Pope Benedict XVI’s’s comments on the use of condoms as a means of protection against HIV infection have been interpreted as the first move in the controversial (and many would argue irresponsible) Vatican stance on the use of condoms as a means of prevention against HIV and AIDS. It is not entirely clear how far the Pope is willing to sanction the use of condoms. Is he, as seems to be the case in the widely reported interview, talking only about their use by male prostitutes with their (male) clients? In which case there is little challenge to the Roman Catholic official position on the use of artificial contraceptives as a means of birth control. Or was the instance of the male prostitute (bearing in mind the interview was in German, translated into Italian, and subsequently into English) used as an example to argue a broader point: that if the intention is to protect against an infection (which, despite the existence drug therapies that mean HIV need not be a lethal disease, still kills more than around 5,500 a day – mostly in sub-Saharan Africa), it might be considered to fall within the requirement to respect the sanctity of life central to Catholic teaching? [Since this post was first put up, the Vatican have clarified the Pope’s comments. They apply, according to officials, to all people, making this potentially a more radical shift in policy.]
It is likely that this statement is an attempt to prepare the ground for a (presumably still distant) change in the official Vatican line on the use of condoms in respect to the HIV and AIDS epidemics. But, possibly equally likely (especially under the current Pontiff), it could also represent the limits the Pope is prepared to concede in the face of the long-standing criticism of Catholic teaching in this regard.
Whilst the statement is (at best) a minor concession, it should be placed in the context of previous comments by Pope Benedict XVI on the use of condoms. In March 2009, during his first official visit to Africa, he suggested not only that condoms were insufficient to defeat HIV and AIDS (in itself, hardly controversial), but argued they ‘even aggravate the problem’. The following year, he declared that Catholic teaching on the use of condoms was the only sure route to preventing infection. Many Catholic leaders and commentators have followed this line. The Roman Catholic Bishops of Africa and Madagascar stated in a 2004 communiqué that condoms: ‘go against human dignity; they change the beautiful act of love into a grabbing for pleasure, without accepting responsibility and thus go against the way in which God has created us’. Catholic commentator Joanna Bogle argued on Britain’s Channel 4 News in 2009 that ’22 million people [in Africa] have AIDS now because of the condom campaign that’s making it worse, not better’.
But alongside the broad defence of Catholic teaching in this area, it is important to remember that senior Catholic voices have, in fact, advocated the use of condoms as a means of prevention against infection for some time, albeit not widely reported, and in language designed not to conflict too openly with official doctrine. Cardinal Barragan, as chair of the Pontifical Council for Health, has argued that where individuals cannot be abstinent, the use of a condom may be acceptable. Similarly, an African cardinal from Cameroon, and two Bishops from sub-Saharan Africa, have also tentatively supported the use of condoms in certain situations. Indeed, it has been known for Catholic health clinics in parts of sub-Saharan Africa to offer family planning services, quietly and without fuss (until it becomes widely known, and comes to the attention of the Vatican authorities). Nor is Catholicism alone in its attitudes towards safe sex and the use of the condom in particular.
This points to the key point, that there is gap between official Catholic teaching, as promulgated by the Vatican, and accepted practice amongst Catholics (condom usage by married women in Spain, for example, is relatively high at over 35%). However, the evidence does seem to suggest that the official Catholic line on condoms in relation to HIV has damaged prevention efforts, and in some countries, and for some people, the effect of its teaching has been lethal. The shift in prevention messaging towards abstinence only campaigns (particularly following US funding policy towards HIV and AIDS prevention programmes under PEPFAR under former President George Bush Jr) has undermined efforts to control the epidemic. So any shift in position, however small, must be welcomed, especially if it does herald a wider shift in policy.
But we must remember that reforming Catholic teaching alone will not be sufficient in making condoms both more accessible and (crucially) used more often. The barriers to condom use are far wider than just religious teachings. There are many reasons why men and women are reluctant to use condoms – cultural, religious, economic, power-relations, etc. Some – arguments over reduction in pleasure, for example – may be easier to overcome, but others will be more intractable. Where women’s rights over their own bodies are not just enshrined in law and enforced, but also respected in broader society, greater availability will not necessarily translate into greater use. Addressing rights in a real, and enforceable way, as well as efforts to promote changes in attitudes towards those (women especially) who ask for a condom to be used, are essential. Whilst women fear violence if they ask a partner to wear a condom, or fear being labelled immoral or willing to have casual sex if they buy condoms themselves (which can open up risks of sexual assault and rape), a change in Catholic teaching will not be sufficient to make substantial change (although it may go some way in helping shift attitudes).
There is also a question of how condoms might be introduced into long-term relationships (in which risks of transmission are higher than over causal sexual contact, due to prolonged exposure to the virus) without undermining those relationships. One member asking to use condoms during sex (unless the partner has a confirmed or suspected diagnosis of infection) is essentially a statement of distrust: how likely is it, within the context of a long-term relationship, that such a request will made?
This is not to suggest promoting condom usage is not a (vitally) important part of broader prevention efforts. Pope Benedict VXI’s comments are interesting, and potentially important, although their true significance and meaning remains to be worked out, not least, presumably, in the corridors of the Vatican. But one thing is clear, even if this does signify a major shift in Catholic teaching, whilst welcome, it will not in itself solve the problem of how to promote greater use of condoms as one of the prevention strategies against infection with HIV. Nor will it end debate within the Catholic hierarchy. Liberals and conservatives will continue to hammer out this issue, and any perceived shift to a more liberal position will face considerable intetrnal resistance. No doubt even a full Vatican sanction for the use of condoms would not be accepted by all, as tensions over Catholic attitudes to life, birth control, and the need to prevent infection continue to play out in the Church.