Evidence Shows Wisdom of Catholic Doctrine
NEW YORK, 24 SEPT. 2005 (ZENIT)Critics continue to assail the
Catholic Church's refusal to endorse condom use in treating the AIDS
problem. Among recent attacks was in the medical journal The Lancet. "[F]aith
seems to present insuperable obstacles to the prevention of disease,"
asserted an editorial dated March 12. "Nowhere is this problem more
acute than in HIV/AIDS."
The editorial was highly critical of Pope John Paul II for his
opposition to condom use, accusing him of being ignorant of African
history, culture and the realities of daily life in the continent.
On May 8, New York Times editorial page commentator Nicholas Kristof
accused the Church of having cost hundreds of thousands of lives due to
its refusal to endorse condom use.
Kristof expressed the hope that the recently elected Benedict XVI would
not only change the Church's position on this issue, but would indeed
"encourage the use of condoms," affirming it would be a "courageous
choice."
The decision by the U.S. government to limit its funding for condoms has
also come in for criticism. According to an Aug. 30 report in the
British newspaper Guardian, Stephen Lewis, the U.N. secretary-general's
special envoy for HIV/Aids in Africa, said that U.S. cuts in funding
were damaging Africa. He also described the Bush administration of
following a "dogma-driven policy" on the issue.
And the New York Times once again weighed in on the matter, in an
editorial Sept. 4. The editorial argued that by limiting condom
availability, the reduction of AIDS in Uganda was being put at risk.
More Catholics, fewer infections
Abundant data exist, however, to show the severe limitations of relying
on condoms to solve the AIDS problem. A letter from Australian-based
bioethicist Amin Abboud, published July 30 by the British Medical
Journal, noted that any change in the Catholic Church's position on
condoms would be detrimental for Africa.
According to Abboud, a statistical analysis of the situation in the
continent shows that the greater the percentage of Catholics in any
country, the lower the level of HIV. "If the Catholic Church is
promoting a message about HIV in those countries," he added, "it seems
to be working."
Data from the World Health Organization puts the figure for HIV
infection in Swaziland 42.6% of the population. Only 5% of the
population is Catholic. And in Botswana, where 37% of the adult
population is HIV infected, only 4% of the population is Catholic. In
Uganda, however, where 43% of the population is Catholic, the proportion
of HIV infected adults is 4%.
Abboud commented that since the death of John Paul II there has been a
"concerted campaign ... to attribute responsibility to him for the death
of many Africans." But, he continued, "Such accusations must always be
supported by solid data. None has been presented so far."
Recognition of the value of promoting abstinence, instead of just
relying on condoms, came in a commentary published in The Lancet last
Nov. 27. Written by a group of medical experts, and endorsed by a long
list of health care experts, the article noted that when campaigns
target young people who have not initiated sexual activity, "the first
priority should be to encourage abstinence or delay of sexual onset,
hence emphasizing risk avoidance as the best way to prevent HIV and
other sexually transmitted infections as well as unwanted pregnancy."
The article did support condom use, but also pointed out that even for
those who have already engaged in sexual activity, "returning to
abstinence or being mutually faithful with an uninfected partner are the
most effective ways of avoiding infection." This goes even for adults:
"When targeting sexually active adults, the first priority should be to
promote mutual fidelity with an uninfected partner as the best way to
assure avoidance of HIV infection," stated the article.
This argument is based on solid medical evidence, the authors pointed
out: "The experience of countries where HIV has declined suggests that
partner reduction is of central epidemiological importance in achieving
large-scale HIV incidence reduction, both in generalized and more
concentrated epidemics."
Questioning orthodoxy
Recent information on the situation in Uganda, which is often cited as
an example of how programs advocating abstinence and fidelity to
partners can reduce the incidence of AIDS, confirms the position of
those who question relying on condoms.
A report published Sept. 13 on Aidsmap, a United Kingdom Web site
dedicated to distributing information on AIDS, summarized the findings
of a study published in the Sept. 1 issue of the Journal of Acquired
Immune Deficiency Syndromes.
The study demonstrated that while campaigns to distribute and promote
condoms in Uganda did increase usage, they did not lead to consistent
use. Moreover, men in the group targeted by the campaigns then "went on
to have a larger number of sexual partners and were somewhat less likely
to use condoms with casual sex partners than the control group."
The findings, noted Aidsmap, "raise uncomfortable questions about the
evidence base that informs the current international orthodoxy in HIV
prevention."
The study compared two groups recruited from poor urban communities in
Kampala. Another conclusion was that "improved availability of condoms
in Uganda has had only a modest effect on condom uptake."
Changing behavior
This latest study confirms the arguments made by Edward Green, in his
2003 book, "Rethinking AIDS Prevention." Green is a senior research
scientist at the Harvard Center for Population and Development Studies
and a member of the President's Advisory Committee on HIV/AIDS.
Green does not have moral objections to condoms, and, in fact, has
worked in the past with organizations that promote contraceptives and
family planning programs. Nevertheless, he raises serious doubts about
the wisdom of fighting AIDS by relying on condom distribution.
In Africa, repeated population surveys show that the most common
behavioral change in response to the diffusion of AIDS is an increase in
the fidelity to one's partner, the reduction of sexual partners, and
sexual abstinence. When, in addition to this spontaneous response, this
type of change is promoted through campaigns, then we are building on
what people naturally do, Green argued. Unfortunately, he added, foreign
experts only too often arrive and impose campaigns that ignore the
benefits of behavioral changes, preferring to rely on distributing
condoms.
In addition, Green cites studies showing that condom promotion campaigns
do not lead to long-term consistent use. And inconsistent use is
associated with a higher risk of sexually transmitted diseases. In fact,
the African countries with the highest condom user rates and numbers of
condoms available, Zimbabwe and Botswana, also rank at the top of the
list for rates of HIV infection.
Neither are condoms infallible, particularly those typically available
in African countries, Green observes. In fact, condoms are widely held
to be one of the least effective methods of contraception, yet
paradoxically, are promoted by experts as the answer to preventing AIDS.
This is not to say, Green points out, that the use of condoms causes
AIDS, "only that condoms might give men a somewhat greater sense of
security than warranted by actual condom effectiveness."
Independently of these debates, the new Pope quickly gave an answer to
those pressing for changes in Church doctrine. Addressing the bishops
from a group of southern African countries on June 10, Benedict XVI
urged them to continue supporting family life and to help those
suffering from AIDS.
The Catholic Church, commented the Pontiff, "has always been at the
forefront both in prevention and in treatment of this illness." And, he
added: "The traditional teaching of the Church has proven to be the only
fail-safe way to prevent the spread of HIV/AIDS."
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