AIDS: Last lines of defence

by Editor · April 22, 2009

The public indignity that greeted Pope Benedict’s comments about Aids prevention, made in March on his flight to Cameroon, has been misplaced. It is difficult to shake a suspicion of political point-scoring.

Surely it is self-evident that appealing to sexual responsibility, as the pope did when he stressed the principles of abstinence outside marriage and fidelity within, is the safest form of sexual behaviour. It is also undeniable that the emphasis on condoms in Aids prevention has failed to inhibit the spread of the disease in Africa and Asia.

At the same time, it was a mistake to allow reporters to put the question of Aids prevention to the pope in a setting where he could not engage in a nuanced and detailed discourse. HIV/Aids is not a subject that can be addressed in soundbites, as the pope did on the flight and as his critics did in response to him.

The problem with the pope’s comments resides not in what he said but in what he did not say.

Pope Benedict’s comments, as delivered, work from a premise that sexual behaviour invariably is a matter of choice. That may be so in Italy or Germany, but it is not so in many parts of Africa and Asia. Before abstinence/fidelity can be fruitfully prescribed, the conditions must be created in which people – impoverished women and girls in particular – enjoy sexual sovereignty. This requires the strategic social and economic empowerment of women, and a dismantling of cultural mores which contribute to the spread of HIV.

But it is not good enough to deal with immediate problems with references to difficult long-term objectives.

What can we say and do when abstinence is not an option? Should we lecture a woman who, in her desperation to feed her children, sells her body, on the virtues of abstinence, as if she enjoys commoditising herself? Or should she be counselled that it is best that the man wear a condom (if she can persuade him to do so!), so that her children should not be orphaned?

The pope observes correctly that indiscriminate condom distribution, as a policy, has failed. He is also right in saying that it produces new problems in sexual behaviour. At the same time, when the condom is the only and final line of defence, it would be reckless to discourage its use. Many leading theologians, not all of them progressives, have acknowledged that condom-use in some circumstances can be licit.

The bishops of Southern Africa have effectively permitted condom use in marriage as a means of HIV-prevention, in their 2001 pastoral letter A Message of Hope (which also pointed out the hazards of a condoms-first policy). In his brief response to the reporters, Pope Benedict made no reference to this perhaps because the Vatican is still working on a teaching where none yet exists.

Ideally, the pope might have expanded his answer to refer to the complexities in the discussion of HIV/Aids prevention policies, which he doubtless is aware of. In the circumstances, he evidently couldn’t do so.

It is therefore all the more important that the Vatican arrive with urgency at a prudent, pastoral document which will account for all the contextual intricacies in HIV/Aids prevention even acknowledging the value of using prophylactics as a last line of defence.