of the prohibition against contraception. There would be no contraceptive effect since this would be an infertile time anyway. That said, the situation where one spouse is infected with AIDS and the other is not, and they are aware of it – is probably more prevalent in the minds of the Sophists than in the lives of those suffering from AIDS.

  • edbyronadams

    “A study in Malawi showed that even though the average number of sexual partners was only slightly over two, fully two-thirds of this population was interconnected through such networks of overlapping, ongoing relationships.”Are those contemporaneous partners or serial partners? It makes a world of difference. The other secrets are the nature of the sexual acts that spread HIV heterosexually in Africa. The problem that “education” about HIV spread and condoms have in common is that it sometimes just covers up the subject.

  • mwcob

    This is the real disconnect between the Church and the media. The Church, by nature, requires a deeper analysis than a snappy headline. Technically, condoms do NOT eliminate the risk, they only mitigate the risk. Condoms still break. OK – so they only break 1% of the time – the other 99% of the time doesn’t really matter if you’re that 1%. The media’s argument also ignores selected indigenous teachings that condom distribution isn’t going to overcome – such as a commonly held belief that sex with a virgin will cure an STD. There’s no incentive to use a condom in that case. I’m Protestant, so I don’t agree with RC teaching on birth control. But don’t try to paint the Pope as somehow ignorant or inept. Rather he refuses to play the “gotcha game” with newspaper hacks.

  • BlueIguana

    I’ve read a couple of comments that contend that condoms are 95% effective (i.e., safe) when used properly. Failure rates can run as high as 16%, particularly in the heat of “passion.” Question to ponder: If you boarded an airplane that held 100 passengers and were told that 5 to 15 of the passengers would die or be injured during the flight, would you call the flight a safe flight? Although not entirely analogous, given the high HIV infection rate in parts of Africa, it exposes the lie that using condoms equals safe (i.e., risk free) sex every time.

  • iphoenix

    To be sure, the Pope, the Vatican, and Edward C. Green probably believe they’ve scored a “slam dunk” with the “condoms lead to riskier behavior” argument. What they actually have done is made the same kind of flimsy, transparent rationalization which dooms every attempt by moralizing goody-two-shoes to address the wicked sinfulness of those who dare to act in ways which create pleasure.The entire “War on Drugs” was lost when those who called themselves “authorities” equalized all illegal drugs. These people forgot three things. First, they forgot marijuana has been around a very long time and is not known, particularly, for its destructive qualities. Second, they characterized the milder illegal drugs, like marijuana, with the same extreme — and ignorantly inaccurate — terms as the more mind altering substances. Thirdly, they forgot that the 60′s and 70′s happened, and a whole generation grew into adulthood having experimented and knowing and understanding the realities of illegal drug use. All those personages saying, “Just say no to drugs,” just made themselves sound like disingenuous yahoos who just wanted everbody to be as “miserable and liking it” as they were themselves!This applies to the argument that providing condoms promotes riskier sexual behavior. This line is so stupid and ignorant that anyone who utters it should be discredited, dishonored, and dismissed outright! Why? Because, while HIV is primarily a sexually transmitted disease, not all sexual acts will likely result in infection. When most people think of sex, they envision the act of sexual intercourse — the insertion of one participants sexual organ into the sexual organ of a partner. Guess what? This is the most efficient and the most common, and therefore the riskiest, way to be infected sexually with HIV. The most common of sex acts, not the kinkiest fetishes of a very particular few, is the riskiest behavior regarding HIV infection. Especially so, apparently, if one is Black African or of Black African descent!Once again, the over-active, pleasure blocking, puritanically inclined minds of a jealous, hateful, and controlling few have, again, disqualified themselves as authorities by betraying their self-serving longings with a self-damning ignorance.These ignoramuses would appear much more “with it” if, first, they acknowledged that pleasure and happiness are good things (if in moderation), and second, they took into account that it is simple, not sinful, human nature to desire and seek out that which is pleasurable.

  • davidscott1

    This latest bit of duncery proves once again that not only is the Pope no divine being’s mortal representative on Earth, he’s a dangerous fool. Condom-bashing indeed. What’s wrong with this man? And this church?

  • BlueIguana

    Davidscott1

  • Apostrophe

    Only an ill-formed conscience can fail to see what the Pope is actually saying.

  • Chops2

    Blueiguana:This is a classic straw man argument. No one credible has ever said using condoms is risk free everytime. Its about doing it as safely as possible. “Question to ponder: If you boarded an airplane that held 100 passengers and were told that 5 to 15 of the passengers would die or be injured during the flight, would you call the flight a safe flight?”If u had sex 100 times and were safe 85-95% percent of the time, wouldn’t u use condoms insetad of being unsafe 100% of the time?The only lie here is the Popes assertion that condoms make the problem worse. Its genocidal stupidity.

  • Chops2

    Blueiguana:The article talked about having multiple sexual partners as being an issue in Africa specifically and risk compensation leading to people not using condoms within that situation as being a huge cause of the epidemic. So its about choices:Answer that please. 1 or 2?No sane person can dispute that the safest way to have sex with multiple partners is to use condoms. As the article said in Thailand etc where there is 100% use they have less rates of infection. SO USE CONDOMS for christs sake, its not brainsurgery. I repeat, the popes comments are genocidal stupidity. He needs to ackowledge reality and aid in a comprehensive educational program not lie about the ineffectivness of contraception because he wants Catholics to breed like rabbits so his clergy can molest them when they grow up only for him to cover it up. Thanks god, thanks a bloody lot.

  • BlueIguana

    Chop2,ps, you’re a bigot!

  • semidouble

    Ahhh the Pope! Someone who does not play the game, wants to set the rules!

  • jmcdavisum

    Chop2The problem is ultimately a behavioral one that involves attitudes about sex. Condoms can be a reasonably effective partial solution, but they will never fix the problem which I would hope is everyone’s goal. Ultimately a much more monogamous society is the only answer to containing the AIDS epidemic in Africa. Condom use can help contain the virus quickly in the short term. Their use can however be a double edged sword. Someone having multiple partners may be less likely to be persuaded by the virtues of monogamy if they feel adequately protected by condoms (which they are not). So they can be a long term barrier to a lasting solution. The trick is to encourage all the tools with the understanding that the eventual goal is a more monogamous society.I don’t agree with the pope, but your knee jerk response does not make any more sense. Its nice and comfortable to have simple ideas. Sure enough the church has resulted in awful things, but it also does a tremendous amount of good around the world. Considering things in their full context does take a lot more time and energy, but it saves you from rash judgements.

  • BlueIguana

    jmcdavisumHere is a lengthy quote from Edward C. Green, Director of the AIDS Prevention Research Project Center at the Harvard Center for Population and Development Studies. Please note what he says in the last paragraph.“We have found no consistent associations between condom use and lower HIV-infection rates, which, 25 years into the pandemic, we should be seeing if this intervention was working. The pope is correct, or put it a better way, the best evidence we have supports the pope’s comments. Condoms have been proven to not be effective at the ‘level of population.” “There is a consistent association shown by our best studies, including the U.S.-funded ‘Demographic Health Surveys,’ between greater availability and use of condoms and higher (not lower) HIV-infection rates. This may be due in part to a phenomenon known as risk compensation, meaning that when one uses a risk-reduction ‘technology’ such as condoms, one often loses the benefit (reduction in risk) by ‘compensating’ or taking greater chances than one would take without the risk-reduction technology.”“I also noticed that the pope said ‘monogamy’ was the best single answer to African AIDS, rather than ‘abstinence.’ The best and latest empirical evidence indeed shows that reduction in multiple and concurrent sexual partners is the most important single behavior change associated with reduction in HIV-infection rates (the other major factor is male circumcision).”

  • withouthavingseen

    Here is a link to an interesting article by a social worker in Kampala, Uganda. She writes, essentially, that condoms haven’t helped slow the spread of AIDS and are insulting in light of the vast needs there:

  • Cheryl6

    To all of you calling the Pope stupid, ill-informed, outdated…etc I have a wake-up call for you. I worked in a medical clinic for several years and can tell you that on average I saw 6 to 12 patients a day that I had to inform of their being infected with an STD. Condom-use does not prevent one from getting infected with genital herpes, chlamydia, syphillis and Human Papilloma just to name a few STD’s. If you happen to become infected with Human Papilloma (HPV) then your percentages of becoming infected with HIV are raised higher since it causes your immune system to become weakened and more susceptible to becoming infected. Condoms cannot prevent the skin on skin contact during sex where the virus of Human Papilloma and Herpes are also present in the flesh of the genitals, inner thighs and lower abdomen. It is not only in the secretions of the vagina and penis that these viruses can be found. How can I look any of my children in the eyes and say to them “Ok honey…use a condom and if you get Chlamydia, HPV or herpes then those are the breaks”. And please spare me the… “what do you want? For kids to have sex without condoms and get HIV?” arguments. They do nothing to negate the statistics as to Human Papilloma being the #1 sexually transmitted disease in the USA with between 20 to 40 million Americans infected or the fact that HPV has over 150 strains. Some of these strains cause cervical cancer and cancer of the mouth. I will promote abstinence every chance I get and not the irresponsibility of assuming that all kids and adults can’t help themselves and will have sex anyway mentality.

  • ebleas

    “Condom-use does not prevent one from getting infected with genital herpes …”My gosh, for someone who worked at an STD clinic, you certainly are misinformed.Condoms Protect Against Genital HerpesUniversity of Washington – Seattle researcher Dr. Anna Ward reported in the Annals of Internal Medicine that her new study of 1800 high risk adults has shown that condoms do help protect men and women from acquiring herpes simplex. Previous studies have shown that condoms do protect women but Ward’s new research is the first to show condoms are effective in preventing herpes simplex in both men and women.”I will promote abstinence every chance I get and not the irresponsibility of assuming that all kids and adults can’t help themselves and will have sex anyway mentality.”And I will continue to point out false and misleading information provided by people like you.

  • ebleas

    “Condoms cannot prevent the skin on skin contact during sex where the virus of Human Papilloma and Herpes are also present in the flesh of the genitals, inner thighs and lower abdomen. It is not only in the secretions of the vagina and penis that these viruses can be found.”Then in addition to teaching sexual abstinence, you better also teach them kissing and touching abstinence as well. Because you can get Herpes Simplex Type I from kissing, you can get HPV (the strain that causes warts) simply from a handshake. So you better teach them never to kiss their relatives, or shake the hand of a stranger. Gee, what a life …

  • ebleas

    “They do nothing to negate the statistics as to Human Papilloma being the #1 sexually transmitted disease in the USA with between 20 to 40 million Americans infected or the fact that HPV has over 150 strains. Some of these strains cause cervical cancer and cancer of the mouth.”Hmmm, instead of worrying so much about them getting cervical cancer, you could have them vaccinated against it … just a crazy thought. Oh, wait, that would cause them to become sexually promiscuous … scratch that.

  • StephenBWise

    Given the large outpouring of support by Africans for Pope Benedict XVI, it’s obvious that more than a few agreed with his statements and the Church’s position on birth control. The African Catholic Church seems to be a lot more alive — and in the Spirit, than the Jesuits and the American Catholic Church.

  • Cheryl6

    Quote by ebleas: “Hmmm, instead of worrying so much about them getting cervical cancer, you could have them vaccinated against it … just a crazy thought. Oh, wait, that would cause them to become sexually promiscuous … scratch that.”—————You’ve just shown your complete ignorance on the topic. First, there are many parts of Africa where the Gardasil (Human Papilloma vaccination) is not available. Second, if you are over the age of 26 then you cannot get the vaccination. So that leaves millions upon millions of women at risk of gettting cervical cancer, cancer of the mouth and certain types of genital warts from the HPV.Third the Gardasil vaccination is only for certain types of HPV not all of the 150 different strains (variations) of the virus. So, your “just get a shot and it won’t be a problem” mindset shows that you lack an understanding of just how widespread the HPV infection problem is worldwide.That you don’t worry about women getting cervical cancer is horrific and irresponsible.It’s this mentality of “don’t worry about it, just get a shot and you’ll be ok” that is causing the Aids epidemic to spread due to many people not takinhg personal responsibility for their own actions.I will continue to promote abstinence over your “just get a shot and you’ll be fine” ignorance.

  • Cheryl6

    Quote by ebleas: “Then in addition to teaching sexual abstinence, you better also teach them kissing and touching abstinence as well. Because you can get Herpes Simplex Type I from kissing, you can get HPV (the strain that causes warts) simply from a handshake. So you better teach them never to kiss their relatives, or shake the hand of a stranger. Gee, what a life …”———-Thanks for reminding me that you can also pass herpes through oral sex. If a person has the herpes virus on the mouth they can pass it on to the genitals of their partner. Then they will have to deal with the breakouts for the rest of their lives. From your sarcasm in dealing with a worldwide epidemic I got to add something useful to your not useful posts. Thanks again.

  • mreiter72

    I agree that people can make a better effort to control themselves, BUT it might be more realistic and safe option for the Pope to lift the church ban on masturbation. Certainly most ignore that, even in the priesthood — I mean, really — but still! Talk about a victimless crime. Masturbation neither impregnates nor spreads sexually transmitted diseases. A person might abstain from intercourse but then when the libido calls, I think the Vatican should bless the hand for being kind enough to be the one to answer.

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