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Will Condoms Really Stop AIDS In Africa?
We're told by the mass media that condom distribution is the solution to the AIDS crisis in Africa and that the Catholic Church is standing in the way of that effort. The research, however, contradicts that view.
If you've watched any of the mainstream news coverage of the Catholic Church in the past month, you've heard several charges repeated over and over: The Church needs to ordain women to address the vocation shortage... the Church needs to change its attitude on contraception and abortion to better accommodate modern realities... the Church needs to moderate its stance on homosexual behavior to be more inclusive... the Church needs to drop its claim to contain the fullness of salvation, since it hinders ecumenism.
Chances are, you're already well equipped to address these objections. But there's one charge that seems to throw Catholics for a loop.
It goes something like this:
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 infection 90% of the time. If the Vatican cared more about people's lives than a rigid doctrine that most Catholics reject, they'd 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. After all, logic and philosophy are easily dismissed as abstractions when human life is involved.
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 (cited by the Zenit News Agency, June 26, 2004). 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 that, "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 ("The White House Initiative to Combat AIDS: Learning from Uganda," Joseph Loconte, Executive Summary Backgrounder).
How could this be? After all, we're told that condoms are 90% 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% figure is accurate (a highly contested point), that means that 10% of the time, condoms don't offer protection against transmission.
That's one out of ten.
If you and I were to go skydiving, and I told you, "Don't worry... the parachutes work 90% of the time," how comfortable would you be making that jump?
Now, of course, the fact that a condom fails to "work" doesn't mean the person will automatically contract HIV/AIDS. Nevertheless, this is hardly the solution to the crisis.
You see, the pro-condom lobby's exaggerations over the effectiveness of its product is actually making the problem worse, for one simple reason: Condoms provide a false sense of security to those who use them. Being convinced of their effectiveness and feeling invulnerable, users will simply continue or actually increase their high-risk behavior. In this way, the claimed 90% effectiveness rate plummets in proportion to the increase in self-destructive behavior. This phenomenon is borne out in the countries that focus on condom distribution to fight the disease.
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.
And 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, their government instituted a program to teach abstinence before marriage and fidelity to one's partner afterwards. They 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%. By 2001, it had dropped to 5%. It was the biggest HIV infection reduction in world history.
Among pregnant women, the drop was even more dramatic (as reported by CNS News, January 13, 2003). In 1991, 21.2% of expecting mothers tested positive for HIV. By 2001, the number had plummeted to 6.2%. Compare this with the 2001 numbers from Kenya (15%), Zimbabwe (32%), and Botswana (38%). All three countries focus on condom distribution, and all three countries continue to see their rates rise.
But wait, the condom advocates object. The Ugandan "miracle" is simply the result of more widespread condom use.
Not so, says Dr. Edward C. Green, an anthropologist at the Harvard University School of Public Health. Dr. Green was a strong proponent of condom distribution to stem HIV/AIDS... that is, until the U.S. Agency for International Development (USAID) hired him to study the reasons behind the success in Uganda.
The results of his research left him little doubt. "Reduction in the number of sexual partners was probably the single most important behavioral change that resulted in prevalence decline," he noted. "Abstinence was probably the second most important change" (testimony before the Subcommittee on African Affairs, as reported by Joseph Loconte).
"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."
Unfortunately, not everyone was pleased with Dr. Green's conclusions. USAID shelved his study and enlisted a well-known condom advocate and employee of ETR Associates (an organization dedicated to "safe-sex" education) to write a new one. Apparently, USAID wasn't concerned with the apparent conflict of interest.
This is especially tragic, as the effectiveness of abstinence and fidelity education has been demonstrated by numerous research groups. As Loconte notes, evidence for the success of Uganda's approach has come from "USAID, the Joint United Nations Program on HIV/AIDS (UNAIDS), the World Health Organization (WHO), the Harvard Center for Population and Developmental Studies, the Ugandan government, and numerous independent studies published in medical journals."
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 exception, of course, is the African country's concession to 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/AIDS 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/AIDS 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/AIDS 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, like the self-sacrifice that abstinence requires.
It's not easy, but real love rarely is.
I'll talk to you next week,
Brian Saint-Paul. "Will Condoms Really Stop AIDS In Africa?" Crisis E-Letter (May 19, 2005).
This article is reprinted with permission from the Morley Institute a non-profit education organization. To subscribe to Crisis magazine call 1-800-852-9962.
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Brian Saint-Paul is the editor of Crisis Magazine.
Copyright © 2005 Crisis