The Pope, condoms and AIDS

Pope Benedict's recent remarks about the use of condoms to address AIDS in Africa caused predictable controversy. They should be set in two different contexts: the West and Africa.

When AIDS first spread in the West it affected particularly the homosexual community. The response was tightly focused. It aimed to win the trust of the gay community, refrained from making any judgments about lifestyle and sexual orientation, educated people about the nature and the spread of the disease, and encouraged them to use condoms in all casual sexual encounters.

Together with the development of retroviral drugs, this strategy has been markedly effective in reducing the incidence and mortality from AIDS.

Within the Catholic Church there was little initial institutional response to AIDS. But like other churches, it has had to deal with the consequences of fear of AIDS. This intensified antipathy to and discrimination against homosexuals. It also led many Catholics and others to assert that discrimination would not be overcome until the churches recognised the equivalence of gay and heterosexual relationships. The same argument was made for the legalisation of gay marriage.

In the face of these pressures Catholic Church leaders insisted that the institution of faithful heterosexual marriage was central to health of society, and that it should be uniquely privileged. They also defended the Catholic understanding of sexuality and the transmission of life in strong and general terms. They believed that discussion of borderline cases, such as the use of condoms where the life of one partner was at stake, was used by critics to undermine Catholic teaching as a whole.

So within the Catholic Church the question of AIDS was linked to homosexuality. The plight of those exposed to AIDS and living with the disease was set within a broader context where the church's teaching on sexuality was felt to be under threat.

The African context was different. Because AIDS there was transmitted mainly through heterosexual intercourse, it affected many women and children. Widows left without income often left their villages, and were faced with the choice of turning to prostitution or of their own and their children's deaths. Without condoms, they would die either way.

In contrast to the Western world, religious congregations and parishes were extensively involved from the beginning in caring for infected and rejected women and children. The local Catholic sisters, priests and many bishops generally recognised the dilemma and some have spoken against an absolute interdiction of condoms.

But they also recognise that the instrumental and value free programs imported from the West were less effective in Africa. The spread of AIDS had cultural roots that also needed to be addressed. A view of marriage in which the woman was more than an object, the eradication of magical views of the causes and protections against AIDS, and a culture of mutual respect and of faithfulness within marriage, were required if AIDS was to be checked. These touched the consideration of human sexuality enshrined in church teaching.

The Pope's criticism of condoms should be seen within both these contexts. It was forged in a Western context, arguing against a view that saw the response to AIDS as simply a technological issue stripped of its moral components. This view suggested that human sexuality is purely a matter of individual choice with no ramifications for human flourishing or for human society. Within this context, to admit any use of condoms would be seen to endorse this instrumental approach and weaken the integrity of church teaching on sexuality.

But the Pope's words also reflect an aspect of the African experience of AIDS. There a value-free Western strategy has been inadequate because it does not deal with important cultural factors. These call for educational programs that touch the human values within sexuality. When the Pope says that condoms may make things worse, he could argue that to provide condoms without a moral framework will encourage complacency, will not guarantee their use, and will leave untouched the conditions that leave women and children infected.

Many in Africa who care directly for victims of AIDS will regard the Pope's comments as one-sided. They too recognise the need for a holistic approach to AIDS in Africa. But they believe that an unqualified opposition to condoms fails to take seriously the situation of the wives of infected husbands and of women forced into prostitution. Although the use of condoms does not offer a solution to AIDS in Africa, it can save some women and children from living and dying with the disease. They argue, too, that the use can be justified by traditional Catholic moral principles.

The Pope's words exemplify a paradox facing Catholic teaching on this, as on many other issues. The more that Church leaders propound in broad terms a Gospel ethic of generous and full living, the more they and the ethic are seen as narrow and uncompassionate.

The African context suggests that it may be better to leave the concerns of the West behind for a while, and to enter imaginatively the life of the African women and children and men infected by AIDS. Reflection from that perspective may suggest a way through ethical complexities and generate words that ring both true and compassionate.