During his 2009 trip to Cameroon, a country with an HIV prevalence rate of over 5%, Pope Benedict XVI made a shocking assertion on condom use to prevent HIV. He told reporters, "You can't resolve it with the distribution of condoms. On the contrary, it increases the problem."
This false and dangerous assertion caused an immediate uproar from governments around the world. The German Health and Development Ministers issued a joint statement that expressed the "crucial role" condoms play in preventing the transmission of HIV. They stated simply, "Condoms save lives." French officials suggested that the Pope's remarks denouncing condom use "endanger public health policies and the imperative to protect human life."
The development minister of the Netherlands noted, "It is extremely harmful and very serious that this Pope is forbidding people from protecting themselves." He also suggested that the Pope was "out of touch with reality." The Spanish health ministry took it a step further. Beyond issuing a statement that characterized condoms as a "necessary element in prevention policies and an efficient barrier against the virus," it also sent one million condoms to Africa to fight the spread of HIV.
Belgium's response to the Pope's remarks tipped the scale, forcing the Vatican to respond. The minister of public health stated, "His statements could undo years of prevention and awareness and endanger many lives." The Belgian Parliament also issued a resolution calling Pope Benedict's remarks "unacceptable" and encouraging official protest by the Belgian government.
These responses did not go unnoticed. The Vatican issued a statement denouncing these critics, calling their words an attempt to "dissuade the Pope from expressing himself on certain themes of obvious moral relevance."
By and large, however, these critics are not out to silence the Pope; rather, they are trying to speak the truth about HIV prevention in order to save lives. It is one thing, after all, to disagree with condom use, but it is another thing entirely to spread misinformation about their efficacy in preventing the transmission of HIV.
Several bishops in Africa, including especially Bishop Kevin Dowling of South Africa, have been outspoken in their support of the use of condoms. Anecdotal evidence also suggests that many people who work with Catholic relief agencies distribute condoms to those at risk of infection.
Pope Benedict's words -- and the Vatican's hard line against homosexuality -- further harm prevention efforts. When the Vatican says homosexual sex is "intrinsically disordered" and tells people with "deep-seated homosexual tendencies" not to have sex, it exacerbates the stigma and shame many people feel, resulting in secrecy and denial about their sexual lives. The Vatican's statements do not encourage honesty between sexual partners, nor with health professionals who can advise their patients about safer sex, the correct use of condoms, and HIV prevention. If we've learned anything about HIV prevention, it's that secrecy about sexual activity, sexual history, and sexual health endangers people's lives.
What Do Catholics Think?
Catholics around the world also disagree with the Pope's stance on condoms. According to a recent poll commissioned by Catholics for Choice, which interviewed Catholics in Ghana, Ireland, Mexico, the Philippines, and the United States, support for condom use among Catholics is overwhelming. When asked if "using condoms is pro-life because it helps save lives by preventing the spread of AIDS," 90% of Catholics in Mexico, 86% in Ireland, 79% in the U.S., 77% in the Philippines, and 59% in Ghana agreed.
When questioned about the church's responsibility to help prevent the spread of HIV in a health care context, 87% of Irish Catholics, 86% of Mexican Catholics, 73% of US Catholics, 65% of Filipino Catholics, and 60% of Ghanaian Catholics believe that "Catholic hospitals and clinics that the government funds should be required to include condoms as part of AIDS prevention."
While condoms are not a panacea for the spread of HIV, they are a critical part of the campaign to reduce the impact of the virus. Medical experts agree that the condom can be a life-saving device: It is highly effective in preventing HIV transmission if used correctly and consistently, and it is the best current method of HIV prevention for those who are sexually active and at risk.
Just as condom use is not the only method of HIV prevention, prevention is not a cure-all for the HIV epidemic. Only when prevention is combined with care, treatment, and education will the epidemic unlock its grip on so many societies.
So, if governments, bishops, medical experts, and rank-and-file Catholics disagree with the Pope's assertion on condoms, then do his words hold any weight? Unfortunately, they do. Quite a bit of weight, in fact, especially in the global South.
The Catholic hierarchy's position holds the most sway in the countries least able to deal economically and medically with HIV disease. Whereas Catholics in Ireland (79%), the U.S. (63%), and Mexico (60%) overwhelmingly agree that "the church's position on condoms is wrong and should be changed," in the Philippines (47%) and Ghana (37%), support for this change was not as high. These results are not surprising, especially in the Philippines, where the ultraconservative bishops conference has tremendous political influence.
These results show that in many countries outside Europe and North America the Catholic Church's teachings can profoundly influence people's behavior, even if following those teachings endangers their health. Ghana, which demonstrates the most support for the Vatican's position, has the highest HIV rate of all the countries surveyed.
The Church's Work in AIDS
It must be said that the institutional Catholic Church remains a key direct service provider to people with HIV. And though most Catholic relief agencies and organizations working on the ground do not provide condoms, these organizations do extensive work in terms of care and treatment both internationally and domestically. Catholic Relief Services, the U.S. bishops' development aid arm, for instance, operates 280 HIV and AIDS projects in 62 countries in Africa, Latin America, and Asia. In 2009 alone, these programs had an expenditure of $170 million. The Catholic Agency for Overseas Development operates in 60 countries, addressing issues of poverty, working to prevent the spread of HIV, and working to change the current global systems that negatively affect people living with or at risk of HIV. That organization provides educational programs aimed at risk reduction as well as holistic care for people with HIV. Caritas International is active in 107 countries providing food, counseling, medicine, employment, and education, as well as working to eliminate stigma. Caritas is also involved in advocacy to government entities and pharmaceutical companies to produce lifesaving child-friendly HIV treatment.
Domestically, Catholic agencies provide extensive services to people with HIV across the U.S. Catholic Charities' Children's Youth Organization provides permanent supportive housing as well as a medical residential care community for people with HIV in San Francisco. Catholic Charities' AIDS Services of Albany, New York, serves all individuals and communities affected by HIV in that region. It provides clients with access to the COBRA case management program and the Ryan White Part D Outreach program. Additionally, it runs a Project Safe Point syringe exchange and access program that provides access to drug treatment programs and HIV testing.
A Powerful Lobbyist
At the same time, however, the institutional church continually lobbies governments to exclude condom promotion from development aid, and the impact of the Vatican's stance on condom use is far reaching and perilous.
The bishops' efforts have not been limited to the global South. In 2008, the U.S. Conference of Catholic Bishops successfully used its lobbying power on Capitol Hill to remove family planning from the President's Emergency Plan for AIDS Relief (PEPFAR).
Provisions in the final PEPFAR bill not only allow faith-based groups to abstain from distributing condoms, but also to refrain from providing referrals to agencies that do. Catholic Relief Services is one of the top recipients of PEPFAR funding: $103 million in 2007. Through its far-reaching programs, the Catholic church has been able impose its myopic anti-condom stance on those countries most affected by the HIV epidemic.
In order to stem the national and international impact of the church's teaching on condoms, Catholics for Choice's Condoms4Life campaign provides a vocal counterpoint to the Vatican's stance on condom use. Using the core message "Good Catholics Use Condoms," the campaign supports Catholics and non-Catholics in using and promoting the use of these lifesaving and life-affirming devices and calls on the hierarchy to join others in the active prevention of the spread of HIV throughout the world.
The Catholic hierarchy proclaims its opposition to condom use in the name of the "pro-life" cause. Pope Benedict and the Catholic hierarchy are unable, however, or perhaps unwilling, to acknowledge that condom use is pro-life. From the World Health Organization to the United Nations, experts agree that condom use goes a long way to reducing the transmission of HIV. Not only the experts, but Catholics around the world, agree that condom use as a means to combat HIV is indeed pro-life.
Jon O'Brien is the President of Catholics for Choice.