If you've watched any of the mainstream news coverage of the Catholic Church in the past months, you've heard the charge repeated over and over: By maintaining its ban on condom use, the Catholic Church is contributing to the AIDS epidemic in sub-Saharan Africa. Condoms have been demonstrated to prevent HIV infection 90 percent of the time. The argument is that if the Vatican cared more about people's lives than a rigid doctrine that most Catholics reject, it would make an exception to allow condom use to prevent the spread of HIV/AIDS. Such a move would do more for "life" than would maintaining a position that allows millions to die as a result of unprotected sex.
Sounds convincing at first, doesn't it? So convincing, in fact, that most Catholics have trouble addressing it. One approach, of course, would be to explain the Catholic moral/theological position on why contraception is inherently evil. But while absolutely true, that approach isn't terribly convincing to a non-Catholic, let alone a non-Christian. But the debate over condoms in Africa need never get to that point. In fact, the whole matter can be settled without ever bringing in moral theology. You see, the fatal flaw in the pro-condom argument is both simple and devastating: Condoms aren't working to stem AIDS in Africa.
Take, for example, a March 2004 article in the medical journal "Studies in Family Planning." Titled "Condom Promotion for AIDS Prevention in the Developing World: Is It Working?," the piece was a meta-review of the scientific literature on the question. The results shocked condom advocates. In the article, researchers Sanny Chen and Norman Hearst noted, "In many sub-Saharan African countries, high HIV transmission rates have continued despite high rates of condom use." In fact, they continued, "No clear examples have emerged yet of a country that has turned back a generalized epidemic primarily by means of condom distribution."
No surprise, then, that Botswana, Zimbabwe, Kenya, and South Africa--the nations with the highest levels of condom availability--continue to have the highest rates of HIV prevalence. How could this be? After all, we're told that condoms are 90 percent effective. And that's precisely the problem. This claim--so prevalent in condom-promotion literature--is actually a tremendous strike against using condoms to reduce AIDS. Think of it: Assuming that the 90 percent figure is accurate, that means that 10 percent of the time, condoms don't offer protection against transmission. Condoms provide a false sense of security to those who use them. Being convinced of condoms' effectiveness and feeling invulnerable, users will simply continue--or actually increase--their high-risk behavior.
But while condoms clearly won't solve the HIV/AIDS crisis in Africa (or anywhere else), there is an approach that will: abstinence. Indeed, in African nations--where HIV/AIDS is transmitted almost exclusively through sexual contact--abstinence is the obvious solution. Better yet, it has been proven effective. Uganda at one time had the highest rate of HIV/AIDS in the world. Starting in the mid to late 1980s, its government instituted a program to teach abstinence before marriage and fidelity to one's partner afterwards. It only reluctantly advised condoms for high risk groups (like prostitutes), whom they knew would not accept the other two approaches. Billboards, radio announcements, print ads, and school programs all promoted the virtues of abstinence and fidelity to prevent HIV/AIDS. The results were astonishing. In 1991, the prevalence rate of HIV was 15 percent. By 2001, it had dropped to 5 percent. It was the biggest HIV infection reduction in world history.
Among pregnant women, the drop was even more dramatic. In 1991, 21.2 percent of expecting mothers tested positive for HIV. By 2001, the number had plummeted to 6.2 percent. Compare this with the 2001 numbers from Kenya (15 percent), Zimbabwe (32 percent), and Botswana (38 percent). All three countries focus on condom distribution, and all three countries continue to see their rates rise.
"Reduction in the number of sexual partners was probably the single most important behavioral change that resulted in prevalence decline," noted Edward Green, an anthropologist at Harvard University's School of Public Health who studied Uganda's program. "Abstinence was probably the second most important change," Green added, in testimony before a House subcommitte on African affairs. "It is a very indicting statement about the effectiveness of condoms," he told Citizen Magazine. "You cannot show that more condoms have led to less AIDS in Africa.... I look at the data and I see that what might be called a more liberal response to AIDS--more and more millions or billions of condoms -- has simply not worked, especially in parts of the world with the highest infection rate, Africa and the Caribbean."
Yet we're still told condom distribution is the solution to the AIDS crisis in Africa. And the Catholic Church is an easy media bogeyman, standing in the way of that effort. Ironically enough, Uganda's successful approach is very close to that recommended by the Church. The only practice the Church does not approve is giving condoms to prostitutes. But if the people of that nation--and indeed, of the world at large--took seriously the Catholic notion of the dignity of women and the nature of sexual intercourse, that last point would be addressed as well.
But what about allowing condoms for faithful married couples where one partner is HIV-positive? Isn't that reasonable? Actually, it's not reasonable at all. Love requires sacrifice. And a person who claims to love another would never knowingly put his beloved in danger. But that's precisely what this approach does. Imagine if I get drunk one night and drive my wife around town. That's not a loving act. And it doesn't suddenly become loving just because I tell her to put on her seatbelt. When an HIV-positive person has sex with someone who's free of the disease, he puts that person at grave risk. That's not love; that's selfishness. In a marital situation where one spouse is HIV-positive and the other negative, the loving thing to do is to abstain from sex. In those cases, love must be shown in other ways, such as the self-sacrifice that abstinence requires. It's not easy, but real love rarely is.
