Friday, March 20, 2009

Condoms, AIDS, and a Papal Misstatement


Pope Benedict XVI made comments that strain the margins of credibility. Beginning a trip to Africa, a continent ravaged by AIDS (most of which coming through heterosexual contact), he made a pronouncement on the use of condoms that stands in stark contrast to the facts. He suggests that condoms, rather than helping to alleviate the situation, encourage and expand the problem. Now it's true that condoms aren't perfect, and they can break, but this isn't why the Pope is against the use of condoms. He's against them because they are a form of birth control. Now, had he said, that condoms are a form of birth control and we don't allow for any form of birth control, even if it will help prevent the spread of an epidemic that might kill millions, then I'd disagree with him, but at least he would be honest. But, from the standpoint of being "pro-life," how ironic it is that the prevention of pregnancy is worse than preventing an illness that could kill millions. And, it's important to remember that many of those being infected with AIDS are the innocent -- wives at home, being infected by unfaithful husbands. Now, should these women bear the consequences of their husbands' actions?

The Pope is welcome to his opinion, but this is irresponsible and could hinder, indeed, likely will hinder efforts to stem the tide of a disease that could depopulate the continent of Africa. It is unfortunate that he has made this statement, one that overshadows much of the rest of his message that is so supportive of the poor and the marginalized of the region. I pray he will recognize this error and rectify the situation, so that the rest of the message can be heard.

4 comments:

Phil said...

Condoms are not the answer to AIDS prevention in Africa. Changing behaviors to prevent serial monogamy is truly the best way to stop the spread of this disease. Condoms may or may not help reduce the spread, but the idea that somehow promoting condom use in Africa is going to stop the spread of AIDS is naive. And research has shown that in many African countries serial monogamy is practiced by both sexes, not just the men. We need to be honest in our judgments of all the projects aimed at reducing the spread of AIDS. Handing out condoms is not the answer, and in some cases it has worsened the problem. Education, compassion, building relationships, reducing the stigma associated with the disease, changing behaviors, and yes, condom use, these together with treatment and reducing poverty and... This is not an easy problem and will not be solved without long-term planning. While the Pope seems to have misstated, I feel your post tries to simplify a complex issue and at least appears to imply that promoting condom usage will solve the AIDS epidemic.

Pastor Bob Cornwall said...

Phil,

I agree, this is a complex issue, and that condom use by itself won't solve the problem. You're right, that these patterns of behavior likely must be changed, but while this is happening, condom use can at least prevent the spread of the disease, for which there is no cure.

But, my point is that the Pope's position stems less from trying to prevent AIDS as it does from stopping the spread of birth control. Now, as a non-Roman Catholic, who believes in and practices birth control, I have a different starting point.

Anonymous said...

Hello Pastor,

I think what the Pope is trying to do, is go to the root of the problem. Which is; changing behavior.

For your possible interest:

Edward C. Green, the director of the AIDS Prevention Research Project at the Harvard Center for Population and Development Studies, and Allison Herling Ruark, a research fellow at the Center, wrote just one year ago in First Things:

In fact, the mainstream HIV/AIDS community has continued to champion condom use as critical in all types of HIV epidemics, in spite of the evidence. While high rates of condom use have contributed to fewer infections in some high-risk populations (prostitutes in concentrated epidemics, for instance), the situation among Africa’s general populations remains much different. It has been clearly established that few people outside a handful of high-risk groups use condoms consistently, no matter how vigorously condoms are promoted. Inconsistent condom usage is ineffective—and actually associated with higher HIV infection rates due to “risk compensation,” the tendency to take more sexual risks out of a false sense of personal safety that comes with using condoms some of the time. A UNAIDS-commissioned 2004 review of evidence for condom use concluded, “There are no definite examples yet of generalized epidemics that have been turned back by prevention programs based primarily on ­condom promotion.”

A 2000 article in The Lancet similarly stated, “Massive increases in condom use world-wide have not translated into demonstrably improved HIV control in the great majority of countries where they have occurred.”
Faith communities are not shutting their eyes to evidence when they choose to emphasize the “core recommended strategy of abstinence before marriage and faithfulness within marriage.” These behaviors have, in fact, proved far more effective than condom use in curbing HIV transmission for the vast majority of any population. A 2001 study of condom use in rural Uganda found that only 4.4 percent of the population reported consistent usage in the previous year, a rate that is probably typical of much of Africa. In contrast to the estimated 95 percent or more of Africans who did not practice consistent condom use in the past year, studies from all over Africa show a solid majority of men and women reporting fidelity over the past year, with a majority of unmarried young men and women reporting abstinence.

Thus far, research has produced no evidence that condom promotion—or indeed any of the range of risk-reduction interventions popular with donors—has had the desired impact on HIV-infection rates at a population level in high-prevalence generalized epidemics. This is true for treatment of sexually ­transmitted infections, voluntary counseling and ­testing, diaphragm use, use of experimental vaginal microbicides, safer-sex counseling, and even income-­generation projects. The interventions relying on these measures have failed to decrease HIV-infection rates, whether implemented singly or as a package. One recent randomized, controlled trial in Zimbabwe found that even possible synergies that might be achieved through “integrated implementation” of “control strategies” had no impact in slowing new infections at the population level. In fact, in this trial there was a somewhat higher rate of new infections in the intervention group compared to the control group.

Pax,
John

Phil said...

Pastor Bob,
As a non-Roman Catholic who believes in but no longer needs to practice birth-control (my wife is post-menopausal), we have a similar starting point. The point of the Pope's message was not about birth control. The question asked concerned AIDS in Africa. As the research cited by anonymous points out, the use of condoms in Africa has not been shown to be effective in preventing or even slowing the spread of AIDS on that continent. When we in the West attempt to put our values and mores on the people in completely different cultures, we often cause more problems than we solve. We can debate the Roman Catholic's stand on birth control, but that is not what this Papal statement was about. By missing the point of the failure of condom use to affect the spread of AIDS in Africa I believe we fail to see the picture as it exists. There are some programs that are working to slow the spread of AIDS in Africa. We should be studying those programs and then implement them in the countries willing to do the things necessary to stop the spread of AIDS. Condom use may have a part in these programs, but it will not be the primary focus as it is here in the West.