The Catholic Church is a major provider of medical care to HIV/AIDS patients. Much of its work takes place in developing countries, although it has also had a presence in the global north. Its opposition to condoms, despite their effectiveness in preventing the spread of HIV, has invited criticism from public health officials and anti-AIDS activists.
Catholic views on condoms
The Catholic Church's opposition to contraception includes a prohibition on condoms. It believes that chastity should be the primary means of preventing the transmission of AIDS. The Church's stance has been criticized as unrealistic, ineffective, irresponsible and immoral by some public health officials and AIDS activists, who share evidence that condoms prevent the transmission of HIV.
The use of condoms specifically to prevent the spread of AIDS has involved Catholic theologians arguing both sides. Pope Benedict XVI pointed out that when a male prostitute uses a condom "with the intention of reducing the risk of infection, can be a first step in a movement towards a different way, a more human way, of living sexuality." He said that the concern for others suggested by this action is laudable, but does not mean that either prostitution or condoms are in themselves good.
1980s In 1988, a debate within the Catholic Church over the use of condoms to prevent AIDS sparked an intervention from the Vatican. The Church in 1968 had already stated in Humanae Vitae that chemical and barrier methods of contraception went against Church teachings. The debate was over whether or not condoms could be used, not as contraceptives, but as a means of preventing the spread of HIV/AIDS and other sexually transmitted diseases. In 1987, the U.S. Conference of Catholic Bishops issued a document suggesting that education on the use of condoms could be an acceptable part of an anti-AIDS program. In response, Joseph Ratzinger, then-prefect of the Sacred Congregation for the Doctrine of the Faith, stated that such an approach "would result in at least the facilitation of evil", not merely its toleration.
In the 1980s, Catholic hospitals received a waiver from the State of New York from the requirement to offer condoms and other services that conflicted with Church teaching in return for state funding. In the same decade, the Archdiocese of New York would not lease classroom space to the New York Board of Education to hold classes on AIDS education unless the board agreed to waive parts of the curriculum that the Church found objectionable. It also objected because the curriculum made "no mention of modesty, chastity, premarital sexual abstinence or even marital fidelity."
In 1989, AIDS activist group ACT UP instigated a civil disobedience action at St. Patrick’s Cathedral in New York City called Stop the Church in part to protest the Catholic Church’s position on condom use.
1990s Pope John Paul II upheld the church's traditional prohibition on condoms. His position was harshly criticized by some doctors and AIDS activists who said that it led to deaths and millions of AIDS orphans. It was also suggested that his position on condoms cost him the Nobel Peace Prize, which he was widely expected to receive.
In September 1990, John Paul II visited the small town of Mwanza, in northern Tanzania, and gave a speech that many believe set the tone for the AIDS crisis in Africa. John Paul II said that condoms were a sin in any circumstance. He lauded family values and praised fidelity and abstinence as the only true ways to combat the disease. In December 1995, the Pontifical Council for the Family issued guidelines saying that "parents must also reject the promotion of so-called 'safe sex' or 'safer sex', a dangerous and immoral policy based on the deluded theory that the condom can provide adequate protection against AIDS."
2000s In 2003, Cardinal Trujillo, then president of the Pontifical Council for the Family, stated in a BBC documentary that the "scientific community accepts" that the HIV virus can pass through condoms. This claim was refuted by the World Health Organisation as "scientifically incorrect" in a formal statement, reflecting their position that condoms provide effective protection against HIV transmission. The Cardinal later provided additional context for his comment in a statement. He attributed his assertion that the virus can pass through microscopic pores in latex to two papers by Catholic authors (Jacques Suaudeau and J.P. M Lelkens), citing studies which "hypothesize that ... the process of vulcanization could contribute to the irregularity of the latex surface and the presence of microscopic pores." The Cardinal's statement did not repeat his previously implied claim of scientific consensus on conclusions from those studies.
In 2005, Pope Benedict XVI (formerly Ratzinger) listed several ways to combat the spread of HIV, including chastity, fidelity in marriage and anti-poverty efforts; he also rejected the use of condoms.
In 2005, a senior research scientist at the Harvard School of Public Health, Edward C. Green, stated that while "in theory, condom promotions ought to work everywhere ... that's not what the research in Africa shows." Green also indicated that strategies that worked in Africa were "strategies that break up these multiple and concurrent sexual networks – or, in plain language, faithful mutual monogamy or at least reduction in numbers of partners, especially concurrent ones."
There was much media attention about Benedict's comments on condom use after his interview with Peter Seewald in 2010. In the interview, Benedict discussed how the Church was helping people with AIDS and the need to fight the trivialisation of sexuality. Replying to the interviewer's comment that, "It is madness to forbid a high-risk population to use condoms", Benedict stated:
This explanation was interpreted by many as a change of tack by the Vatican which necessitated a clarification from the Vatican that "the pope does not morally justify the disordered exercise of sexuality, but maintains that the use of the condom to diminish the danger of infection may be "a first assumption of responsibility", as opposed to not using the condom and exposing the other person to a fatal risk. Due to confusion over a translation, it was later clarified that Benedict's comments did not just refer to men, but women and transgender people as well.
As John Haas, the president for the American National Catholic Centre for Bioethics noted, Benedict did not address the issue of whether condoms are effective at preventing HIV transmission. The new statement from Benedict was criticized by conservative Catholics such as Jimmy Akin, who described Benedict's statements as "private opinions" as opposed to "official Church teaching".
2010s After a trip to Africa, in which he spoke little on AIDS but visited with HIV positive children, Pope Francis dismissed the question of whether or not condoms should be used to fight transmission. An annoyed Francis said the church's views on condom usage was a small issue compared to a lack of clean water and malnutrition.
Dissent There have been a number of Catholics and theologians who have dissented from the Church's position on the use of condoms.
Some bishops have suggested that condom use may be acceptable in some circumstances to prevent AIDS. In 1996, the Social Commission of the French Bishops' Conference said that condom use "can be understood in the case of people for whom sexual activity is an ingrained part of their lifestyle and for whom [that activity] represents a serious risk." In 1993, the German Bishops' Conference noted: "...consideration must be given ... to the spread of AIDS. It is a moral duty to prevent such suffering, even if the underlying behavior cannot be condoned in many cases..."
Carlo Maria Martini, the archbishop of Milan, opined that when one spouse has HIV but the other does not that using condoms could be considered "a lesser evil". But he quickly noted that the church should not acknowledge these considerations publicly because of "the risk of promoting an irresponsible attitude."
Kevin Dowling, bishop of Rustenburg, believes that the Catholic Church should reverse its position on the use of condoms to prevent HIV transmission. Following this, he received a number of rebukes from the South African papal nuncio. The bishops' conference condemned his words, describing condoms as "an immoral and misguided weapon" in the fight against HIV, and argued that condom use could even encourage the spread of HIV by promoting extramarital sex.
Martin Rhonheimer, theologian and professor of Ethics and Political Philosophy at the Pontifical University of the Holy Cross, believes that using a condoms to prevent AIDS can be justified on the basis of the principle of double effect. Because the pair use the condom to prevent disease, not conception, the infertility of this act should be considered as side effect of using a condom. Janet E. Smith disagreed, saying the "embedded meaning" of using a condom must be consider as its essential part.
Scientific assessment According to sex education experts, abstinence-only sex education is not effective, and comprehensive sex education should be used instead. Research has found that abstinence only education fails to decrease people's risks of transmitting STDs in the developed world.
The Church's stance has been criticized as unrealistic, ineffective, irresponsible and immoral by many public health officials and AIDS activists. Empirical evidence suggests that condoms reduce the numbers of those who are infected with an STD, including HIV. Some researchers claim that the primary challenge is getting people to use condoms all the time.
Medical care for AIDS patients
The Catholic Church, with over 117,000 health centers, is the largest private provider of HIV/AIDS care. While not allowing the use of condoms, Catholic Church-related organizations provide more than 25% of all HIV treatment, care, and support throughout the world, with 12% coming from Catholic Church organizations and 13% coming from Catholic non-governmental organizations.
According to the Vatican, care providers include 5,000 hospitals, 18,000 dispensaries, and 9,000 orphanages located both in rural and urban environments. Much of the Church's aid effort is concentrated in developing nations – in Africa, Asia, and Latin America. Catholic medical centers treat those already infected and make efforts to prevent the spread of the disease. Catholic hospitals were among the first to treat HIV/AIDS patients in the early 1980s.
United States By 2008, Catholic Charities USA had 1,600 agencies providing services to people with AIDS, including housing and mental health services. The Archdiocese of New York opened a shelter for AIDS patients in 1985. In the same year, they also opened a hotline for people to call for resources and information. The Missionaries of Charity, led by Mother Teresa, opened hospices in the Greenwich Village neighborhood of New York, Washington, D.C., and San Francisco in the 1980s as well. Individual parishes also began opening hospices for AIDS patients.
Australia AIDS arrived in Australia in the 1980s. Soon after, the Sisters of Charity began to admit patients with the new disease at St Vincent's Hospital, Sydney, in Sydney's inner city, which became a world leader in HIV research. However, despite its geographic proximity to the infected community, it was reported that the atmosphere at St Vincent's was initially homophobic in the early 1980s, but hospital administrators took action to correct the situation.
Africa