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FAMILY VALUES VERSUS SAFE SEX A Reflection by His Eminence, ALFONSO CARDINAL LÓPEZ TRUJILLO
MAIN POINTSThe Catholic Church’s Criticism of the Condom in AIDS-Prevention Programmes The Same Concern, from non-Ecclesiastical Circles Condom Failure and its Latex Material HIV/AIDS Increase and Decrease with Condoms and Chastity, Respectively The Right to Correct and Complete Information The Church Promotes Life, Through a Real Protection from HIV/AIDS and STD’s The Need to Rediscover Truly Responsible Sexual Behaviour Conclusion: The Need to Strengthen Marriage and the Family
Introduction1.
The mass media have circulated news that I granted
an interview to the BBC, which was broadcasted last October 12, 2003,
on the eve of Pope John Paul II’s 25th Anniversary in his service as Bishop
of Rome. On that occasion, I answered different questions for more than an
hour, especially those dealing with the family. But, surprisingly, what was
shown from the whole interview on the BBC Panorama’s film, Sex & The
Holy City, were merely three questions of less than half a minute each,
the answers to which were certainly much more complete. The program
apparently tried to deliberately and systematically criticize the Catholic
Church for supposedly contributing to the death of people by not allowing the
use of condoms to prevent the spread of HIV/AIDS. The bishops of England and Wales have rightly
complained to the BBC for that film, which, along with another program, was
“biased against and hostile to the Catholic Church”, and which has “given
offence to many Catholics… For many decades the BBC has deserved [and]
enjoyed a worldwide reputation for fairness and objectivity, especially in
its News and Current Affairs. This reputation is increasingly tarnished.”[1][1] Many individuals and groups also manifested their
disgust with the said BBC’s Panorama program.[2][2] In that interview I warned about “safe sex”, stating that one cannot
truly speak of objective and total protection by using the condom as a
prophylactic,[3][3] when it comes to the transmission not only of
HIV/AIDS (Human Immunodeficiency Virus, which causes the Acquired Immune
Deficiency Syndrome), but also of many other STD’s (Sexually Transmitted
Diseases). I emphasized that in order to control the pandemic, it is
necessary to promote responsible sexual behaviour that is inculcated by means
of authentic sexual education, that respects the dignity of man and woman,
and that does not consider others as mere instruments of pleasure and thus
objects “to be used”. I also said that such responsible sexual behaviour
takes place only in conjugal love, assuming the responsibilities of marriage
as a reciprocal, exclusive and total self-giving of a man and a woman in a
community of love and life. Therefore, my position was absolutely clear against the so-called
inordinate sex, against promiscuity that is fuelled today by certain
permissive political measures and certain means of communication. That is why
I reminded the audience that the Church teaches a moral position that is
valid for all, both believers and non-believers. I also proposed that the
Ministries for Health should require labels for condoms, as they do in the
case of cigarettes, stating that the protection condoms provide is not total,
and that the risks are indeed significant.[4][4] In order
to stress that the level of protection provided by the condom against
HIV/AIDS and STD’s is not sufficient, I also referred to a certain
permeability suggested by the results of scientific investigations. Such
concern also has to be given attention considering that the AIDS virus is 450
times smaller than the sperm cell – in addition to other risks brought about
by different factors in the condom’s structure and in its actual usage.[5][5] The Catholic Church’s Criticism of the Condom in AIDS-Prevention Programmes2. The Catholic Church has repeatedly criticized programs promoting condoms as a totally effective and sufficient means of AIDS prevention. The different Bishops’ Conferences all over the world have expressed their concern regarding this problem. The Catholic Bishops of South Africa, Botswana and Swaziland categorically “regard the widespread and indiscriminate promotion of condoms as an immoral and misguided weapon in our battle against HIV/AIDS for the following reasons. * The use of condoms goes against human dignity. * Condoms change the beautiful act of love into a selfish search for pleasure – while rejecting responsibility. * Condoms do not guarantee protection against HIV/AIDS. * Condoms may even be one of the main reasons for the spread of HIV/AIDS. Apart from the possibility of condoms being faulty or wrongly used they contribute to the breaking down of self-control and mutual respect.”[6][6] The Sub-commission for Family and Life of the Spanish Episcopal
Conference said that the campaigns that promote the condom in Spain to
supposedly stop HIV/AIDS are gravely irresponsible for three reasons:
“because they tend to be deceitful, because they hide information, and
because they do not contribute towards prevention, but rather to a greater
spread of risky behaviour, since they imply that the health authorities are
giving their approval to behaviour and lifestyles that are responsible for the
epidemic”.[7][7] The Catholic Bishops’ Conference of the Philippines maintained that
while “an encounter with people infected with HIV-AIDS should be a moment of
grace – an opportunity for us to be Christ’s compassionate presence to them
as well as to experience His presence in them”, nonetheless, [t]he moral
dimension of the problem of HIV-AIDS urges us to take a sharply negative view
of the condom-distribution approach to the problem”. Besides, “[a]s in
contraception, so also in preventing HIV-AIDS infection condom use is not a
failsafe approach”.[8][8] Even earlier, the bishops of the
United States of America affirmed in their 1987 statement: “ … abstinence
outside of marriage and fidelity within marriage as well as the avoidance of
intravenous drug abuse are the only morally correct and medically sure ways
to prevent the spread of AIDS. So-called safe sex practices are at best only
partially effective … As the National Academy of Sciences has noted in its
study of AIDS, ‘many have argued that it is more accurate to speak in terms
of ‘safer’ sex because the unknowns are still such that it would be
irresponsible to certify any particular activity as absolutely safe’”.[9][9] 3.
I thought that the Church’s position and the
reasons behind it were already well-known. I am quite concerned because
people, especially the young, are misled when total protection is seemingly
offered to them, while in fact there is no such total protection. Aware of the
immensity of the pandemic, while at the same time maintaining the different
but complimentary levels of what is moral and what is merely hygienic, I
wanted to speak out regarding the need not only to contain the continuous
expansion of this pandemic, but also the need to prevent condom users from
getting an infection that they previously thought was impossible to get, and
which until now has had lethal consequences. There are persons at risk of being contaminated, even though they think
that their sexual relations, from the hygienic point of view, are totally
safe. How many fall victim to this error? They would have taken a different
attitude, at least to a certain extent, had they been given more valid and
objective information. Indeed, a great number of sources giving the correct
information on condom ineffectiveness are public, but, apparently many are
not well publicized. The mere fact that this discussion has led persons to
doubt to a certain extent the effectiveness of condoms in preventing
infection is already, I think, a timely service. The reader is invited
above all to reflect why, despite the invitation to promiscuity made by the
“safe sex” campaign and the distribution of an enormous quantity of
prophylactics where the pandemic is more widespread, the problem of infection
has become even greater.[10][10] These are precisely the points I wish to consider in this present
reflection, with the aid of information gathered from different sources. I
have no reason to doubt the expertise of persons and institutions with
internationally renowned competence on these matters. The position of the
Church is truly human and responsible: it is a call to fully respect the
human person’s freedom and dignity. The family suffers, above all in the poor
countries. The fact that families and youth are oftentimes misinformed and
given false security should not be tolerated any longer. It is clear that if
I make this reflection, it is because of the close relationship between
family and procreation, and also because matters regarding the family
touching on condoms and other contraceptives pertain to our field of work. In
describing the tasks of the Pontifical Council for the Family, the Apostolic
Constitution Pastor Bonus states that it “strives to ensure that the rights of the
family be acknowledged and defended even in the social and political realm.
It also supports and coordinates initiatives to protect human life from the
first moment of conception and to encourage responsible procreation.”[11][11] As a Father of the Church said, “We should not be ashamed of the things
that God has created”. Not only should we not be ashamed of things
created by God, we should also defend them, for everything that he has
created is good. Human sexuality, conjugal love, responsibility, freedom,
bodily health: these are God’s gifts to us that we have to treasure. The Concern of some Moralists Raised by Studies Indicating that Condoms might not Provide Total Protection against the Transmission of HIV and STD’s4.
I mentioned earlier that I thought the position of
the Church and the foundations of my assertions were already well-known. On
the other hand, it might also be possible that this position is still unknown
to many, as manifested in concrete campaigns where scientific aspects are mixed
with certain economic interests on the part of condom producers, and with an
“ideology” of the powerful against the poor in line with “population control”. A well-known and authoritative moralist, Dionigi Tettamanzi, who is now
the Cardinal of Milan, tackled these matters in a voluminous book, Nuova
bioetica cristiana, published in 2000. He clearly shows why the condom
cannot guarantee the so-called “safe sex” when used as a prophylactic. “The
Ministry of Health [in Italy], through the National Commission for the fight
against AIDS, often supplies the following information to children, youth,
and other interested parties: ‘The chances of contamination increase with
more unprotected intercourse; thus, if you are not sure of your partner, always
use a condom’[12][12] But is the condom truly an effective means to stop contamination? Some
critical reflections become necessary. a) The first reflection is of a properly
hygienic nature. It is said that the condom is to be used as a ‘defense’ measure,
as a ‘barrier’ so as not to contaminate and be contaminated during sexual
intercourse. Now, what is at stake, that is, caring for one’s health (and
life) and another’s, calls for an accurate critical analysis of the real
efficacy of this defensive means or barrier. “There are two types of efficacy that could be considered in
particular. First, ‘technical’ efficacy: since when did the condom
‘prevent’ the risk of contamination? In scientific circles, it is openly
admitted that condoms are in fact not 100% safe. On an average, it is said
that there is a 10-15% inefficacy, since the AIDS viruses are much more
‘filtrating’ [able to pass through] than the sperm.[13][13] Therefore, even at a ‘technical’ level of efficacy, one should
question the scientific seriousness and the consequent professional
seriousness of the condom campaign. There is a great risk involved: to
‘deceive’ persons by propagating ‘safe sex because one is protected’, while
in fact it is not safe, or is not safe in the way it might be thought to be.
The illusion becomes much more dangerous and serious when there is an even
greater duty for persons ‘at risk’ or who indulge in promiscuous sexual
relationships not to spread the infection (both to the partner and,
eventually, to present or future children).’” [14][14] 5. Another Italian moralist, Elio Sgreccia,
currently a bishop and Vice-President of the Pontifical Academy for Life,
wrote that campaigns based only on the free distribution of condoms, “can
become not only fallacious, but counterproductive and encourage… the abuse of
sexuality; at any rate, they are devoid of truly human content and do not
contribute to holistically responsible behaviour.”[15][15] Many other moralists and experts also tackled
these questions, including Lino Ciccone and Jacques Suaudeau, some of whom
will also be cited in this paper. Cardinal Tettamanzi further notes along this line that it is totally
unacceptable for the State to organize and promote “safe sex” campaign,
because of the lack of efficiency of condoms as a “barrier” against
infection, and especially because of the danger of an irresponsible use of
sexuality. For instance, when a soldier receives a condom, he knows that he
should avoid contamination; but at the same time he is being induced to
believe that any form of sex is licit. To these considerations one must add
the risks to an individual’s freedom of choice: when the “safe sex” campaign
is undertaken in such a way that it exerts undue pressure on youth and on the
public in general, together with an illusion of the condom’s efficiency, it
becomes tantamount to an imposition.[16][16] There is a paradox here in that the State (which
claims to be neutral) is allowed to actively propagate and spread
contraceptives, while it would be accused of being denominational if it
undertook an educational campaign on the value (including hygienic) of
marital fidelity![17][17] The Same Concern, from
non-Ecclesiastical Circles
6.
The concern that
condoms do not provide total protection against AIDS and STD’s is not at all
new, nor limited to Church circles. Dr. Helen Singer-Kaplan, who founded the
Human Sexuality Program at the New York Weill Cornell Medical Center, Cornell
University, wrote in her book, The Real Truth about Women and AIDS:
“Counting on condoms is flirting with death”[18][18]. A Dutch medical journal also stated that,
“Practice shows that there is a great need for a method that prevents both
HIV as well as pregnancy. Sad to say, the people still have not become aware
that this method cannot be the condom”.[19][19] In the 1980’s and the 1990’s, questions on the
real protection provided by condoms arose from electron microscopic studies
on the latex material, a concern related to the fact that the AIDS virus is
about 25 times smaller than the sperm cell’s head, 450 times smaller than the
sperm cell’s length, and 60 times smaller than the syphilis bacterium.[20][20] In 1987, the Los Angeles Times published an article entitled, Condom
Industry Seeking Limits on U.S. Study.[21][21] It stated that “[t]he condom industry has
launched an intensive campaign to weaken, delay or possibly shut down a
federally funded Los Angeles study of the effectiveness of condoms in
preventing transmission of the AIDS virus… The research has taken on a new
element of urgency in the wake of a series of questions raised about the
ability of condoms to reliably prevent the spread of human immunodeficiency
virus (HIV)”.[22][22] Two years later, the same reporter wrote in an
article, 4 Popular Condoms Leak AIDS Virus in Clinical Tests, that
“Four of the nation’s most popular condom brands permitted the AIDS virus to
escape in laboratory tests conducted for UCLA, prompting researchers to warn
users they should not assume that all condoms work equally well in preventing
spread of the disease… Overall, among the thousands of condoms tested, the
study found that 0.66% of condoms--more than one of every 200--failed, either
allowing water or air to escape, breaking in tensile strength tests or
leaking the AIDS virus.” [23][23] As a summary of these and other
studies, Dr. John Wilks stated the following in his Letter to the Editor in
the Nov 17, 2003, issue of The Australian: “In 1989, the Los
Angeles Times reported that four of the nation’s most popular condom
brands permitted the AIDS virus to escape in laboratory tests conducted for
UCLA, … Carey and associates (‘Sexually Transmitted Diseases’, 1992) reported
that HIV-sized particles leaked through 29 of 89 commercially purchased latex
condoms in simulated intercourse… Voeller (‘AIDS Research and Human
Retroviruses’, 1994) reported that leakage of virus-sized particles occurred
in different brands of condoms of different ages at a rate of 0.9 per cent to
22.8 per cent in the laboratory setting… Lytle and others (‘Sexually
Transmitted Diseases’, 1997) reported that under test conditions, 2.6 per
cent of latex condoms allowed some virus penetration…”. In still another
test, only 30% of membrane samples from “Trojan” brand condoms were found to
be absolutely without defects.[24][24] It should be stated that the
remaining 10-30% from these figures, which represent the failure range, is
relatively high when one deals with a potentially mortal disease such as
AIDS, especially if there is an alternative that provides absolute protection
against the sexual transmission of the same: namely, abstinence before
marriage, and fidelity to one’s spouse. Given that AIDS is a serious threat, any inadequate information based
on false security offered by condoms used as prophylactics would be a grave
irresponsibility. Hence, a continuous effort to present the correct
information clearly and comprehensively, avoiding all ambiguities and
confusion, is certainly called for – not only for the benefit of the public
in general, but also in order to help the sincere and countless efforts to
prevent the pandemic of AIDS and the other sexually transmitted diseases. The Workshop Summary:
Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease
(STD) Prevention
7.
The above cited medical literature and many others
have opened several questions regarding condom effectiveness in preventing
sexually transmitted diseases. In fact, on June 12-13, 2000, four US
government agencies responsible for condom research, condom regulation,
condom use recommendations, and HIV/AIDS and STD prevention programs
co-sponsored a Workshop precisely “to evaluate the published evidence
establishing the effectiveness of latex male condoms in preventing HIV/AIDS
and other STDS”. The four agencies were the US Agency for International
Development (USAID), Food and Drug Administration (FDA), Centers for Disease
Control and Prevention (CDC), and the National Institutes of Health (NIH).
The Workshop Summary: Scientific Evidence on Condom Effectiveness for
Sexually Transmitted Disease (STD) Prevention was later prepared by the
National Intitute of Allergy and Infectious Diseases, the National Institutes
of Health, and the Department of Health and Human Services, and was published
on July 20, 2001.
[27][27] The Workshop’s focus was on
“the latex male condom for the prevention of HIV/AIDS and STDs during
penile-vaginal intercourse”. “Representatives of the sponsoring agencies and
outside experts were asked to work as a panel”, including experts on “STDs,
genitourinary tract anatomy, contraception, condoms, behavioral science,
epidemiology, medicine and public health”. “The workshop examined only
peer-reviewed literature [a total of 138 papers] because these studies have
been subjected to independent scientific evaluation prior to publication.” An
additional 42 other papers are cited in the Workshop Summary.[28][28] The said Workshop Summary
explains that available scientific
evidence indicated that the condom reduces the risk of AIDS/HIV by 85%.[29][29] There is then a 15% risk
that remains. The Workshop also studied
in particular the transmission of other genital infections, and the usual
conclusion is that studies demonstrated either no or some protection
through condom use, or that there is insufficient data to confirm risk
reduction. The diseases studied individually are the following: Gonorrhea (caused
by Neisseria gonorrhoeae), Chlamydial infection (Chlamydia
trachomatis), Trichomoniasis (Trichomonas vaginalis), Genital Herpes (Herpes Simplex
Virus or HSV), Chancroid (Haemophilus ducreyi) and Syphilis (Treponema
pallidum).[30][30] The Human papillomavirus (HPV) is given some more attention, with the
conclusion stating clearly that “[t]here was no evidence that condom use
reduced the risk of HPV infection…”[31][31]. HPV is a very important STD associated with
cervical cancer, which in the US kills many more women than the HIV.[32][32] There is no such thing then as a
100% protection from HIV/AIDS or other STD’s through condom use today. This
data should not remain unnoticed, since many users, including youth, think
that the condom provides total protection. 8.
In an article subsequent to the Workshop Summary,[34][34] four of the Workshop panel members, along
with other experts, further analyse points and issues stemming from this Workshop,
such as the definition of terms,[35][35] risk prevention (i.e., provides absolute
or total protection) versus risk reduction (i.e., provides partial
protection),[36][36] cumulative risk, factors that influence condom
effectiveness[37][37] and public health implications. Condom Failure and Pregnancy
9. Most probably related to the condom’s efficiency in preventing the transmission HIV/AIDS and STD’s is its efficiency in preventing pregnancy. The WHO explains that perfect use of the condom does not prevent pregnancy all the time. “Estimated pregnancy rates during perfect use of condoms, that is for those who report using the method exactly as it should be used (correctly) and at every act of intercourse (consistently), is 3 percent at 12 months”[40][40]. Needless to say, the condom’s typical use, which includes perfect and imperfect use (i.e. not used at every act of intercourse, or used incorrectly) is much less effective in preventing pregnancy. “The pregnancy rate during typical use can be much higher (10-14%) than for perfect use, but this is due primarily to inconsistent and incorrect use, not to condom failure”.[41][41] Indeed, pregnancy in spite of
condom use is well documented, with the Pearl index placed at around 15
failures per 100 women years within the first year of use.[42][42] If pregnancy may occur in spite of condom use,
wouldn’t it be only logical to conclude that the condom also allows
transmission of HIV and STD’s, given that the disease-causing organisms may
be present with the sperm cells, in the seminal fluid, and even elsewhere,
such as on skin surfaces not covered by the condom? Moreover, one must
consider that a woman can become pregnant only during her fertile days
(approximately 5-8 days in a cycle, taking into account the sperm’s lifespan
inside her body), while the HIV and STD’s may be transmitted on any day. Condom Failure and its Latex Material10. The above considerations on studies pointing towards condom failure
are not limited to theoretical arguments. That
condoms may be defective is not mere theory, but a fact confirmed by
real-life experiences in the real world. One may perhaps assume that in the
condom’s ideal or perfect state, that is, with a surface with no defects
whatsoever, the latex material theoretically might provide a high degree of
protection against the passage of HIV-sized particles. However, when it comes
to the actual or real state of latex materials, in distributed items such as
condoms, the situation could be quite different. For instance, some permeability and electric tests indicate that latex
may allow passage of particles bigger than the HIV.[43][43] Likewise, holes and weak spots in condoms may be
detected by tests, as can be seen in a 1998 article on the US Food and Drug
Administration website. “Condom manufacturers in the United States
electronically test all condoms for holes and weak spots. In addition, FDA
requires manufacturers to use a water test to examine samples from each batch
of condoms for leakage. If the test detects a defect rate of more than 4 per
1,000, the entire lot is discarded. The agency also encourages manufacturers
to test samples of their products for breakage by using an air burst test in
accordance with specifications of the International Standards Organization.”[44][44] If four leaking condoms are allowed in every
batch of 1,000, there could be hundreds of thousands or even millions of
leaking condoms circulating all over the world, either sold or distributed
for free, and most probably contributing to the spread of HIV/AIDS and STD’s.
Does the public know this? Does the public know that the risks increase the
more often and the more promiscuously one is exposed, considering the
cumulative risk factor, as explained earlier? 11. Condoms, in addition to having possible manufacturing defects, could undergo deterioration during shipping, handling and storage, and even further degradation after purchase by the end user. To a greater or lesser degree, factors such as the following have been proposed as possibly contributing to the degradation of latex (and thus to condom failure): exposure to sunlight, heat (including body heat when placed in pockets or wallets), humidity, pressure, certain spermicides and even to atmospheric ozone.[47][47] Besides, the condom may still suffer last-minute physical damage immediately prior to or during actual use, such as contact with pointed or sharp objects including fingernails. The US Food and Drug
Administration (FDA) website warns that, “[c]onsumers
should make sure the condom package is undamaged, and check each condom for
damage as it is unrolled to be used. The condom should not be used if it is
gummy or brittle, discolored, or has a hole. Condoms also should not be used
after their expiration date or, if they don’t have an expiration date, more
than five years after the date of manufacture. Only water-based lubricants
(for instance, glycerine or K-Y jelly) should be used with latex condoms,
because oil-based lubricants such as petroleum jelly weaken natural rubber.”[48][48] If such precautions exist, it must be because
real dangers also exist – in this case, a life-threatening danger, that would
be irresponsible to simply take lightly. There are also condoms made from
other materials such as polyurethane, which are “comparable
to latex condoms as a barrier to sperm and HIV virus”, and natural membrane (lambskin) condoms, “which are useful in preventing pregnancy, [but] are not effective
protection against HIV or other sexually transmitted diseases. Although sperm
cannot pass through the lambskin material, small microorganisms, including
HIV, can penetrate these condoms”.[49][49] Even in the case of serodiscordant couples, from the medical
perspective, the condom does not seem to be the real answer: among consistent
condom users, there is still the possible transmission of the HIV.[50][50] The Workshop Summary discussed earlier
also says that “[t]here is demonstrated exposure to HIV/AIDS through sexual
intercourse with a regular partner (with an absence of other HIV/AIDS risk
factors). Longitudinal studies of HIV- [negative] sexual partners of HIV+
[positive] infected cases allow for the estimation of HIV/AIDS incidence
among condom users and condom non-users. From the two incidence estimates,
consistent condom use decreased the risk of HIV/AIDS transmission by
approximately 85%.”[51][51] To further promote “safe sex”, some have advised
the use of a double condom, the efficiency of which remains questionable,
taking into account the different factors presented above.[52][52] User-Related Condom Failures
12. Aside from the above considerations on the physical integrity of the condom, one must also remember that condoms are often used improperly. For instance, one might flip the condom over after starting to apply it on the wrong side, allowing sperm, if already present, to be introduced directly into the vagina. Starting intercourse without a condom or taking it off during intercourse, not holding on to the condom during withdrawal, not withdrawing while the penis is erect, reuse of condom, etc., are some other examples of incorrect condom use, which could easily take place. One study shows that in vivo, slipping and rupture of the condom account for 0.1-16.6% and 0.5-6.7% of condom failure, respectively.[53][53] The typical, real-life use of
condoms is far from perfect; it is rather frequently used inconsistently and
incorrectly. This is not difficult to understand, given that consistent use
requires an enormous amount of self-discipline (and memory), and correct use
requires a relatively meticulous 7-step process, if one follows the
guidelines laid down by the Centers for Disease Control and Prevention.[54][54] In one of their brochures, the Medical Institute
(Texas) says, “When given a basic list of procedures for correct condom use,
less than half of sexually active adolescents report they use condoms
correctly”.[55][55] Without going into detail, suffice it to say
that the sexual act, because of its instinctive and passionate aspects, and
at times the absence of a minimum of self-control, brings along with it the
above-mentioned risks before, during and after the use of the condom. The Medical Institute (Texas)
explains the results of inconsistent condom use in the most simple terms:
“What if I use them most of the time? You’re at risk. In fact, the CDC says,
‘Used inconsistently (less than 100 percent of the time), condoms offer
little more protection than when they are not used at all.’”[56][56] HIV/AIDS Increase and Decrease with Condoms and Chastity, Respectively13. That condoms do not provide total protection against the transmission of HIV and STD’s is compounded by the fact that the “safe sex” campaigns have led not to an increase in prudence, but to an increase in sexual promiscuity and condom use.[57][57] In fact, there are studies showing that HIV/AIDS cases increase as the number of condoms distributed also increases.[58][58] Human behaviour is an important factor in the transmission of AIDS. Without adequate education aimed at abandoning certain risky sexual behaviour in favour of well-balanced sexuality, as in pre-marital abstinence and marital fidelity, one risks perpetuating the pandemic’s disastrous results. There are reports supporting the idea that where abstinence before
marriage and fidelity to one’s spouse have been successfully promoted, the
HIV/AIDS pandemic has dramatically decreased. For instance, Uganda has pushed for a
chastity-based program, and there the incidence of HIV/AIDS is managed
relatively better than in other countries. “As AIDS sweeps across Africa,
Uganda remains a lone success story, as millions of Ugandans have embraced
traditional sexual morality, including sexual abstinence outside of marriage
and fidelity within marriage, in order to avoid infection. But the
international AIDS community has been reluctant to promote this strategy
elsewhere, continuing, instead, to place its faith in condoms.”[59][59] In connection with this, the U.S.
Agency for International Development, in its case study, Declining HIV
Prevalence, Behavior Change, and the National Response. What Happened in
Uganda?, states in a table showing HIV trend and behavioural data in
Uganda, Kenya and Zambia, that, “prevalence declines in Uganda relate more to
reduction in sex partners than condom use”. [60][60]
Similarly, the Joint United Nations Programme on HIV/AIDS (UNAIDS) AIDS
epidemic update of December 2003 states: “HIV prevalence continues to
recede in Uganda, where it fell to 8% in Kampala in 2002 – a remarkable feat,
considering that HIV prevalence among pregnant women in two urban antenatal
clinics in the city stood at 30% a decade ago. Similar declines echo this
accomplishment across Uganda, where double-digit prevalence rates have now
become rare… To date, no other country has matched this achievement – at
least, not nationally”.[61][61] In Thailand and in the
Philippines, the first HIV/AIDS cases were reported in 1984; by 1987,
Thailand had 112 cases, while the Philippines had more, with 135 cases.
Today, in the year 2003, there are around 750,000 cases in Thailand, where
the 100% Condom Use Program had relatively great success. On the other hand,
there are only 1,935 cases in the Philippines[62][62] - and this, considering that the Philippines’
population is around 30% greater than Thailand’s! Relatively low rates of
condom use by the people in general, and staunch opposition from the Church[63][63] and a good number of government leaders against
the condom program and sexual promiscuity, are well-known facts in the
Philippines. Commenting on some of these
reports, Jokin de Irala, Professor of Epidemiology and Public Health at the
University of Navarre, Spain, said: “That which is being done in many
countries is simply irresponsible. To trust condoms blindly without anything
else in the preventive strategy, when it has been seen that such method has
not been sufficient to stop the epidemic in groups that are a priori
very concerned, such as homosexuals, is an error that can end up having to be
paid dearly… The people could demand from their authorities greater
seriousness and originality when it comes to resolving these problems. They
should ask at least for the same courage that has been shown, for example,
when the fight against tobacco was started seriously. We cannot remain
passive, naively believing that such a complex problem could be solved by a
‘patch’ such as the condom.”[64][64] 14. As to the transmission of HIV in general, even though the WHO affirmed in 2002 that 99% of HIV infections in Africa were due to non-protected intercourse, one should also consider what some authors have recently put expressed, that is, the possibility that the majority of new HIV/AIDS cases in Africa are not due to sexual relationships, but rather to the reuse of needles for injections, given the inadequate sanitary infrastructure in the continent.[65][65] In this sense, the present orientation of the anti-AIDS efforts focusing exclusively or heavily on condom distribution is obviously insufficient and questionable. The Right to Correct and Complete Information15.
AIDS represents a serious danger for which there is
still no cure. Condom users should be guaranteed their ethical and juridical
rights to be correctly and completely informed of the risks involved in the
sexual transmission of this disease, and of the true effectiveness of the
prophylactic. Given the AIDS pandemic proportion, what the Church aims for is
not mere risk reduction (which is actually transformed into risk
augmentation if the real risks of transmission are not explained to the
public), but rather risk elimination; not partial protection,
but total protection; not relative protection, but
absolute protection. It is truly misleading to say that one promotes
“safe sex”, when in fact one is actually promoting “safer sex”, that is, sex
that is safer than not using a condom at all; but it is still far from being
total protection. To claim that it is “technically correct” to say that the
condom “provides protection” (leading people to think they are fully
protected), when in fact one actually means that it “provides partial
protection”, or “85-90% protection”, or “relative protection”, is to lead
many to their death. To emphasize that the condom “reduces risks”, but hiding
the fact that it “does not eliminate risks”, leads to confusion. To advertise that the condom is “effective in preventing transmission
of HIV and many other STD’s”, or “will help reduce the risk of their
transmission” (perhaps claiming that in some countries its production has
already been perfected), when one actually means that it is “up to a certain
degree effective in preventing HIV and some STD’s but not totally, and that
there is no evidence that it reduces the risk of HPV infection”, then this is
not only a lack of respect for women’s rights; it is outright anti-woman, and
anti-man as well. To encourage “behaviour change” among adolescents in sex
education programs, when one actually means “to encourage them to use a
condom when they engage in pre-marital sex”, while at the same time
encouraging pre-marital sex itself, is to destroy not only adolescent
reproductive health, but also their emotional, mental, health, and spiritual
health, and indeed their future and entire lives. 16. The false security
generated by the “safe sex” campaigns are hindrances to this right to correct,
complete information. Appeals from true, sincere consumer and health
advocates, especially authentic women’s health advocates, to fully and
clearly reveal available information on condom effectiveness (or rather,
ineffectiveness), have been frequently falling on deaf ears, for one reason
or another. Such appeal is based on the right of the consumer to know the
true characteristics of the product he or she is using – even more if such
characteristics have a bearing on the consumer’s health and life. The public
has to be informed that the condom does not guarantee total protection
against AIDS and other STD’s. In the same way that cigarettes carry the
warning that the smoke they produce is dangerous to the health of the smoker
and those nearby, perhaps condoms should also be required to carry warning
labels, on their packaging and on the shelves and apparatus where they are
displayed, stating that they do not guarantee total protection against
HIV/AIDS and STD’s, or that they are not safe. Dr.
Luis Fernández Cuervo of El Salvador even goes a step further, alluding to
the possibility of taking legal action against those who promote “safe sex”,
similar to the legal action taken against tobacco companies. “If a habitual
smoker contracts cancer he or she can legally sue the tobacco company, making
it liable. This way, in the United States, they have obtained juicy millions
in compensation (?!). As if a smoker did not know, for more than fifty years
now, that tobacco could lead him or her to cancer! But if a person who is
sexually promiscuous and uses the condom becomes sick with AIDS, this person
has no right to sue the laboratory that manufactured the condom, nor the many
groups that promote the condom as ‘safe sex’. This is odd, very odd.”[66][66] 17.
The HIV/AIDS and STD
pandemics continue to grow, in spite of the great efforts to curb their
growth. Taking into account the data presented in different studies and
experiences on the field, the idea of “safe sex”, as it has been presented in
condom campaigns, seems false, or at least dubious, and thus has to be
submitted to scrutiny. What is more, since there is a certain level of risk,
it is also a grave responsibility of national and international institutions,
both public and private, as well as of the mass media, to contribute to
providing correct, complete information about the existence of these risks,
which could lead people to their death. Formal protests have been and should
continue to be made by those who think that certain groups hinder such efforts
to bring the whole truth into light.[67][67] The Church Promotes Life, Through a Real Protection from HIV/AIDS and STD’s18.
The statements reflecting the hard fact of condom
failure by no less than international and national agencies, along with the
scientific studies and real-life experiences, go totally against the accusations
made against the Church: namely, that the Church contributes to the death of
millions by not promoting or allowing the use of condoms in the fight against
the pandemic. Indeed, shouldn’t it be the opposite: that is, that those
promoting the condom without properly informing the public of its failure
rates (both in its perfect use and in its typical use, and the cumulative
risks), have led to, lead to, and will continue to lead to the death of
many? Are there not many who fall victim to a false sense of security
generated by campaigns promoting “safe sex”, oblivious to the fact there are
multiple factors that lead to condom failure? Victims of the “safe sex” fallacy tell us, in the numerous centres
caring for HIV/AIDS patients promoted by the Catholic Church, that if they
had only known the real risks beforehand, if only they had been properly
informed, they would not have engaged in promiscuous sexual behaviour, they
would not have entered into sexual relationships outside of marriage, and
they would have remained very faithful to their families. The Catholic Church
is very close to the AIDS patients, and welcomes them with charity, defending
their human dignity, and recognizes the drama they undergo, with the mercy
shown by the Good Samaritan. Cardinal John O’Connor, the late Archbishop of
New York and great pro-life leader, used to visit clinics for AIDS patients
once a week. The Catholic Church can surely claim expertise in the fight
against the HIV/AIDS pandemic, providing 25 percent of all the care
worldwide, having committed professionals and volunteers, religious and lay
alike, to care not only for the individuals but also for their families, in
the most holistic manner, respecting the dignity of the human person and the
family through the proper use of sex and promoting the life-long commitment
of spouses.[68][68] 19. For those who have already exposed themselves to the risks outlined above, a responsible mode of action would be to determine whether or not one might have already been infected, considering that a real danger exists. Each person has the obligation to take care of his or her health and that of others, and to do so, each person has the right to be aided by society as far as possible. Moral as well as epidemiological considerations urge those who have repeatedly exposed themselves to potential contamination to undergo tests to determine whether they in fact might have already been infected with the HIV or other microorganisms causing STD.[69][69] Not to do so would mean not to take necessary precautions to preserve one’s health and life, and that of others. Not to take the tests could mean to unknowingly contribute to the spread of the debilitating, deadly disease to one’s own family and society at large. These persons should be encouraged and helped to approach international and local institutions offering voluntary counselling and testing services for those who may need them. The
Church is ready to help. Through the generosity of millions of people,
including persons of other faiths who collaborate in our apostolate, the
Catholic Church is able to provide 25% of services for HIV/AIDS patients, and
to run a great number of hospitals, clinics and other health care facilities
worldwide. The Church continues to undertake the promotion of authentic
reproductive health and women’s health, which includes complete information
using unambiguous terminology, and a truly safe sexual practice based on
authentic human sexuality. The Need to Rediscover Truly
Responsible Sexual Behaviour
20. It is obvious that this article can only be limited to a few but serious investigations, focusing on the sexual transmission[70][70] of HIV/AIDS and STD’s. There are many more studies explaining that condoms do not provide total protection against these diseases, many of which could be easily found on the internet. One has to seriously distinguish between the proper use of the condom and the failures of the same due to different causes. Regarding the latter, the user can not be safe, just as in the case of other accidents with regrettable consequences. The greatest force of these considerations is the call to avoid the various consequences of disordered sexual behaviour, and even worse, the risk of promiscuity, even prior to considering the use of the condom itself. Rather than focusing merely on the aspects dealt with by the expert investigators, one has to keep in mind above all the integral good of the person, in line with the proper moral orientation, which will be necessary to provide total protection against the spread of the pandemic. With or without the threat of HIV/AIDS and STD’s, the Church has always called for education in chastity, premarital abstinence and marital fidelity, which are authentic expressions of human sexuality.[71][71] Moreover, the Church does not
propose the development of condoms with better quality that would assure 100%
effectiveness against the transmission of HIV and STD’s.[72][72] What is being proposed is to live one’s
sexuality in a way that is consistent with one’s human nature and the nature
of the family. It has to be mentioned too that the WHO admits that abstinence
and marital fidelity is a strategy capable of completely eliminating the
risk of infection from HIV and other STD’s; condoms, on the other hand, reduce
the risk of infection.[73][73] 21. It is important, by way of synthesis, to transcribe the recommendation made by Luc Montagnier, who is credited with having discovered the HIV: “Medical means are not enough… In particular, it is necessary to educate the youth against the risk of sexual promiscuity and wandering”.[74][74] The CDC has likewise informed that, “the only strategies of prevention that are truly effective consist in (sexual) abstinence and sexual relations with a non-infected partner, while respecting reciprocal fidelity”.[75][75] This is why one of the most important Italian infectious diseases experts, Prof. Mauro Moroni, affirms that, “AIDS is a typical behaviourally spread epidemic… If those behaviours are removed, AIDS could be stopped without any specific prophyllactic intervention”.[76][76] Prof.
Lino Ciccone adds: “Therefore a true and effective prevention is above all
the set of initiatives that aim at putting an end to whatever promotes sexual
laxity, presented as a triumph of liberty and civilization – similar to what is
being done to help youth not to fall into the slavery of drugs or to free
them from them. In other words: true prevention takes place only through a
serious educational effort. An education free from equivocations and
widespread reductive concepts, which leads to the discovery, or rediscovery,
of the values of sexuality and a correct scale of values in human life. “Any other option that excludes
such ways, or worse, that implies an ulterior push towards sexual promiscuity
and/or the use of drugs, is anything but prevention, and to promote the same
is tragically deceitful. A typical example of this mystification are all the
campaigns that promise victory over AIDS only if the use of the condom is
generalized. In this way sexual promiscuity is encouraged, which is the first
cause of the epidemic.”[77][77] Ciccone’s observations coincide
fully with the serious problem that I have wanted to delve into. “It has to
be noted moreover that it becomes an authentic crime, when one endorses as
guaranteed the defense against infection when the condom is used. This is the
message that is also launched with the slogan related to the condom of ‘safe
sex’. As a contraceptive the condom already registers a notable margin of
failure, but, as a defense against sexually transmissible diseases, the
failure is decidedly much higher. The following is a very recent and
authoritative confirmation coming from a scientific source: ‘In general terms
the barrier methods […] protect against sexually transmitted diseases (risk
reduction of around 50%). […] This protection takes place with regards to
many pathogenic agents: Papilloma virus […], HIV.’”[78][78] Conclusion: The Need to Strengthen Marriage and the Family22. I have presented in a conference in Chile the detrimental effects of going against human dignity, of trivializing the true meaning of sex, and of making instrumental and commercial the use of sex.[79][79] A lifestyle that is disordered and corresponds neither to the totality of the human person nor to the will of God, cannot be a true good. We have seen how different peoples have been wounded by such trivialization of sex. In general, cultures have always distinguished between sex without responsibility and sex that is protected by marriage, in favour of the family. Some might say that this
is an excessive demand. But we have to be confident that the Lord, “will not
let you be tempted beyond your strength”.[80][80] In several places there is an emergence of youth
movements whose members publicly promise to maintain a responsible attitude
towards sex, and to remain chaste, abstaining before marriage, and to be
faithful to their spouses. For what reason then should this model not be
presented to youth, especially at a time when there are many problems in a
society that seems to be confused? The fight against the HIV/AIDS pandemic
also has to tackle disordered sexual behaviour. 23. Marriage has to be presented as
something precious, something that will help bring happiness and fulfilment
to a person, as couples undertake a life-long project of mutual, exclusive,
total, irrevocable and sincere self-giving. “In the ‘unity of the two’, man
and woman are called from the beginning not only to exist ‘side by side’ or
‘together’, but they are also called to exist mutually ‘one for the other’… This
mutual gift of the person in marriage opens to the gift of a new life,
a new human being, who is also a person in the likeness of his
parents.”[81][81] Prof. Livio Melina, a moral
theologian, reminds us that a culture of the family is essential for the family
to be strengthened in two evidently fragile, central points: fidelity in
love, and parenthood. Regarding the crisis of fidelity, he
says that it is manifested “as an incapacity to maintain continuity in time
to the delightful event of affection: it is becoming more rare for love to
‘have a story’, to be prolonged in time, to be constructed and thus become a
habitable home.[82][82] The romantic conception of love, which dominates
today, perceives love as a spontaneous event, outside the control of freedom,
disengaged from the ethical responsibilities of providing care and diligent
work, dissenting from institutionalization.”[83][83] The Holy Father Pope John Paul II
said, “A pastoral proposal for the family in crisis presupposes, as a
preliminary requirement, doctrinal clarity, effectively taught in moral
theology about sexuality and the respect for life… At the root of the crisis
one can perceive the rupture between anthropology and ethics, marked by a
moral relativism according to which the human act is not evaluated with
reference to the permanent, objective principles proper to nature created by
God, but in conformity with a merely subjective reflection on what is the
greatest benefit for the individual's life project. Thus a semantic evolution
is produced in which homicide is called ‘induced death’, infanticide,
‘therapeutic abortion’, and adultery becomes a mere ‘extra-marital
adventure’. No longer possessing absolute certainty in moral matters, the
divine law becomes an option among the latest variety of opinions in vogue.”[84][84] Chesterton with his pleasant irony said that
what is lacking, as with the birds, is to construct a “stable nest”, if they
are truly mature. Prof. Melina further comments that
a culture of the family will also help solve the crisis of parenthood,
“manifested as a refusal to assume the burdens, perceived as too heavy, to
give life to children”.[85][85] Such crisis has given rise to what we have
oftentimes described as the “demographic winter”. The crisis of fidelity and
the crisis of parenthood are but dimensions of the crisis of the moral
subject, that is, of the person. Melina proposes two paths or ways to
reconstruct the moral subject: the way of virtues, and the way of
interpersonal relationships.[86][86] 24. It is true that where there has been no education towards a serious responsibility in love; where the dignity especially of women is not given sufficient importance; where a faithful monogamous relationship is ridiculed; where condoms are distributed to the youth in parties and to children in schools; where immoral lifestyles are diffused and all forms of sexual experience are regarded as positive; and where parents are not allowed to give adequate formation to their children: such “impossibility” turns into a serious, limiting condition. The end result is not only alarming in terms of the spread of HIV/AIDS, but in that man and woman can no longer have full confidence in each other. What will become of these children’s future, without the proper information and the necessary parental guidance? But the greatest help that the
Church, and perhaps all people of good will, could offer to curb this
terrible pandemic, relying on Divine Providence, is to strengthen the family.[87][87] The different groups, movements, associations,
institutes and centres that work in favour of family and life have special
roles to play. The family is the Domestic Church and the basic unit of
society, the school of virtues the first environment where children receive
their education from their first educators, their parents. Catholic families
should become examples of holiness, letting their close relationship with God
in their life of prayer and in the sacraments overflow into a genuine concern
for others. The Holy Father has repeatedly insisted, “Family, become what you
are!”. May the family truly become what it really is, after the example of
the Holy Family, the model for all families. Notes
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