Everyone involved in fighting AIDS agrees that the surest way to avoid contracting HIV is to abstain from sexual relations. For those who choose not to abstain, the best way is to confine sexual activity to a mutually monogamous relationship.
Hence, it’s virtually impossible for someone who follows the Catholic Church’s moral teachings on sexuality to contract HIV — the virus that causes AIDS — unless he or she gets a tainted blood transfusion; uses dirty needles that contain the virus; or contracts it from an HIV-positive mother before or at the time of birth.
Indeed, Catholic News Service reported in June that Pope Benedict XVI told bishops from southern Africa that adherence to church teachings on sexuality "has proven to be the only fail-safe way to prevent the spread of HIV/AIDS."
Nonetheless, many AIDS activists have attempted to brand the Catholic Church — which, according to Vatican estimates, provides more than one-quarter of all health and social services to people with HIV/AIDS throughout the world — as an enabler of the epidemic. Church teachings against artificial contraception have been attacked by AIDS activists who want the church to endorse the use of condoms to stem HIV infection.
For example, in March of this year, the British medical journal The Lancet published a scathing editorial condemning Pope John Paul II’s stance on condoms. "(W)hen it comes to organized religion — and especially the policies of the current Pope — faith seems to present insuperable obstacles to the prevention of disease," the editorial stated.
But those who attack the church for its opposition to condoms ignore the proven value of promoting abstinence, observed Father Robert J. Vitillo, special adviser on HIV and AIDS for Caritas Internationalis, a worldwide confederation of national Catholic emergency-relief, social-service and development organizations. In an interview with the Catholic Courier, Father Vitillo, who is based in Geneva, Switzerland, defended abstinence.
"At times, the public-health educators, who are so desirous of finding the easy, technical solution for HIV prevention, forget to mention the important prevention means of abstinence and fidelity," he said.
The Lancet since has published Father Vitillo’s letter responding to its editorial. In it, the priest pointed out that Pope John Paul II was "first among high-profile religious leaders to embrace and dialogue with people living with HIV and AIDS. His social doctrine seriously advanced the vision of both religious and public health officials to make anti-retroviral treatment accessible to people living with HIV and AIDS in low-income countries."
Africa provides one of the best examples of the value of promoting abstinence and fidelity in the fight against AIDS, several observers noted. Since the early 1990s, the Ugandan government has made promoting abstinence and fidelity a major part of its campaign against AIDS. According to the United Nations publication Africa Recovery, the number of Ugandan teenagers remaining virgins until age 19 rose from 20 percent in 1990 to more than 50 percent in 1995. Meanwhile, according to another U.N. report, Uganda’s HIV-infection rate dropped from more than 20 percent in the 1980s to 7 percent in 2005.
Nevertheless, Ugandan President Yoweri Museveni has called on the church to drop its opposition to condoms. "This is not to support immorality, but to recognize the weakness of those we live with and help them to live a healthy life," he told a conference meeting of sub-Saharan Catholic bishops June 15, according to a report from the U.N. news service IRIN News.
Kristin A. Weinhauer, HIV/AIDS technical adviser to Catholic Relief Services, the U.S. bishops’ overseas relief and development agency, said her agency does not finance, distribute or promote the use of condoms. However, Weinhauer said that CRS staff will provide information about the fact that condoms reduce the risk of HIV transmission.
"The goal of CRS is to give sound public-health information," Weinhauer said. "At the same time, we can’t go against Catholic teachings."
The Catholic Church has never made a definitive pronouncement on the use of condoms in the fight against HIV/AIDS, according to Jesuit Father James Keenan, professor of theological ethics at Boston College. The priest, who edited the 2000 book Catholic Ethicists on HIV/AIDS Prevention, noted that church leaders have, in fact, sent mixed messages on condoms. In recent years, some church leaders have totally condemned them, while others have allowed condom use in certain, limited circumstances.
In 2003, Cardinal Alfonso Trujillo of Colombia, president of the Pontifical Council for the Family, drew intense criticism from AIDS activists when he condemned promotion of condoms because condoms are not effective if used improperly and because they can be defective. On the Vatican’s Web site, the cardinal published a lengthy defense of this position, noting that even such organizations as Planned Parenthood acknowledge that condoms are not 100 percent effective in reducing the rate of AIDS infection.
On the other hand, church leaders in such nations as Chad, Senegal, France and the Netherlands have allowed that condoms may be used in certain specific situations — for example, within a marriage in which one partner is HIV-positive and the other is HIV-negative.
In 2001, the Catholic bishops of South Africa, Botswana and Swaziland issued "A Message of Hope" about HIV/AIDS, condemning as immoral the "widespread and indiscriminate" promotion of condoms. Yet they also acknowledged couples in which one of the parties is living with HIV/AIDS. "The Church accepts that everyone has the right to defend one’s life against mortal danger," they wrote. "This would include using the appropriate means and course of action."
When Pope Paul VI issued the encyclical Humanae Vitae in 1968, that document’s ban on artificial contraception referred to interference with conception, not protecting oneself against a deadly disease, noted Father Keenan, who said he supports the encyclical.
Yet he said it is perfectly consistent with Catholic principles to allow couples to use condoms to protect one partner from HIV infection. In such cases, the condoms serve as prophylactics, not contraceptives, he said, noting that distinguishing among various intentions is important to Catholic morality.
He added that the church’s just-war theory allows for the killing of innocent civilians in limited cases, and argued that the church needs to look at the condom-HIV issue the same way.
“If we can figure out that we can (morally) attack a military target in a civilian population … why all of a sudden do we say a moral distinction here doesn’t apply?” he said.
Catholic AIDS activists note, meanwhile, that fighting AIDS is not just about preventing its spread — it’s also about improving the health and welfare of millions of people who are vulnerable to the virus because of their living conditions.
The underlying causes that make people poor and marginalized — and more vulnerable to AIDS transmission — are often ignored, Father Vitillo told the Courier.
“The lack of good health care and nutrition, lack of access to treatment of other sexually transmitted infections all make people more prone to HIV transmission when they engage in behaviors that put them at risk of this infection,” he said. Father Vitillo added that women in many countries have no rights over their own bodies, and that young girls often are forced into sexual relationships.
Daniel T. Lunney, executive director of the National Catholic AIDS Network, noted that fighting HIV involves raising people’s self-esteem and improving their personal relationships.
“These things are much more healthy for individuals than giving them a condom,” he said.