Condoms, STDs, and abstinence

[MJJean]

My question hasn’t been answered. Are married couples in which one partner has HPV or herpes required to stay away from condoms?

Yes. First, HPV and herpes transmission is not prevented by condom use. The chances of transmission are lower, not eliminated. Again, the infectious sores appear in the general genital region, not just inside the vagina or on the penis. S

From the CDC:

How common is genital herpes?
Genital herpes is common in the United States. In the United States, about one out of every six people aged 14 to 49 years have genital herpes.

How is genital herpes spread?
You can get herpes by having vaginal, anal, or oral sex with someone who has the disease.

Fluids found in a herpes sore carry the virus, and contact with those fluids can cause infection. You can also get herpes from an infected sex partner who does not have a visible sore or who may not know he or she is infected because the virus can be released through your skin and spread the infection to your sex partner(s).

How can I reduce my risk of getting herpes?
The only way to avoid STDs is to not have vaginal, anal, or oral sex.
If you are sexually active, you can do the following things to lower your chances of getting herpes:
Being in a long-term mutually monogamous relationship with a partner who has been tested and has negative STD test results;
Using latex condoms the right way every time you have sex.
Herpes symptoms can occur in both male and female genital areas that are covered by a latex condom. However, outbreaks can also occur in areas that are not covered by a condom so condoms may not fully protect you from getting herpes.

I went to their page on HPV and got the same fact sheet for that disease which also includes

If you are sexually active
Use latex condoms the right way every time you have sex. This can **lower **your chances of getting HPV. But HPV can infect areas that are not covered by a condom - so condoms may not give full protection against getting HPV;
Be in a mutually monogamous relationship – or have sex only with someone who only has sex with you.

Bolding and “eek” are mine.

Just wanted to get that out there so folks reading don’t falsely believe condoms prevent the transmission of the diseases mentioned.

 

[Hoosier_Daddy]

If someone has an STD, how does he reconcile the prohibition against condoms with the medical imperative to not spread his disease to another? I’m talking within marriage here, not “society in general” or casual sex.

One would need to get the best treatment available and of course inform a potential spouse of this situation BEFORE marriage. Then one would need to stay in keeping with the Church’s laws in regard to contraception. Sex in marriage would not be open to life with a condom so it cannot be permitted. If one had a situation where the STD either disfigured them or was indeed life threatening, it could be an impediment to marriage.

 

[CaliLobo]

Yes. First, HPV and herpes transmission is not prevented by condom use. The chances of transmission are lower, not eliminated. Again, the infectious sores appear in the general genital region, not just inside the vagina or on the penis. S

From the CDC:

How common is genital herpes?
Genital herpes is common in the United States. In the United States, about one out of every six people aged 14 to 49 years have genital herpes.

This is the thing that shocks me. And to think that the average number of sex partners a person has had by age 30 is ten! So statistically, the average person has had sex with one or two herpes sufferers by the time he is 30. The average person has exposed himself to the virus!!

And scarier is the fact that 90% of those with herpes aren’t aware of it. So assuming 20% of America has herpes, about 18% of Americans are walking around unaware!!

And to think that this is not that bad, because herpes is a manageable condition?? How disingenuous. Is this the best that public health can do?

Notice how STDs are now called STIs? I’m sorry, but they are diseases.

And to say that there’s nothing we can really do about it because humans are pleasure seeking creatures, and it’s unrealistic to abstain from sex completely?

What do we do?? Maybe they’re right; we can’t realistically hope to abstain completely. The only other choice is to teach our young people to be marriageable earlier, but I digress…

My recent thoughts have led me to prepare for marriage by not risking myself anymore. It is too big of a risk for me to have sex casually, when marriageability is at stake. I have turned around from my previous thoughts a year ago.

 

[MJJean]

This is the thing that shocks me. And to think that the average number of sex partners a person has had by age 30 is ten! So statistically, the average person has had sex with one or two herpes sufferers by the time he is 30. The average person has exposed himself to the virus!!

Yup. If anyone is contemplating having pre-marital sex or divorcing just go to the CDC and look at STD’s. Those pages are enough to make one happy to be celibate or married.

And scarier is the fact that 90% of those with herpes aren’t aware of it. So assuming 20% of America has herpes, about 18% of Americans are walking around unaware!!

And to think that this is not that bad, because herpes is a manageable condition?? How disingenuous. Is this the best that public health can do?

Well, to be fair, it’s not the CDC or any other government agency’s fault people make bad choices. What else can public health officials do that they aren’t to convince people to either abstain or at least make informed choices? The CDC info is taught in schools (at least here they have a whole STD pamphlet they hand out to the kids in sex ed including public health office locations that perform STD tests for free), and the same info is available at the health department and online. I don’t think people don’t know he risks, I think they tend to simply believe it will never happen to them…until it does.

Notice how STDs are now called STIs? I’m sorry, but they are diseases.
Heck, I’m old enough to remember my mom calling it VD…

And to say that there’s nothing we can really do about it because humans are pleasure seeking creatures, and it’s unrealistic to abstain from sex completely?
At least the CDC mention abstaining or at least being monogamous. I don’t think it’s unrealistic to abstain completely, but I do think that in our current culture it’s not very likely that most people will abstain. There’s really more of a social stigma to remaining a virgin into adulthood than there is for those that are promiscuous. I remember being in freshman year of HS and having people think I was “off” because I hadn’t had sex yet. I became sexually active at 15 and most of my friends thought I was a late bloomer. Thankfully, neither myself or my husband contracted any diseases. And for that we sincerely thank God.

What do we do?? Maybe they’re right; we can’t realistically hope to abstain completely. The only other choice is to teach our young people to be marriageable earlier, but I digress…

I agree. First, it is rather unrealistic to expect those in their sexual prime to abstain completely. Why shouldn’t the 20 somethings be marrying? College? Student Load debt? Yeah, turns out you can be married and continue your education and that education doesn’t have to include a mountain of debt. This extended adolescence thing makes me nutty. It’s almost as if childhood became this time of being completely taken care of until you graduate college instead of a time when you’re cared for by the adults AND taught what you need to know to be an adult by the time you’re legally an adult. I kid you not, I don’t know a single teen besides mine that know how to cook, clean, and use envelopes or go online to pay bills, budget and do simple household repairs. Sure, education is important, but so is learning the other real life skills needed to be grown and married. I think a lot of parents are dropping the ball there. They figure the kid can learn about all that dreary adult stuff later. Later happens to be when they’re 25!

My recent thoughts have led me to prepare for marriage by not risking myself anymore. It is too big of a risk for me to have sex casually, when marriageability is at stake. I have turned around from my previous thoughts a year ago.

Good for you! And good for your future spouse and kids. Remember, STD’s can transmit to the child during pregnancy and birth. There are medications that can help prevent the spread of some STD’s to babies, but they aren’t 100%. Not to mention some STD’s require a c-section delivery to prevent exposing the baby. It’s not just about the spouses, it’s something that can cause serious issues during and after pregnancy, too.

Additionally, a lot of people are asymptomatic and don’t realize they have an STD until it’s caused them fertility issues.

 

[thewanderer]

The Catechism and Humanae Vitae teach the immorality of contraception.

The pill is medical treatment in some circumstances. Condom is not a medical treatment.

Mind you, there is the odd theologian (eg. Ron Conte) who rejects the use of the pill as medical treatment. I will try to provide a link to his analysis and to the contrary view, later.

I know that contraception, when used as contraception is wrong, but if the contraceptive effect is simply an unintended side-effect then the principle of double-effect can come into play. The whole point though is that the pill is moral because it is not being used as contraception. But in this case the condom is also not being used as contraception, so I just don’t understand why the principle of double-effect wouldn’t still apply.

 

[thewanderer]

I imagine the difference between the pill and condoms is that the pill can be used as medicine for disease in a context that has nothing to do with sex (the woman would be taking it even if she didn’t have a partner) but condoms are only used to make sex less risky. Which can be done by abstaining.
Of course I could be wrong.

I think I see what you’re saying… but I still don’t see why the principle of double effect doesn’t apply.

 

[thewanderer]

That was my thought, as well.

The Pill, other hormone treatments, and surgical treatments that reduce or eliminate fertility are being used to correct a problem within the body outside of sex. The reduced or eliminated fertility are truly unfortunate side effects of the treatment.

In the case of condom use, the condom is not treating a disease. It is an attempt to prevent the spread of a disease. Yet the user can prevent the spread of the disease by abstaining from sex, by seeking out a spouse among those who already have the same disease, or by finding a spouse willing to share the disease.

What about a faithful couple where one spouse becomes infected due to an accident working in a hospital with contaminated bodily fluids? The couple is already married, and having marital relations is a positive good. The only way they can attain that good end while also preventing further spread of the disease is through condom use. So, when I look at how the principle of double effect works and compare it to this situation I see a good effect and a bad effect, building up and supporting the marriage through marital relations without spreading disease vs lack of fertility. The good effect does not rely on the bad effect and the good effect is proportional to the bad effect. And, since we know from the pill that so called “contraceptives” are only considered to be contraceptives according to Catholic moral theology if the contraceptive effect is intended and desired we know that the means is not inherently immoral so long as the contraceptive effect is not desired or intended. So I still just have a hard time seeing why this would be wrong according to Catholic moral theology.

 

[jmcrae]

I think I see what you’re saying… but I still don’t see why the principle of double effect doesn’t apply.

That would be a question for the affected parties to discuss in private with a priest. I really don’t think it makes sense to try to come up with a “one size fits all” answer on the Internet.

The general principle is that condoms disrupt the unity between husband and wife, by placing a physical barrier between them.

Anything beyond that is way above the pay grade of anyone out here in the wilds of the Internet. Specific cases need to be discussed with a priest, with the door closed, and realizing that advice given to you isn’t necessarily advice for the whole world to follow.

 

[Rau]

I know that contraception, when used as contraception is wrong, but if the contraceptive effect is simply an unintended side-effect then the principle of double-effect can come into play. The whole point though is that the pill is moral because it is not being used as contraception. But in this case the condom is also not being used as contraception, so I just don’t understand why the principle of double-effect wouldn’t still apply.

The contrary argument is that contraception is always contraception - the act is intrinsically that - quite apart from the purposes or intentions for which it is pursued.

The Theologian Ron Conte makes that case in a number of posts on his blog:
ronconte.wordpress.com/2014/10/05/the-birth-control-for-a-medical-purpose-question/

ronconte.wordpress.com/2012/02/03/catholic-answers-forums-promotes-abortifacients/

ronconte.wordpress.com/2011/02/04/can-a-catholic-married-woman-use-the-birth-control-pill-for-a-medical-purpose/

His argument is that the moral object of the Act (be it taking the Pill or wearing a condom **and **having sex) is evil (depriving the marital act of its procreative meaning), and thus the Act is immoral.

Note that the principal of double effect is a tool for evaluating the morality of an act against the criteria set out here:
vatican.va/archive/ccc_css/archive/catechism/p3s1c1a4.htm

It is not itself doctrine.

The USCCB provides this Q&A
*
Q: Is there ever a time “contraceptives” may be used for medical reasons?*

Catholic teaching does not oppose the use of hormonal medications – such as those found in chemical contraceptives – for legitimate medical purposes, provided there is no contraceptive intent.

But artificial hormones typically treat only the medical symptoms. They do not correct the underlying disease or condition. They also carry the same physical health risks as hormonal contraceptives.

Thankfully, with growing advancements in understanding fertility, knowledgeable gynecologists can often prescribe non-contraceptive drugs and recommend safer and healthier treatments to correct underlying problems or eliminate discomfort.
Source: usccb.org/beliefs-and-teachings/what-we-believe/love-and-sexuality/index.cfm#medical

Delightfully vague, since it does not reference marital relations, but it is hard to imagine they are not assumed.

Humanae Vitae

Conte notes that HV, quoted below, is regularly used to claim contraceptive drugs for medical purposes is OK, and then he argues it does not say that:

*Pope Paul VI: “On the other hand, the Church does not consider at all illicit the use of those therapeutic means necessary to cure bodily diseases, even if a foreseeable impediment to procreation should result there from — provided such impediment is not directly intended for any motive whatsoever.” (Humanae Vitae, n. 15.)*Conte:
*This passage only permits a moral means to be used toward a moral end. It is not an exception to the magisterial teaching that the end does not justify the means. The phase “provided such impediment is not directly intended” excludes any intrinsically evil means (second font of morality) to the end of curing or treating medical disorders, no matter what the motive (first font of morality). Every intrinsically evil act is an intentionally chosen act that is inherently and directly ordered toward an evil end (its moral object). But the intended end or purpose or motive for which the act is chosen cannot justify the intentional choice of an intrinsically evil act.

Thus the passage specifically condemns what they use the passage to claim to justify. The good intended end of treating a medical disorder does not justify the choice of an intrinsically evil means, nor does it cause that intrinsically evil means to become not intrinsically evil.*

The interpretation of Paul VI by Conte is a bit hard to make sense of. I think he is saying (that Paul VI is saying…) that receiving a medical treatment - I don’t know - say, radiation therapy for a cancer, that has as a side-effect, the halting of the menstrual cycle, while carrying on marital relations, would not be sinful, but taking a pill which by design halts the menstrual cycle, while conveniently treating another condition, is a different matter. That is, the former is not contraception, but the latter is. Put another way - the latter is “I am choosing a contraceptive act for the spin-off benefit”.

Interestingly, the USCCB extract seems OK with choosing the contraceptive treatment, so long as that is not why you choose it. I assume Conte would take issue with this.

 

[Rau]

That would be a question for the affected parties to discuss in private with a priest. I really don’t think it makes sense to try to come up with a “one size fits all” answer on the Internet.

I understand no one is actually asking for direction to apply in their circumstances.

I believe the morality of the contemplated Act ought to be discoverable in an abstract discussion.

 

[thewanderer]

Interestingly, the USCCB extract seems OK with choosing the contraceptive treatment, so long as that is not why you choose it. I assume Conte would take issue with this.

I will go with the USCCB over Ron Conte any day. This is not the only argument of his that I have problems with. But thanks for bringing up all the different views about the subject, its always good to hear what different people have to say on a difficult topic.

 

[Rau]

I will go with the USCCB over Ron Conte any day. This is not the only argument of his that I have problems with. But thanks for bringing up all the different views about the subject, its always good to hear what different people have to say on a difficult topic.

Does Conte make an error in his analysis? What problem do you have with his analysis (as opposed to the conclusion)?

 

[Rau]

…
Interestingly, the USCCB extract seems OK with choosing the contraceptive treatment, so long as that is not why you choose it. I assume Conte would take issue with this.

I should add that I think the USCCB answer to the question is poorly expressed. Moral theology is crystal clear that intrinsically wrong acts can’t be made moral when motivated by a suitably good Intention. Yet it almost seems that they are implying the morality hangs on the Intention. I’m sure they don’t mean that.

Contraception is intrinsically evil. The issue hangs on whether our hypothetical couple have contracepted.

 

[thewanderer]

Does Conte make an error in his analysis? What problem do you have with his analysis (as opposed to the conclusion)?

My issue is with his premise that it is sinful whether or not the intention is to avoid conception.

 

[thewanderer]

I should add that I think the USCCB answer to the question is poorly expressed. Moral theology is crystal clear that intrinsically wrong acts can’t be made moral when motivated by a suitably good Intention. Yet it almost seems that they are implying the morality hangs on the Intention. I’m sure they don’t mean that.

Contraception is intrinsically evil. The issue hangs on whether our hypothetical couple have contracepted.

Exactly, and from other generally accepted explanations I cannot see why it is considered immoral to use condoms solely for the sake of preventing disease. However, seeing as it is generally accepted that this would be wrong and immoral I am hesitant to assume that I am right in thinking that. However, I definitely do not understand why it would be immoral if it is not immoral to use the pill for medication, or even the morning after pill after a rape so long as the woman has not ovulated, both of which seem to be accepted as moral.

 

[Xantippe]

Exactly, and from other generally accepted explanations I cannot see why it is considered immoral to use condoms solely for the sake of preventing disease. However, seeing as it is generally accepted that this would be wrong and immoral I am hesitant to assume that I am right in thinking that. However, I definitely do not understand why it would be immoral if it is not immoral to use the pill for medication, or even the morning after pill after a rape so long as the woman has not ovulated, both of which seem to be accepted as moral.

For the morning after pill, it’s not interfering with lawful intercourse between husband and wife.

Similarly, encouraging HIV positive prostitutes to use condoms with married clients or encouraging HIV positive gay men to use condoms is not interfering with lawful intercourse between husband and wife.

This may be a somewhat speculative piece of theology (one of my close friends works in this area), but under this argument, the essential question is whether or not the contraception is messing with marital unity and fertility. (And of course there is double effect for use of the birth control pill, which is a much more established piece of moral theology.)

 

[Rau]

Exactly, and from other generally accepted explanations I cannot see why it is considered immoral to use condoms solely for the sake of preventing disease. However, seeing as it is generally accepted that this would be wrong and immoral I am hesitant to assume that I am right in thinking that. However, I definitely do not understand why it would be immoral if it is not immoral to use the pill for medication, or even the morning after pill after a rape so long as the woman has not ovulated, both of which seem to be accepted as moral.

There are several issues there. The case of Rape for instance…it is moral to interfere with the progression towards conception that follows a rape because that progression is in fact part of the rape, and it is entirely proper to intervene. The rape is an assault, and it is proper to repel it at all stages. Rape is not a unitive act requiring openness to procreation. The acts performed as intervention (administering drugs etc) are not directly contraception - they are an intervention in a rape. You might say they are indirectly contraceptive. [By the same logic, it is also entirely proper for a woman being raped to beg the aggressor to wear a condom.]

This highlights the difficulty sometimes faced in identifying the moral object of an Act.

Conte reasons that the moral object of an Act involving marital relations and the taking of a contraceptive pill (for any reason) is the deprivation of the procreative aspect of marital relations, and that result is wilfully chosen. [One could abstain from sex and avoid making such a choice.]

In another post, on another thread, he writes:
*If the chosen act is **ordered toward *thwarting the procreative meaning of sexual acts, then the act is direct contraception and is intrinsically evil. The Magisterium clearly teaches that contraception is immoral regardless of whether it is chosen as an end (for a contraceptive purpose or intention), or as a means to a good end (a purpose or intention that is not contraceptive). Source: forums.catholic-questions.org/showpost.php?p=9732093&postcount=58 Note the expression “ordered toward”, rather than a reference to “Intentions” (since intentions cannot change the moral object.)

 

[Rau]

…(And of course there is double effect for use of the birth control pill, which is a much more established piece of moral theology.)

Established by whom exactly?

While the licitness of the above is often quoted, be it by Apologists on this site, or even in the Q&A on the USCCB site, I am yet to read a well expressed piece of analysis that demonstrates the morality of marital relations while taking the contraceptive pill (for a medical purpose). The Conte analysis I linked above is of the right kind of analysis, but arrives at the reverse conclusion.

 

[Ron_Conte]

Sorry for entering this discussion rather late.

The USCCB text is not an act of the Magisterium. It is a website FAQ. There’s a bias sometimes in online discussions where people give excess weight to a source whose views they like, and too little weight to magisterial documents.

Veritatis Splendor and the CCC and the USCCB are very clear on intention, moral object, and circumstances.

1. intention: the purpose or end chosen by the subject
2. moral object: the end toward which the act itself is inherently ordered
3. circumstances: the reasonably anticipated consequences of the act

USCCB: “Every moral act consists of three elements: the objective act (what we do), the subjective goal or intention (why we do the act), and the concrete situation or circumstances in which we perform the act… All three aspects must be good – the objective act, the subjective intention, and the circumstances – in order to have a morally good act.” [United States Catholic Catechism for Adults, U.S. Conference of Catholic Bishops, July 2006, p. 311-312.]

CCC: “Legitimate intentions on the part of the spouses do not justify recourse to morally unacceptable means (for example, direct sterilization or contraception).” CCC 2399

VS: circumstances or intentions can never transform an act intrinsically evil by virtue of its object into an act “subjectively” good or defensible as a choice. [VS 81]

A common point of confusion concerns intention and the moral object. The intention is in the subject, the person who acts; it is the end chosen by the person. The moral object is inherent to the chosen act itself; it is intrinsic to the moral nature of the act. Hence, when a moral object is bad, the act is termed intrinsically evil or inherently wrong.

However, every intrinsically evil act must be intentionally chosen (deliberately chosen). For the will is involved in all three fonts of morality. Direct abortion is condemned by the Church because the intrinsically evil act of killing the innocent is intentionally chosen. But direct abortion is condemned regardless of whether it is the end or the means. Therefore, even when direct abortion is chosen for a medical purpose, such as to save the life of the mother, it is gravely immoral.

The same applies to abortifacient contraception. The good end of treating a medical disorder is a lesser good than saving the life of the mother. And the good end is attainable without killing the unborn by using the medication while refraining from marital relations. So in no way is abortifacient contraception (while sexually active) justified by a medical purpose.

Having marital relations is far less important than protecting the lives of the unborn. A married couple cannot justify using abortifacient contraception, while sexually active, for any purpose or intended end.

 

[Rau]

The same applies to abortifacient contraception. The good end of treating a medical disorder is a lesser good than saving the life of the mother. And the good end is attainable without killing the unborn by using the medication while refraining from marital relations. So in no way is abortifacient contraception (while sexually active) justified by a medical purpose.

Having marital relations is far less important than protecting the lives of the unborn. A married couple cannot justify using abortifacient contraception, while sexually active, for any purpose or intended end.

Taking avoidable risks with another human life to manage acne (or even something more serious) cannot be a right judgement.

But can we take a few more steps forward by removing the “abortifacient” element from the medication being taken. I would appreciate your consideration (analysis of the morality based on the 3 fonts) of 2 real-world (though made up) scenarios.

1. A woman has a non-trivial medical condition. The only effective treatment also has the effect of preventing ovulation. She takes the medication. May she and her husband engage in marital relations while taking this medication?
2. A man contracts a serious communicable STD. He believes it is inappropriate to have marital relations with his wife due to the risk of infecting her. He is receiving treatment, but the risk of infecting his wife will remain. May this couple utilise a condom to eliminate the risk of infection transfer.