When a married person is HIV positive
"Therefore a man leaves his father and his mother and cleaves to his wife, and they become one flesh" (Gen 2:24). This statement contains the amazing truth about spousal love, as a guiding light for the life of men and women. Divine revelation presents human love to us in a new way by integrating that love into the plan of God, revealed in the most elementary human experiences.
The new horizon that they acquire from God is the genuinely personal value of these relationships in which the identity of every human person is constituted. In particular, we discover the dimension of the gift of self, characteristic of marital love, which explains the call "to leave father and mother", in order to "become one flesh". This new condition is a real spiritual bond in the bodiliness, the corporality of the spouses, inasmuch as the body of the husband is no longer for himself but for his wife, and vice-versa (cf. 1 Cor 7:4). Moreover, the account in Genesis understands the "being one flesh" as implying fruitfulness, which is an element of being made in the image of God, since God's love is the source of all paternity (Eph 3:15); this meaning is linked to the blessing that the first spouses received from God (Gen 1:28).
This context of love provides the profound meaning of sexuality. The man, Adam, left to himself, is not fruitful ("It is not good that the man should be alone" [Gen 2:18]); he needs union with the woman in order to become so. This oneness in the flesh is a sign of fecundity by means of the gift of self in the context of marital love, which includes the dimension of difference, intrinsic to sexuality. The truth of personal love appears therefore within a dynamic of unity in difference, that implies the promise of fertility. This loving dynamism finds its archetypal expression in marital love. Spousal love creates the place in which God himself can intervene with the gift of the "novum", which is to say, the gift of a new, unique and unrepeatable person with an eternal destiny. This possibility is not simply a biological fact; it is a vocation from God that calls for the proper response from the human person.
The value of "being one flesh", through the gift of self constitutes the basis of the normative truth which Paul IV taught authoritatively in Humanae Vitae: "the inseparable connection, established by God, which human beings on their own may not break, between the unitive meaning and the procreative meaning, both of which are inherent in the act of marital intercourse" (n. 12). It is the flesh that unites the gift of the spouses with the promise of fertility. If human beings deprive sexual union of its unitive and procreative meaning, they undermine their true love.
Marital love is therefore a specific ray of the truth about man, leading him to discover the significance of life, which is received as a gift and lived in reference to the gift of self. Spousal love has therefore a full moral meaning. It is not just a relationship arising from an accidental encounter, but rather the authentic expression of a meaning which includes the act of marital intercourse itself. Human sexuality seeks to be configured through spousal love; in that love it finds the fullness of life which spouses should not falsify. In this regard, the little understood teaching of Humanae Vitae that "it is necessary that each and every marital act remain ordered per se to the procreation of human life" (n. 11) is extremely enlightening. With regard to what defines a
contraceptive intention, we should note that there is a difference between "making an act infertile" and "engaging in an act which is not fertile". In the former case, infertility is intended by the person who imposes it on the act, whereas in the latter, it is a biological characteristic of an act of sexual intercourse. Only in the first example is the infertility of the act intentionally sought and, for this reason, possesses a moral significance. The question can also be approached by adopting the broader perspective of the requirement of "being one flesh", where the refusal of a complete giving of one's body to the other implies also the breaking of the unitive meaning, something much more than a mere physical union. This consideration is very far from a physicalism which makes simple biology unduly sacred, but instead expresses the personal character of love in the flesh. One may thus avoid the risk of a teleologism which would see sexual intercourse as material to be adapted as one wills.
This teaching casts a powerful light on spousal love, which should be received by husbands and wives so that they may respond to the various situations that arise in their marriages, and at times are a great trial. In their marital consent, they promise to be true to each other "in good times and in bad, in sickness and in health", thanks to a love that does not depend on external circumstances, but which is expressed, in a creative way, by their faithfulness in the events of human life.
One current problem is linked to the proliferation of sexually transmitted diseases that affect the intimate life of spouses; in the case in point, AIDS raises especially serious questions because of the widespread extent and seriousness of the disease. To combat the spread of the disease, the use of condoms has been insistently recommended both by medical experts and by politicians. This gives rise to the ethical question on the permissibility of the use of condoms by a husband and wife when one of the two is HIV positive.
The response to the problem of AIDS requires that there be accurate information regarding the medical aspects of this terrible disease, in order to act with real responsibility in situations where there is the possibility of death. The treatment of AIDS has made enormous progress, and for those who have access to the proper medicines, the disease can be controlled. The life expectancy of those who have been infected has increased noticeably and their state of health in general has considerably improved. The risk of transmission has been reduced and new techniques now ensure that in most cases babies born from mothers with AIDS do not become infected. All these facts need to be given proper attention in addressing the implications of AIDS for human health.
In this connection, it is important to note that while the use of a condom in a single act of intercourse may have a certain efficacy in the prevention of the transmission of the virus that causes AIDS, nevertheless it cannot guarantee absolute security even in the single act, and still less in the broader context of the entire sexual life of a couple. It is therefore improper to present the use of condoms as an effective means for avoiding transmission. Indeed, the numerous campaigns advocating their indiscriminate use have shown the contrary; by fostering the false conviction that there is no danger, they increase the possibility of infection. Presenting the condom as a solution to the problem is a serious error and choosing it merely as a habitual practice shows a lack of responsibility with regard to the other person.
Let us turn to the properly ethical perspective. The light of marital love leads couples to refuse to take paths that corrupt it. It is from this perspective that the falsity of the condom solution becomes evident. Sexual intercourse with a condom cannot be considered fully marital, since the action has been deliberately deprived of its intrinsic meanings. The prophylactic, acting as a barrier, in a certain way distorts the act of sexual intercourse, depriving it not only of its procreative significance by placing an impediment to conception, but also breaking the significance of being "one flesh" in the sense of the total gift of spousal union. An act of intercourse in which there is a deliberate intention not to transmit the husband's seed to the wife is a rejection of the mutual giving of the bodies of the spouses. From the moral standpoint this act is not fully marital. This is the general ethical evaluation of such an act, apart from the prudential question of the risk of possible infection.
Given this evaluation, the light of marital love will help such spouses to face the demanding situations of their lives, so that they may respond even to the most difficult challenges. In this light, faced with the unavoidable possibility of transmitting the virus, spouses may make the decision together to abstain from sexual relations for reasons of health, as is the case with other diseases. Their marriage vows imply a commitment to respond generously: in this truly difficult situation, drawing upon the commitment they have made, they will receive the strength necessary to live out the truth of their vocation, trusting in the grace of God and seeking the guidance of the Church, which will help them on their way.
The specific light of God's plan for the human person ensures that the marital love of spouses may always find an appropriate solution, to be lived out responsibly, above all in moments of great trial. Such a solution affirms the value of human life, viewed in the light of a love that calls to be lived out in total self-gift.
*Lecturer in moral theology at the San Dámaso Faculty of Theology, Madrid, and at the Pontifical John Paul II Institute for Studies on Marriage and Family