Catholic Church and HIV/AIDS
||The neutrality of this article is disputed. (July 2012)|
Since the 1980s, 30 million people have died from AIDS. Throughout this period, the condom has been considered the most effective preventive measure against AIDS by mainstream medical and scientific opinion. Throughout the same period, the Catholic Church has maintained a moral stance, first developed in the 1960s, that contraception of all kinds is evil. Therefore, condoms should not be used at all; or they should only be used in exceptional circumstances.
In practice, the church's position on condoms has been largely ignored in industrial countries, where condom use significantly reduced the spread of the disease. The church's teachings have been most influential in developing countries, where the death rate from AIDS has been highest. Presumably, millions of AIDS victims would still be alive today if the church had lifted the condom ban in the 1980s.
In response to this problem, the Catholic Church has become one of the largest private providers of care to HIV AIDS patients in the world. However, in relation to the sexual transmission of the disease, the Church still holds that sexual abstinence before marriage and monogamy inside marriage are a better means of limiting the spread of the epidemic than is the use of condoms. In 2010, Pope Benedict XVI characterized condom use as not a "real or moral solution" to the spread of AIDS, but potentially a "first step" in the direction of moralization and responsibility, when used with "the intention of reducing the risk of infection".
This Catholic position on AIDS prevention is controversial. Issues therefore emerge as to collaboration with secular organizations such as UNAIDS and the World Health Organization in the provision of AIDS care and prevention education. Catholic organizations like Caritas are heavily engaged in the provision of AIDS care in Developing Nations.
- 1 Background
- 2 Provision of care for AIDS patients
- 3 Church teaching on the use of condoms
- 4 Condom controversy
- 5 Dissent in the Church
- 6 Criticism
- 7 See also
- 8 External links
- 9 References
The sexual revolution of the 1960s precipitated Pope Paul VI's 1968 encyclical Humanae Vitae (On Human Life) which rejected the use of contraception, including sterilization, asserting that these work against the intimate relationship and moral order of husband and wife by directly opposing God's will. It approved Natural Family Planning as a legitimate means to limit family size. The assertion of Papal authority on this issue was an unusual departure from Conciliar authority which was the normal process of the Church Councils such as Vatican II.
HIV-AIDS emerged from Africa and became a global phenomenon in the late 20th Century. The Catholic Church responded by establishing dedicated AIDS patient care services across the globe and by emphasizing its traditional teachings against pre-marital sex as a means of combating the spread of the disease.
Provision of care for AIDS patients
The Catholic Church became a world leader in the provision of care to victims of AIDS. In 2008, the UK's Guardian newspaper reported that:
[T]he Catholic Church is the biggest private provider of AIDS care in the world, providing anti-retroviral treatment, home-care visits and counseling to one in four of the world's 33.3 million AIDS patients, according to the Catholic charity Caritas International. In 2008, members of the Catholic HIV and AIDS network spent 180 million euros (about $235 million) on assistance...
With the spread of the disease to North America, the Church in the United States established the National Catholic AIDS Network to provide care to AIDS patients, their families and loved ones. By 2008, Catholic Charities USA had 1,600 agencies providing services to AIDS sufferers, including housing and mental health services.
AIDS arrived in Australia in the 1980s. Soon after, the Sisters of Charity began to admit patients suffering from the mysterious new disease at St Vincent's Hospital, Sydney, in Sydney's inner city, which became a world leader in HIV research.
Much of the Church's aid effort is concentrated in developing nations - in Africa, Asia, and Latin America. According to PBS news, in 2011, there were "117,000 Catholic medical facilities, from clinics in the deepest jungle to large urban hospitals in the developing world, that are involved in treating both people that are already infected with AIDS and trying to prevent the transmission to at-risk populations".
In a 2 June 2006 address to the United Nations General Assembly High Level Meeting on HIV-AIDS, Cardinal Javier Lozano Barragan said that while in terms of prevention, the Church advocated "formation and education towards proper behaviour", in terms of health care, the church stressed "the formation of doctors and related medical personnel, of chaplains and volunteers. We fight the stigma, facilitate testing, counselling and reconciliation. We provide anti-retrovirals and drugs to stop the vertical transmission (mother to child), and also promote measures to stop the blood contagion."
In the area of caring, the Cardinal said "we stress avoiding contagion and taking care of orphans, widows and persons with AIDS who are in prison. We are helping with the social reintegration of HIV-positive people, and collaborate with governments and other institutions both on the civil and ecumenical levels that are dealing with the pandemic."
Our work focuses on the training of health-care professionals as well as prevention, treatment, care and assistance. We accompany the sick and their respective families at every stage. Specifically, Caritas Internationalis is engaged in this important work in 102 countries. The Holy See has launched initiatives all around the world against the pandemic in 62 countries: 28 in Africa, 9 in America, 6 in Asia, 16 in Europe and 3 in Oceania
— Cardinal Javier Lozano Barragan, Address to United Nations, 2 June 2006
The Cardinal singled out a number of Catholic congregations heavily associated with HIV-AIDS related care: the Vincentians, Sant'Egidio, Camillians, Hospitaller Brothers of St John of God (Fatebenefratelli), Jesuits, Sisters of Mother Teresa, Bambino Gesù Hospital of the Holy See and Catholic pharmacists.
Church teaching on the use of condoms
Pope Benedict XVI, citing the case of prostitution, said it was "first step" towards morality for the prostitute to use condom "in order to diminish the risk posed to another person is intending to reduce the evil connected with his or her immoral activity. The Pope pointed out that the use of a condom 'with the intention of reducing the risk of infection, can be a first step in a movement towards a different way, a more human way, of living sexuality.' An action which is objectively evil, even if a lesser evil, can never be licitly willed. The pope did not say – as some people have claimed – that prostitution with the use of a condom can be chosen as a lesser evil."
The use of condoms to prevent disease is a controversial issue, with Catholic theologians arguing both sides. While dissenting theologians exist, the Church continues to teach that contraception of all forms is intrinsically evil.
While condoms might serve as a largely effective barrier to the transmission of HIV, condoms also impermissibly impede the procreative aspect of the sexual act which is understood by the Church to have a deeply theological meaning. As such, their use is forbidden. Theology aside, Church officials deny that their teaching against condom use is followed by those same people who flout Church teaching on illicit sexual activity.
A common position of Church leaders is that officially permitting condom use as a method of preventing disease could be interpreted as permitting fornication, which degrades and debases sex.
The condom is widely accepted by medical and administrative authorities as the most reliable way to stop the spread of AIDS. The Catholic Church instead emphasizes "education towards sexual responsibility", focusing on partner fidelity rather than the use of condoms as the primary means of preventing the transmission of AIDS. The Church's position is that all responsible sex must occur within the framework of a faithful, monogamous marriage. In addition, various members of the Church hierarchy have pointed out that condoms have a non-zero risk of transmitting AIDS.
Church officials argue that reliance on condoms to prevent transmission of AIDS can result in a false sense of security because of the problem of "leakage and breakage". Other more serious claims have been made, however. In 2003, contrary to empirical evidence, the president of the Vatican's Pontifical Council for the Family - "senior spokesman" Cardinal Alfonso Lopez Trujillo - claimed that condoms are permeable to the aids virus. He explained to BBC interviewers that "The Aids virus is roughly 450 times smaller than the spermatozoon. The spermatozoon can easily pass through the 'net' that is formed by the condom." These false claims were echoed by an archbishop of Nairobi, as well as by Catholics as far Asia and Latin America. Also according to The Guardian, the BBC confirmed that this misinformation has real, damaging effects at the ground level.
The Church is concerned that promotion of condom use will lead to irresponsible, risky sexual behavior (promiscuity and prostitution). Both individuals and governments could come to rely on condoms as the primary line of defense rather than emphasizing the need for "partner fidelity".
In light of the Church's principle that condoms as a rule cannot be tolerated, even for AIDS and other STI prevention, and their condemnation of other safe-sex behaviors in the place of intercourse for those at risk, then it would be logical to place more emphasis on testing potentially at-risk persons (and lowering or eliminating the cost, and/or ensuring coverage of comprehensive STI testing and AIDS testing, and increasing its availability, speed, and accuracy), and any and all of their partners, whether they are in a monogamous relationship or not, before they begin sexual relations and at regular intervals while sexual activities are going on (whether it be inside or outside of a marriage or partnership).
Pope John Paul II
John Paul II's position against artificial birth control, including the use of condoms to prevent the spread of HIV, was harshly criticised by doctors and AIDS activists, who said that it led to countless deaths and millions of AIDS orphans. Critics have also claimed that large families are caused by lack of contraception and exacerbate Third World poverty and problems such as street children in South America.
On 15 November 1989, John Paul II addressed the 4th International Conference of the Pontifical Council for the Pastoral Care of Health Care Workers in the following terms : it seems profoundly damaging to the dignity of the human being, and for this reason morally illicit, to support a prevention of AIDS that is based on a recourse to means and remedies that violate an authentically human sense of sexuality, and which are a palliative to the deeper suffering which involve the responsibility of individuals and of society. This was interpreted in May 1990 by the Roman Catholic bishops of Madagascar as a "solemn reminder" giving ground for their view that in the context of positions such as that of cardinal Lustiger who stated that it was a "lesser evil", "the condom remains a 'moral evil'".
In September 1990, John Paul II visited the small town of Mwanza, in northern Tanzania, and gave a speech that many believe set the tone for the AIDS crisis in Africa. Being unequivocal, he told his audience that condoms were a sin in any circumstances. He lauded family values and praised fidelity and abstinence as the only true ways to combat the disease.
In December 1995, the Pontifical Council for the Family issued guidelines saying that parents must also reject the promotion of so-called "safe sex" or "safer sex", a dangerous and immoral policy based on the deluded theory that the condom can provide adequate protection against AIDS.
Pope Benedict XVI
In 1988 a debate within the Catholic Church over the use of condoms to prevent AIDS sparked an intervention from Rome. The Church in 1968 had already stated in Humanae Vitae that chemical and barrier methods of contraception went against Church teachings. The debate was over the different issue of whether or not condoms could be used, not as contraceptives, but as a means of preventing the spread of HIV/AIDS and other sexually transmitted diseases. In 1987, the U. S. Conference of Catholic Bishops issued a document suggesting that education on the use of condoms could be an acceptable part of an anti-AIDS program.
In response, Cardinal Ratzinger stated that such an approach "would result in at least the facilitation of evil" – not merely its toleration. For the full text of the letter, see: On "The Many Faces of AIDS" (See also Karol Wojtyla's Love and Responsibility). Critics argue that Ratzinger's approach would lead to increases in the frequency of HIV/AIDS infections, while many Catholics dispute this and emphasize the value of faithful relationships or chastity.
In 2005, the Pope listed several ways to combat the spread of HIV, including chastity, fidelity in marriage and anti-poverty efforts; he also rejected the use of condoms.
In March 2009, the Pope was sharply criticized after he stated that "if there is no human dimension, if Africans do not help [by responsible behaviour], the problem cannot be overcome by the distribution of prophylactics: on the contrary, they increase it" and reiterated his view that "the solution must have two elements: firstly, bringing out the human dimension of sexuality, that is to say a spiritual and human renewal that would bring with it a new way of behaving towards others, and secondly, true friendship offered above all to those who are suffering, a willingness to make sacrifices and to practise self-denial, to be alongside the suffering." In that same month, a senior research scientist at the Harvard School of Public Health, Dr. Edward C. Green, penned an article entitled "The Pope May Be Right" (in another publication "The Pope Was Right") in which he stated that while "in theory, condom promotions ought to work everywhere...that's not what the research in Africa shows." The writer also indicated that strategies that worked in Africa were "Strategies that break up these multiple and concurrent sexual networks -- or, in plain language, faithful mutual monogamy or at least reduction in numbers of partners, especially concurrent ones." 
In response to the Pope's comments, an editorial was published in the Lancet, which said that "the Pope has publicly distorted scientific evidence to promote Catholic doctrine on this issue." It also pointed out that the pope's statement had provoked "an unprecedented amount of international condemnation," including by the president of the International AIDS Society.
In 2010 comments the Pope made in an interview with journalist Peter Seewald regarding condom use attracted attention in the media. In the context of an extended discussion on the help the Church is giving AIDs victims and the need to fight the banalization of sexuality, and in response to the charge that "It is madness to forbid a high-risk population to use condoms", Pope Benedict stated:
|“||There may be a basis in the case of some individuals, as perhaps when a male prostitute uses a condom, where this can be a first step in the direction of a moralization, a first assumption of responsibility, on the way toward recovering an awareness that not everything is allowed and that one cannot do whatever one wants. But it is not really the way to deal with the evil of HIV infection. That can really lie only in a humanization of sexuality.
She of course does not regard [the use of condoms] as a real or moral solution, but, in this or that case, there can be nonetheless, in the intention of reducing the risk of infection, a first step in a movement toward a different way, a more human way, of living sexuality.
. This explanation was interpreted by many as a change of tack by the Vatican which necessitated a clarification from the Vatican that "the pope does not morally justify the disordered exercise of sexuality, but maintains that the use of the condom to diminish the danger of infection may be “a first assumption of responsibility”, as opposed to not using the condom and exposing the other person to a fatal risk."
A number of episcopal conferences have suggested that condom use may be acceptable in some circumstances to prevent AIDS. One of the first episcopal conferences to take such a stance was the French Bishops Council which asserted in 1989 that, “The whole population and especially the young should be informed of the risks. Prophylactic measures exist.” In 1996, the Social Commission of the French Bishops' Conference said that condom use “can be understood in the case of people for whom sexual activity is an ingrained part of their lifestyle and for whom [that activity] represents a serious risk.” In 1993, the German Bishops Conference noted: “In the final analysis, human conscience constitutes the decisive authority in personal ethics... consideration must be given...to the spread of AIDS. It is a moral duty to prevent such suffering, even if the underlying behavior cannot be condoned in many cases...The church...has to respect responsible decision-making by couples.”
Dissent in the Church
Carlo Maria Martini
In April 2006, in response to a very specific question from the bioethicist Ignazio Marino, Cardinal Carlo Maria Martini opined that in certain cases, the usage of condoms might be allowable stating, "The use of condoms can, in certain situations, be a lesser evil". He stressed the particular case of married couples where one has HIV or AIDS. But he quickly noted that it's one thing the principle of the lesser evil in such cases, and quite another the subject who has to convey those things publicly, thus it is not up to the Church authorities to support condom use publicly, because of "the risk of promoting an irresponsible attitude". The Church is more likely to support other morally sustainable means, such as abstinence.
Cardinal Godfried Danneels is seen as one of the leaders of the "reformist party" within the Church. For instance, he has said that, although abstinence is preferable, condoms are acceptable as a means of preventing AIDS. In an interview with the Dutch Catholic broadcaster RKK, he said: "When someone is HIV positive and his partner says 'I want to have sexual relations with you', he doesn't have to do that, if you ask me. But, when he does, he has to use a condom, because otherwise he adds to a sin against the sixth commandment (thou shalt not commit adultery) a sin against the fifth (thou shalt not kill)." He added: "This comes down to protecting yourself in a preventive manner against a disease or death. It cannot be entirely morally judged in the same manner as a pure method of birth control."
Dowling first announced his position on condom use in 2001, in a response to a question by a Catholic news agency reporter during a bishops' conference in southern Africa. After stating that the bishop's conference had not taken a position on condom use, Dowling was asked for his personal opinion, and said that he believed condoms should be used to prevent the spread of HIV.
Following this, he received a number of rebukes from the South African papal nuncio. The bishop's conference condemned his words, describing condoms as "an immoral and misguided weapon" in the fight against HIV, and argued that condom use could even encourage the spread of HIV by promoting extramarital sex.
Catholics for Choice
Catholics for Choice, a dissident group, maintains that condom use will prevent the spread of AIDS, since couples will have sex despite Vatican prohibition. Two bishops share the beliefs of Condoms4Life, and have come out in support of condom use when one partner has AIDS, arguing the Roman Catholic Church's official position on this issue is unconscionable.
The Church's stance has been criticized as unrealistic, ineffective, irresponsible and immoral by some public health officials and AIDS activists. They often refer to the scientific consensus that condoms greatly reduce the risk of STD transmission, but also that Abstinence-only sex education is ineffective - discussed below.
Empirical evidence suggests that, although condoms do not guarantee the perfect prevention of STD transmission, condoms greatly reduce the risks of transmission. Other studies have focused more on HIV/AIDS and have reliably found more than an 80% drop in the risk of transmission when condoms are used. Researchers report that the primary challenge is getting people to use condoms all the time.
Some evidence suggests that abstinence-only sex education does not work, and comprehensive sex education should be used instead. For instance, abstinence only education fails to decrease people's risks of transmitting STDs in the developed world.
UNAIDS has collaborated with the Roman Catholic Church, especially Caritas Internationalis, in the fight against AIDS, something which many people only realised after a December 2005 message by Pope Benedict XVI. However, it indicated in a 2009 communiqué that it did not agree that condoms were unhelpful in AIDS prevention.
In 2003, the WHO denounced statements by the Roman Curia's health department, saying: "These incorrect statements about condoms and HIV are dangerous when we are facing a global pandemic which has already killed more than 20 million people, and currently affects at least 42 million." 
However, according to Edward C. Green, director of the AIDS Prevention Research Project at the Harvard Center for Population and Development Studies: "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. James Shelton, of the US Agency for International Development, said that one of the ten damaging myths about the fight against AIDS is that condoms are the answer. "Condoms alone have limited impact in generalised epidemics [as in Africa]," Shelton wrote.
- Islam and AIDS
- Drug Resources Enhancement against Aids and Malnutrition (DREAM) promoted by the Community of Sant'Egidio
- Religion and AIDS
- Vatican.va: Family values Versus Safe Sex: A Reflection by His Eminence, Alfonso Cardinal López Trujillo
- Caritas Internationalis: HIV & AIDS
- Paul VI, Pope (1968). "Humanae Vitae". Vatican. Retrieved 2 February 2008.
- James T. Bretzke, S.J. (26 March,). "The Lesser Evil". America Magazine. Retrieved 2008-05-16.
- Guevin, Benedict; Martin Rhonheimer (Spring 2005). "Debate: On the Use of Condoms to Prevent Acquired Immune Deficiency Syndrome". The National Catholic Bioethics Quarterly: 35—48.
- May, William E. (Summer/Fall 2007). "The Theological Significance of Consummation of Marriage, Contraception, Using Condoms to Prevent HIV, and Same-Sex Unions". Josephinum Journal of Theology (Pittsfield, Massachusetts: Catholic Library Association) 14 (2): 207—217.
- "Condoms and Sexually Transmitted Diseases".
- Thavis, John (2009-03-18). "Pope's condom comments latest chapter in sensitive church discussion". Retrieved 2010-02-21.
- Vatican: condoms don't stop Aids
- "Catholic Church to Ease Ban on Condom Use". © 2006, 2009 Deutsche Welle. 24 April 2006. Retrieved 12 January 2009.
- "Top Catholics Question Condom Ban". © 2005, 2009 International Herald Tribune. 16 April 2005. Retrieved 12 January 2009.
- Discorso di Giovanni Paolo II al partecipanti alla Conferenza Internazionale promossa dal Pontifico Consiglo per la Pastorale degli Operatori Sanitari, Vatican website
- Episcopal Conference of Madagascar, "AIDS: Imminent Danger for Man Today, for the Family and Society", 14 May 1990, in "Speak Out on HIV & AIDS: Our prayer is always full of hope", by the Catholic Bishops of Africa and Madagascar, Paulines Publications Africa, Nairobi, 2004, p.32
- John Paul’s 1990 speech ‘sentenced millions to die’
- Pontifical Council for the Family The Truth and Meaning of Human Sexuality
- BBC News. (2005) Pope rejects condoms for Africa. Retrieved from: http://news.bbc.co.uk/2/hi/europe/4081276.stm
- Butt, Riazat. "Pope claims condoms could make African Aids crisis worse." The Guardian. 17 March 2009. 17 March 2009.
- Benedict XVI, Interview during his fight to Africa, 17 March 2009
- Washington Post. Green, Edw. C. "The Pope may be right." 29 March 2009.
- Editors of the Lancet (2009). "Redemption for the pope?". The Lancet (Elsevier) 373 (9669): 1054. doi:10.1016/S0140-6736(09)60627-9. Retrieved 16 July 2013.
- "Pope Benedict on condoms in the light of the world". Catholic World Report.
- Quinn, Ben (20 November 2010). "Pope signals shift away from Catholic church's prohibition of condoms". The Guardian (London).
- "STATEMENT ON PONTIFF'S WORDS REGARDING CONDOMS - "The Pope Does Not Reform or Change the Church's Teaching"". Zenit. 21 November 2010.
- French Bishops Council, “AIDS: Society in Question,” 1996.
- German Bishops Conference, “Bevölkerungs-wachstum und Entwicklungsforderung (Population Policy and Development),” 1993.
- Time Magazine, 1 May 2006.
- BBC. Cardinal backs limited condom use 21 April 2006
- L'Espresso. When Does Life Begin? Cardinal Martini Replies 20 May 2006
- TERRAS, Christian. Revue Golias, online publication
- Lindow, Megan (2005). "European Heroes 2005: Lives in the Balance". Time. Retrieved 2007-04-23.
- Nolen, Stephanie (7 April 2007). "South African bishop defies Vatican on condoms". Globe and Mail. Retrieved 2007-04-23.
- Reformers Turn Up Heat on Church
- French Bishop Supports Some Use of Condoms to Prevent AIDS
- One South African Bishop Supports Condoms To Prevent AIDS
- Partnerships in civil society
- Villhauer, Tanya (2005-05-20). "Condoms Preventing HPV?". University of Iowa Student Health Service/Health Iowa. Retrieved 2009-07-26.
- "Condom". Planned Parenthood. 2008. Retrieved 2007-11-19.
- Cates, W., Steiner, M. J. (2002). "Dual Protection Against Unintended Pregnancy and Sexually Transmitted Infections: What Is the Best Contraceptive Approach?". Sexually Transmitted Diseases 29 (3): 168–174. doi:10.1097/00007435-200203000-00007. PMID 11875378.
- Winer, R; Hughes, J; Feng, Q; O'Reilly, S; Kiviat, N; Holmes, K; Koutsky, L (2006). "Condom use and the risk of genital human papillomavirus infection in young women". N Engl J Med 354 (25): 2645–54. doi:10.1056/NEJMoa053284. PMID 16790697. Retrieved 2007-04-07.
- National Institute of Allergy and Infectious Diseases; National Institutes of Health, Department of Health and Human Services (2001-07-20). "Workshop Summary: Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention" (PDF). Hyatt Dulles Airport, Herndon, Virginia. pp. 13–15. Retrieved 2010-09-22.
- Cayley, W.E. & Davis-Beaty, K. (2007). Weller, Susan C, ed. Effectiveness of Condoms in Reducing Heterosexual Transmission of HIV (Review). John Wiley & Sons, Ltd. doi:10.1002/14651858.CD003255.
- World Health Organization Department of Reproductive Health and Research (WHO/RHR) & Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs (CCP), INFO Project (2007). Family Planning: A Global Handbook for Providers. INFO Project at the Johns Hopkins Bloomberg School of Public Health. p. 200.
- Nordenberg, Tamar (March–April 1998). "Condoms: Barriers to Bad News". FDA Consumer magazine (U.S. Food and Drug Administration). Retrieved 2007-06-07.
- Ott, MA; Santelli, JS (October 2007). "Abstinence and abstinence-only education.". Current opinion in obstetrics & gynecology 19 (5): 446–52. doi:10.1097/GCO.0b013e3282efdc0b. PMID 17885460.
- Fact Sheet (includes research citations).
- Kirby, D. (2007). "Emerging Answers 2007: Research Findings on Programs to Reduce Teen Pregnancy and Sexually Transmitted Diseases". National Campaign to Prevent Teen Pregnancy.Homepage of the study.
- Underhill, K; Operario, D, Montgomery, P (2007-10-17). "Abstinence-only programs for HIV infection prevention in high-income countries.". Cochrane database of systematic reviews (Online) (4): CD005421. doi:10.1002/14651858.CD005421.pub2. PMID 17943855.
- La Croix article
- Jean Lopez, Kathryn (19 March 2009). "From Saint Peter’s Square to Harvard Square". National Review. Retrieved 29 August 2013.