The NewsHour’s global health unit is in Rome this week to report on a two-day conference being hosted by the Vatican on the global fight against AIDS. The meeting was prompted in part by confusion over the pope’s recent comments on condom use and HIV prevention. Watch Ray Suarez preview his reports below:
Catholic charities are a major player in the fight against HIV/AIDS — providing about 25 percent of AIDS care in Africa– so when Pope Benedict XVI appeared to crack open the door last year for condoms as a prevention method in very limited circumstances, the statement made waves in public health circles.
“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,” the pope said in a book of interviews published in November of 2010.
To AIDS activists, it appeared to be a big turn around for the pope, who was criticized for saying condoms could make the HIV epidemic worse during a trip to Africa in 2009. But a series of statements by Vatican officials since then indicate the remarks were not meant as a shift in Church teachings.
The Vatican said in December the comments were misconstrued but that in the specific context of “gravely immoral” prostitution, use of a condom could be a “first step in respecting the life of another.” It stressed the pope was not condoning condom use between a man and woman or within a marriage.
In the run-up to the conference, the Vatican newspaper published an article Wednesday by Father Juan Perez-Soba, a moral theologian who teaches in Rome at the John Paul II Institute, stating again that condoms could make the epidemic worse.
He wrote that campaigns promoting condoms provide a false sense of security, and reinforced that use of condoms within marriage “deforms” the act of procreation. Abstinence would be the appropriate response in a marriage where one member is HIV positive and one is not, he said.
Whether the conference will be used to restate the Church’s long held teaching against the use of condoms or provide a new set of more nuanced guidelines for care providers on the ground remains to be seen, but many charities working in the field welcome any ongoing discussion.
Ann Smith, HIV corporate strategist for CAFOD, the official Catholic aid agency for England, said the group welcomed the pope’s statement because it reflected some of the difficult ethical issues that have to be weighed when looking at HIV/AIDS prevention.
“It brought to the fore CAFOD’s own reflections and experiences over the years and the discussions we’ve had with bishops and theologians,” Smith said. “We’ve struggled with this.”
CAFOD money is never used to supply or distribute condoms in the 50 countries the organization works in, but in 2004 they adopted a policy of asking all its agencies on the ground to share full information on HIV prevention.
“People need to know all risk reduction options, both the effectiveness and limitations of those options,” Smith said. “Delaying the age of first sexual encounter, reducing the number of partners and concurrent partners, certainly the scientific evidence that condoms reduces but do not remove the risk of infection — that information needs to be part and parcel of people’s understanding.”
But Smith emphasized that no single prevention is the answer to HIV and that people who make condoms out as the silver bullet in this debate are wrong.
“The situations that make people vulnerable to HIV are complex so prevention needs to be a complex response. There aren’t simple solutions,” she said.
For Bishop Kevin Dowling, who runs a large HIV/AIDS program Rustenberg, South Africa, the pope’s statement suggested not a change in the Church’s policy but repositioning the question to consider use of a condom not for contraceptive purposes, but for its protective purposes. He said for many people working on the front lines, the issue is really about saving lives where possible.
“The issue becomes how do you prevent the death dealing virus causing these poor people to literally die in horrendous conditions?” Dowling told the NewsHour. “That is where the issue of the use of a condom, not for contraceptive purposes, but to prevent the transmission of a death-dealing virus comes into play.”
Both Dowling and Smith expressed frustrations that the Catholic Church’s role in helping many victims of HIV is often lost in the media focus on the condom debate.
In many developing countries, especially those that are post-conflict and have very weak governments, Catholic institutions and other faith-based charities are the only providers of health services, said Thomas Woods, a senior adviser at the Center for Interfaith Action on Global Poverty.
“The Catholic Church has been involved in the developing world and providing care for a very long time,” Woods said. “It’s very significant in terms of infrastructure.”
Up to 70 percent of health services in some African countries are provided by faith-based groups like Catholic charities, according to the World Health Organization.
The ten largest organizations in the international Catholic HIV and AIDS Network spent $241 million on the epidemic in 2010, and Catholic Relief Services has been a major partner in the President’s Emergency Plan for AIDS Relief, receiving more than $700 million for provision of services since 2004.
Woods points to the tight networks that church communities provide as part of their strength in responding to health emergencies.
“[In many countries] people don’t have faith in their politicians but they do have faith in their spiritual church leaders,” he said. “So when those people that they trust provide advice, they listen.”