Condoms in Africa

[camerong]

I can’t decide with certainty how I feel about whether we should distribute condoms in Africa. On one hand, I subscribe to the Church’s teachings that condom use is a grave sin. On the hand, I also have found persuasive the research indicating that wider condom distribution could save hundreds of thousands or millions of lives, and most who would use condoms are not Catholic and have no religious belief against condom use.

I think the answer is probably that we do not commit a sin by letting a person get infected with HIV, even though we could have stopped it by giving her a condom. Alternately, we (very probably) do sin if we give out condoms, even if it saves a person’s life. We are called to be faithful and avoid sin, not to save lives. Is this the best way of approaching the issue?

 

[manualman]

Your question contains a false dillemma. The church does not control what the UN or any of the secular NGOs do. That’s not our jurisdiction. They are going to continue on the road of “condoms are the answer” and Africa will continue its horrific slide into HIV/AIDS disaster.

Humans are not machines, and don’t respond well to one-variable predictions. ALL the condom strategies inherently presume that human behavior is the same whether or not a condom is present. This assumption is patently untrue and this factor is IGNORED in virtually all of the pro-condom organizations.

The reality is that when condoms and condom education programs are introduced, people’s behavior CHANGES through a phenomenon called ‘risk compensation.’ When someone THINKS he is “safe” by using a condom, he is likely to have sex with more partners, more often than someone who knows about AIDS and knows that being promiscuous is the cause of it.

Ultimately, condoms cannot stop AIDS. Only faithful and monogamous marriages can do that.

Mark my words, there is going to be continued death and devastation in Africa because of AIDS until the condom farce is exposed for what it is: a band-aid on a gaping wound.

 

[camerong]

I’m not sure I agree. Take sex workers in Africa, for example, which are a significant factor in the spread of HIV/AIDS. The decision of sex workers to work more or less seems unlikely to be tied to condom use. Maybe some are limiting their income out of fear of HIV, and if they had condoms, would have more sex because they would be less afraid. But I would imagine that at least some either don’t understand the nature of the risk, or do and have resigned themselves to contracting HIV (which they prefer to starving to death). For these women, the limiting factors are availability of clients, physical abilities, etc., and condom use is unlikely to change their habits. For these women, I think the choice I gave above very much applies. We could argue about the likelihood of the existence of such women, but surely there is at least one for whom this applies, and so the decision cannot be avoided by saying that condoms only increase the immoral behavior. If condoms did not increase the incidence of sex, but only decreased the incidence of HIV and other STDs, would giving the person a condom be a right or wrong act?

(In case I’m not being obvious, I’m trying to eliminate variables so we can only address the moral issue at the heart; I am in no place to debate epidemiology, as few if any are on this forum. But, regardless of the epidemiological circumstances, I feel confident there are at least some for whom the moral issue is relevant, such as the sex worker discussed above.)

 

[crazzeto]

I can’t decide with certainty how I feel about whether we should distribute condoms in Africa. On one hand, I subscribe to the Church’s teachings that condom use is a grave sin. On the hand, I also have found persuasive the research indicating that wider condom distribution could save hundreds of thousands or millions of lives, and most who would use condoms are not Catholic and have no religious belief against condom use.

I think the answer is probably that we do not commit a sin by letting a person get infected with HIV, even though we could have stopped it by giving her a condom. Alternately, we (very probably) do sin if we give out condoms, even if it saves a person’s life. We are called to be faithful and avoid sin, not to save lives. Is this the best way of approaching the issue?

How does this affect your views:

washingtonpost.com/wp-dyn/content/article/2009/03/27/AR2009032702825.html

When Pope Benedict XVI commented this month that condom distribution isn’t helping, and may be worsening, the spread of HIV/AIDS in Africa, he set off a firestorm of protest. Most non-Catholic commentary has been highly critical of the pope. A cartoon in the Philadelphia Inquirer, reprinted in The Post, showed the pope somewhat ghoulishly praising a throng of sick and dying Africans: “Blessed are the sick, for they have not used condoms.”

Yet, in truth, current empirical evidence supports him.

We liberals who work in the fields of global HIV/AIDS and family planning take terrible professional risks if we side with the pope on a divisive topic such as this. The condom has become a symbol of freedom and – along with contraception – female emancipation, so those who question condom orthodoxy are accused of being against these causes. My comments are only about the question of condoms working to stem the spread of AIDS in Africa’s generalized epidemics – nowhere else.

In 2003, Norman Hearst and Sanny Chen of the University of California conducted a condom effectiveness study for the United Nations’ AIDS program and found no evidence of condoms working as a primary HIV-prevention measure in Africa. UNAIDS quietly disowned the study. (The authors eventually managed to publish their findings in the quarterly Studies in Family Planning.) Since then, major articles in other peer-reviewed journals such as the Lancet, Science and BMJ have confirmed that condoms have not worked as a primary intervention in the population-wide epidemics of Africa. In a 2008 article in Science called “Reassessing HIV Prevention” 10 AIDS experts concluded that “consistent condom use has not reached a sufficiently high level, even after many years of widespread and often aggressive promotion, to produce a measurable slowing of new infections in the generalized epidemics of Sub-Saharan Africa.”

Let me quickly add that condom promotion has worked in countries such as Thailand and Cambodia, where most HIV is transmitted through commercial sex and where it has been possible to enforce a 100 percent condom use policy in brothels (but not outside of them). In theory, condom promotions ought to work everywhere. And intuitively, some condom use ought to be better than no use. But that’s not what the research in Africa shows.

Why not?

One reason is “risk compensation.” That is, when people think they’re made safe by using condoms at least some of the time, they actually engage in riskier sex.

Another factor is that people seldom use condoms in steady relationships because doing so would imply a lack of trust. (And if condom use rates go up, it’s possible we are seeing an increase of casual or commercial sex.) However, it’s those ongoing relationships that drive Africa’s worst epidemics. In these, most HIV infections are found in general populations, not in high-risk groups such as sex workers, gay men or persons who inject drugs. And in significant proportions of African populations, people have two or more regular sex partners who overlap in time. In Botswana, which has one of the world’s highest HIV rates, 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. 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 worked in Africa? 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. “Closed” or faithful polygamy can work as well.

In Uganda’s early, largely home-grown AIDS program, which began in 1986, the focus was on “Sticking to One Partner” or “Zero Grazing” (which meant remaining faithful within a polygamous marriage) and “Loving Faithfully.” These simple messages worked. More recently, the two countries with the highest HIV infection rates, Swaziland and Botswana, have both launched campaigns that discourage people from having multiple and concurrent sexual partners.

Don’t misunderstand me; I am not anti-condom. All people should have full access to condoms, and condoms should always be a backup strategy for those who will not or cannot remain in a mutually faithful relationship. This was a key point in a 2004 “consensus statement” published and endorsed by some 150 global AIDS experts, including representatives the United Nations, World Health Organization and World Bank. These experts also affirmed that for sexually active adults, the first priority should be to promote mutual fidelity. Moreover, liberals and conservatives agree that condoms cannot address challenges that remain critical in Africa such as cross-generational sex, gender inequality and an end to domestic violence, rape and sexual coercion.

Surely it’s time to start providing more evidence-based AIDS prevention in Africa.

When one looks to how Unganda was handled, we see success with abstiance. When some one looks to see how condoms are working out in the rest of Africa, they notice they arn’t working out.

 

[camerong]

Wow, that is really interesting. I would never have guessed such a thing would come from a senior researcher at the Harvard School of Public Health. I highly respect that department, but given their liberal bias, that means this article probably understates the truth, or perhaps the truth was obvious long before they finally got around to recognizing it. Good post.

I suppose this is the correct answer, when one sees an apparent paradox between practical well-being and an infallible teaching of the Church, it is a “false choice” as a poster above said. Glad I asked this question!

 

[crazzeto]

Wow, that is really interesting. I would never have guessed such a thing would come from a senior researcher at the Harvard School of Public Health. I highly respect that department, but given their liberal bias, that means this article probably understates the truth, or perhaps the truth was obvious long before they finally got around to recognizing it. Good post.

I suppose this is the correct answer, when one sees an apparent paradox between practical well-being and an infallible teaching of the Church, it is a “false choice” as a poster above said. Glad I asked this question!

Printed in one of th more libreal papers to boot Now I’ll confess to not being exactly what you would call, a true “conservitive”. I do absoultly support the church’s social agenda in on many points that makes me agree with conseritives. But I find it funny how often it also makes me find my self on the more “liberal” side of the spectrum as well. Ah well, that’s life and if there’s any truth to being Catholic… We don’t exactly fit in with anyone politically

 

[camerong]

Printed in one of th more libreal papers to boot Now I’ll confess to not being exactly what you would call, a true “conservitive”. I do absoultly support the church’s social agenda in on many points that makes me agree with conseritives. But I find it funny how often it also makes me find my self on the more “liberal” side of the spectrum as well. Ah well, that’s life and if there’s any truth to being Catholic… We don’t exactly fit in with anyone politically

I find that too. The Vatican declares health care is a basic human right? But I really like being able to fall back on the Church for as many political issues as possible. Chalk condoms in Africa up as another one those!

 

[otjm]

A social scientist without so great a bias that they could not recognize the truth when it is in front of them would find that before 1930, sexual acitivity outside of marriage was contained within a minority of people.

In 1930, the Lambeth Conference (Epsicopal/Anglican) was the first mainline church organization to recognize the legitimate use of birth control within the family for the purpose of limiting births. Prior to that, all mainline churches (and some non-religious groups) condemned the use of birth control.

By the time Humanae Vitae was released, the only mainline church to condemn the use of birth control was the Catholic Church.

Parallel to that was an increase in sexual activity outside of marrige, which culminated after the release of the Pill and changes to secular laws (which also outlawed birth control by and large) in the sexual revolution of the 1960’s. And promiscuity, along with a higher age before first marriages has resulted.

While that may not be the sum total of all causes of the breakdown in sexual mores and morals, it should be enough evidence that one would give pause before suggesting the use of condoms as means of avoiding AIDS; the change in sexual behavior pattern from Lambeth on is ample evidence that what supposedly was simply between a husband and wife soon and rapidly spread far beyone that.

 

[crazzeto]

A social scientist without so great a bias that they could not recognize the truth when it is in front of them would find that before 1930, sexual acitivity outside of marriage was contained within a minority of people.

In 1930, the Lambeth Conference (Epsicopal/Anglican) was the first mainline church organization to recognize the legitimate use of birth control within the family for the purpose of limiting births. Prior to that, all mainline churches (and some non-religious groups) condemned the use of birth control.

By the time Humanae Vitae was released, the only mainline church to condemn the use of birth control was the Catholic Church.

Parallel to that was an increase in sexual activity outside of marrige, which culminated after the release of the Pill and changes to secular laws (which also outlawed birth control by and large) in the sexual revolution of the 1960’s. And promiscuity, along with a higher age before first marriages has resulted.

While that may not be the sum total of all causes of the breakdown in sexual mores and morals, it should be enough evidence that one would give pause before suggesting the use of condoms as means of avoiding AIDS; the change in sexual behavior pattern from Lambeth on is ample evidence that what supposedly was simply between a husband and wife soon and rapidly spread far beyone that.

Great post! It’s very true, but the problem is this… The people who were bashing the Pontif were doing so not so much based on a logical thought process about human behaviour and how condoms work, but rather used a thought process which dictates “you must support the sexual revolution, and your idological agenda”. I suggested as much when a particular anti-catholic athiest when the Pontif made his original comments (on another forum).

I got confirmation later when I posted a follow thread with the very information I posted above (including some other news peices from Catholic sources). I only got very sparce comments back, but the second most frequent poster in the thread was a gay, athiestic anti-catholic. His concerns were obvious “so what’s the church trying to say?? We shouldnt’ have sex before marriage?? Well God forbid!!” (well yeah, actually God did forbid but anyway…). Then the (straight) athiest anti-catholic who posted the original Pontif bashign thread followed up the gay guy’s post with a “yeah God forbid” (again, yeah he did).

You see, it beecomes abundantly obvious they could actually care less about African’s getting AIDS. What they care most about is supporting their immoral sexual idology.

 

[manualman]

You see, it beecomes abundantly obvious they could actually care less about African’s getting AIDS. What they care most about is supporting their immoral sexual idology.

Well that’s a bit simplistic if you are trying to paint ALL Africa condom campaigners with that paintbrush. Argumentative internet posters, maybe. But the actual people on the ground doing UN AIDS work haven’t simply devoted their lives to rationalizing a sexually perverse ethic. They mostly genuinely believe that condoms will help things there.

Too bad good intentions are of no help at all if they lead to actions that are counter productive to the intention! That’s (IMO) THE biggest problem in the political left today: the failure to recognize that good intentions are a lousy substitute for genuinely effective policies.

 

[crazzeto]

Well that’s a bit simplistic if you are trying to paint ALL Africa condom campaigners with that paintbrush. Argumentative internet posters, maybe. But the actual people on the ground doing UN AIDS work haven’t simply devoted their lives to rationalizing a sexually perverse ethic. They mostly genuinely believe that condoms will help things there.

Too bad good intentions are of no help at all if they lead to actions that are counter productive to the intention! That’s (IMO) THE biggest problem in the political left today: the failure to recognize that good intentions are a lousy substitute for genuinely effective policies.

Well for starters I wasn’t talking about the average un-aids worker if you read my posting carefully. But I would submit that anyone looking at the impirical data and not drawing the conclusion that the UN-AIDS program is ineffective because of the very problems the Pontif pointed out many months ago is doing exactly as I stated. They’ve started with an idology, and fit an African AIDS “solution” around the idology, rather than running/participating in an evidence based program.