The Pope is Right About Condoms

The Pope is Right About Condoms March 24, 2009

Last week, while traveling in Africa, Pope Benedict came under withering criticism when he suggested that condoms were not the answer to the AIDS crisis. “You can’t resolve it with the distribution of condoms; on the contrary, it increases the problem.” But as Dr. Edward Green, Director of of the AIDS Prevention Research Project at the Harvard School of Public Health noted in an interview yesterday, from an empirical perspective the Pope was absolutely right:

I am a liberal on social issues and it’s difficult to admit, but the Pope is indeed right. The best evidence we have shows that condoms do not work as an intervention intended to reduce HIV infection rates, in Africa. (They have worked in e.g. Thailand and Cambodia, which have very different epidemics) . . . What we see in fact is an association between greater condom use and higher infection rates. We don’t know all the reasons for this but part of it is due to what we call risk compensation. This means that a man using condoms believes that they are more effective than they really are, and so he ends up taking greater sexual risks. Another fact which is widely overlooked is that condoms are used when people are engaging in casual or commercial sex. People don’t use condoms with spouses or regular partners. So if condom rates go up, it may be that we are seeing an increase of casual sex.

(HT: Mirror of Justice)

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  • “There has been considerable interest in understanding what may have led to Uganda’s dramatic decline in HIV prevalence, one of the world’s earliest and most compelling AIDS prevention successes. Survey and other data suggest that a decline in multi-partner sexual behavior is the behavioral change most likely associated with HIV decline. It appears that behavior change programs, particularly involving extensive promotion of “zero grazing” (faithfulness and partner reduction), largely developed by the Ugandan government and local NGOs including faith-based, women’s, people-living-with-AIDS and other community-based groups, contributed to the early declines in casual/multiple sexual partnerships and HIV incidence and, along with other factors including condom use, to the subsequent sharp decline in HIV prevalence. Yet the debate over “what happened in Uganda” continues, often involving divisive abstinence-versus-condoms rhetoric, which appears more related to the culture wars in the USA than to African social reality.” Uganda’s HIV prevention success: the role of sexual behavior change and the national response. Green EC – AIDS Behav – 01-JUL-2006; 10(4): 335-46.

  • Uganda’s HIV prevention success: the role of sexual behavior change and the national response. Green EC – AIDS Behav – 01-JUL-2006; 10(4): 335-46.

  • I can’t say it’s surprising at this point, but it is disappointing that for the vast majority of those who follow ‘the mainstream media’, the dominant story regarding a 7 day visit by the Pope to AFRICA is that the Catholic Church opposes contraception (who knew?).

    Writing from Uganda, Martyn Drakard of MercatorNet exclaims “The international media has a woeful ignorance of Africa,” and wonders: “Why don’t they listen to someone who knows?:

    As he flew from Rome to Cameroon for his first African trip, Benedict XVI held a press conference. He spoke of many things relevant to Africa: the credit crisis, its ethical dimension, its social welfare dimension; solidarity between the developed and developing world; corruption; the vibrancy of the faith and energy of the people; how he hopes to implement Catholic social teaching; and a forthcoming Synod of African Bishops. He even rebutted suggestions that he was “lonely” in the Vatican.

    Yet what did the media pick up? That the Pope is opposed to condoms as a solution to Africa’s supposedly overwhelming problem: AIDS.

    Or as John Allen Jr. remarked:

    “I don’t think I’ve ever covered a papal trip where the gap between internal and external perceptions has been as vast as over these three days. It’s almost as if the pope has made two separate visits to Cameroon: the one reported internationally and the one Africans actually experienced.”

  • grega

    What does the Pope suggest – Abstinence
    Great that does not even seem to work within the highly motivated celibate priestclass.
    Fat chance infected married couples stops having sexual relations.
    A bit of honesty on all parts would be helpful.

    For those of us on the more liberal end of society we do have to recognize that the social groups/societies in this world that indeed succeeded in avoiding significant infection with AIDS are the devout religious ones – particular of the islamic faith.

    In that sense sure the Pope is right on – but the not so dirty little secret is as a society we are simply not willing to pay the price in terms of limitations to our freedom of expression and cultural norm that would come with the offered solution.
    We instead very much prefer to come up with moral tweaks and medical/technical remedies.
    ‘Condomes’ fit so nicely into our societal trick bag because we invented them for that reason in the first place. That Cat is out of its bag for a long time.

  • radicalcatholicmom

    Grega: Last night on PBS they focused on South Africa’s AIDS epidemic and how it got to be where it is right now. They have had free condoms for forever but culturally to wear condoms is just not accepted. Now South Africa’s Gov is FINALLY gearing up to combat AIDS on multi-levels. I assume they will follow the highly effective Ugandan model, which is Abstain (there-by decreasing numbers of sexual partners) Be Faithful (single partner) and Condom usage among those infected in single relationships. Together with education teams, this approach has worked.

    In Africa, the number ONE risk factor for women is marriage. Yep, marriage. According to the new S.Africa Health Minister, she notes migration and AIDS go hand in hand. Men move to find work. Women and families stay behind. Men find lovers, return to wives on vacations and there you go. Now the government and corporations (who were watching their employees die by the thousands) are working to ensure families are united and allowed on job sites. It is working! New cases are falling significantly.

    So yes, our Holy Father is correct, condoms are not THE answer. Society has to decide what is important and then act on it.

  • David Nickol

    It seems to me that the pope said so little that it is difficult to say he is right or wrong. Suppose the pope had said the following, “Studies show that in certain populations in Africa, when condoms are used inconsistently, as they very frequently are, they give a false sense of reduced risk that may actually result in people taking more risk than they would have otherwise, thus making things worse.” That would be open to empirical verification. But he didn’t say that. And he also didn’t say that condoms are used consistently and effectively in some high-risk populations, like sex workers.

    Would the pope agree with Dr. Green that condoms were part of the solution to the epidemics in Thailand and Cambodia?

    Obviously, the most effective response to the HIV/AIDS epidemic requires figuring out what is effective in which population, and emphasizing the most effective solution for each group you deal with. If there are populations in which providing condoms and information on how to use them is ineffective, then other approaches need to be taken with those populations.

    However, the pope appeared to be making a blanket condemnation of using condoms. He didn’t say, “Yes, well, they worked in Thailand and Cambodia, but we need a different approach here.” He would have condemned their use in Thailand and Cambodia just as strongly as he is condemning their use in Africa.

  • David Nickol usually gets it. What few beside him ever consider is that to the pope/the Catholic church it doesn’t matter whether condoms have benefits or not. The reason it opposes them is completely separate from that. Condoms could bring world peace, Fellatio* could be the fountain of youth and the Catholic church would still oppose it on the books. In brief, it’s not a utilitarian argument.

    It all comes down to the fact that sperms must have one stop and one stop only on their travels and that is the wifely vagina. Arguments for or against condoms based on disease etc., including by popes, completely miss the Catholic point.

    Now, why you have such peculiar rules re: sperms may be traced back to the concept that the ‘seed’ was the entire new being. Augustine et alii considered masturbation worse than (heterosexual, non-contraceptive) incest. Obviously they also didn’t know that there were millions of swimmers jockeying for position.

    The ovum wasn’t discovered until the 19th century. 50/50 DNA mother/father also wasn’t known when the concept of Jesus having been fathered divinely arose. The Greeks apparently understood that to some degree, given the ‘existence’ of demigods.

    * If I understand correctly, Catholics are allowed fellatio as long as they stop in time…

  • beDecent

    This means that a man using condoms believes that they are more effective than they really are, and so he ends up taking greater sexual risks.

    So, the real problem is a lack of education. Just because condoms are freely available, if the people aren’t taught how to effectively use them, well then, they won’t. Kids think two condoms would be more effective than one, until they are told differently. I wonder, how are Africa’s sex education programs?

    In a society where it’s the norm to wear a bulletproof vest outside, more people are getting shot. That’s called correlation, and it really needs to be taken into consideration to come to a solid conclusion.

  • Kurt

    The matter that concerns me is less the technical accuracy of the Pope’s comment but (even after Williamson, Regensburg, the plane in Mexico, etc.) he doesn’t understand that it was foolish to make such a comment in transit to Africa.

    If you want to speak about condoms, make a major address and have your Vatican PR flaks in place to explain it to the media. Throwing out a line, as he did, gave him no opportunity to make a thoughtful, full statement. It gave his advisors no notice,and caused this topic to overwhelm his trip (which, if this was the theme he wanted for his trip, fine, but I think it was not).

    If I understand correctly, Catholics are allowed fellatio as long as they stop in time…

    I believe the Church’s teaching is that it is permissible so long as an authentic attempt is made to properly complete the marital act. Note the Church uses the term “authentic attempt” and not “successful attempt” and that the Church does not provide diagrams to aid the faithful in the acrobatics required.

  • David Nickol

    So, the real problem is a lack of education.


    I agree here. Given that condoms are effective when used consistently and correctly, if it is discovered that people don’t use them consistently and correctly, then one would think the first approach would be to find a way to get people to use condoms consistently and correctly.

    I am not an expert, but I doubt if there is any AIDS-prevention program that relies solely on condoms. I think the typical approach is the ABC approach (abstain, be faithful, use condoms). And clearly the pope and the Catholic Church would oppose such an approach.

    It also appears to be the case that Dr. Green is speculating about “risk compensation.” And the World Health Organization disagrees with him:

    Kevin De Cock, director of the H.I.V./AIDS program at the World Health Organization, said there was no scientific evidence showing that condom use spurs people to take more sexual risks.

    He said in an interview by telephone that condoms were highly effective “to prevent the transmission of H.I.V. if they are used correctly and consistently.”

    Mr. De Cock said abstinence and reducing the number of partners were also needed and praised faith-based groups, noting that many Catholic charities provided treatment for people with the virus in some of the poorest and most remote parts of the world.

    So even if the pope was making an argument based on “risk compensation” and not about the morality of condoms, there is no conclusive evidence that he is right.

  • M.Z.

    This is frustrating on many levels, because even here in the US, we have the same problems. Lack of contraception use in any form is not the leading predictor of AIDS, STDs, or even pregnancy. I believe it is somewhere around the 4th best predictor. The problem of course is that writing a check doesn’t solve the problems of the other leading predictors. The other not so small problem is that many people believe behaviors that are predictors should be acceptable.

  • Very tangentially, since I just found it online. This short story by Somerset Maugham is highly delightful. “The Judgment Seat”
    This quote alone
    “I sometimes think,” said the Eternal, “that the stars never shine more brightly than when reflected in the muddy waters of a wayside ditch.”

  • Christina Viering

    Just say no.

  • digbydolben

    For me, the important story coming away from the Pope’s trip to Africa is that Ratzinger–even as compared with his predecessor–is entirely lacking in the qualities of a “pastor,” and is, therefore, absolutely unqualified to be a modern pope:

    Not only did he take the bait on that plane, which he did not have to do, but he also made subtly derogatory remarks about the “inculturation” of the Catholic liturgy by his hosts. His natural place is in a theology faculty, but it is NOT on Peter’s bark. He is a disaster as Supreme Pontiff of the Catholic and Apostolic Church.

  • Spirit of Vatican II

    I am amazed to hear from radicalcatholicmom that Uganda’s ABC program recommends condom usage only within single faithful relationships. I had interpreted the ‘use Condoms’ clause as meaning that even if you cannot practice abstinence or fidelity, at least have the sense to use a condom. I also thought that Catholic missionaries in Uganda handed out condoms to all who needed them.

    The Pope does well to uphold abstinence and fidelity, but he does not do well to recommend disuse of condoms — this is lethal advice.

  • Spirit of Vatican II

    The Pope’s divisive, myopic and destructive attitude can be clarified if you look up a piece on condoms by a recently deceased Hispanic hierarch, whose name eludes me just now. The piece is insane, but it is proudly displayed on the Vatican’s website.

  • grega

    Sadly it is quite obvious where this one will go –
    it just adds to the pile of unpractical church advice.
    Most Catholics have concluded long time ago to take church advice related to this “department” with more than a grain of salt. Come on, who really expects that the aging celibates who made it to the top of the Vatican will come up with something refreshingly honest and realistic? They really do not care to bake this into something workable – isn’t is much more convenient to spin out’anchient’ wisdom?
    They have done that for the longest time really – it seems every time society takes significant progressive steps the catholic hirachy all but freeze up – 130 years ago they all of a sudden they urgently needed papal infalliability – Really significant amounts of mental energy have gone into they fight to push back the ‘evils of modernity’ for the better part of the last 500 years.

  • Spirit of Vatican II

    Yes, grega, but I worry about the kids who are being educated by Catholic and Muslim fundamentalists all over the world.