This weekend, over 100 experts from around the world gathered for a two-day symposium organized by the Vatican’s Pontifical Council for Health Care Workers on preventing HIV and caring for those who are living with the virus. While some HIV-prevention advocates had hoped the Vatican would use this opportunity to build on recent comments by the pope suggesting a more favorable stance toward condom use for HIV prevention, Vatican officials at the symposium toed the line and emphasized chastity and behavior change.
In November 2010, Pope Benedict XVI made comments during an interview for the book Light of the World, in which he said, in part, “there may be a basis in the case of some individuals, as perhaps when a male prostitute uses a condom, where this can be a first step in the direction of a moralization, a first assumption of responsibility.” Progressives within the church and AIDS activists hailed the comments as a first step in the loosening of the Vatican’s prohibition on condoms as part of HIV-prevention but Vatican officials quickly and repeatedly backed away from the remarks.
Nonetheless, some hoped that the pope’s sentiments could be the starting point for a new conversation about HIV-prevention that included condoms. Michel Sidibé, the executive director of UNAIDS, mentioned the pope’s comments when he spoke on Saturday telling attendees: “This has helped me to understand his position better and has opened up a new space for dialogue.” He went on to say:
“Yes, there are areas where we disagree and we must continue to listen, to reflect and to talk together about them. But there are many more areas where we share common cause.”
But Church officials who spoke this weekend seem mainly to ignore the pope’s comments. Cardinal Tarcisio Bertone, the Vatican secretary of state, did not mention condoms. Instead, he focused on other behavior: “Educating people to avoid high-risk behavior, when based on solid moral principles, fully demonstrates its effectiveness and translates into greater openness toward those already affected by the virus.” Other officials spoke of the importance of abstinence and chastity before marriage and fidelity within marriage. In fact, at the conference the Vatican affirmed that married couples in which one member has HIV should practice abstinence within their marriage as well.
By not addressing condoms directly, the Vatican missed an opportunity for a realistic look at the role condoms play in preventing HIV and AIDS especially in Africa. Some scientists are now questioning how much of the limited HIV-prevention resources should be invested in condom availability programs as opposed to programs that take other approaches. Dr. Edward Green, the former director of the AIDS prevention research project at Harvard University, says that evidence shows what works in Africa, where the epidemic is largely driven by concurrent heterosexual partners, is male circumcision and partner reduction. Green, who also spoke at the conference on Saturday, said in an interview: “I’m not anti-condom. They should be accessible, affordable, free. Just don’t bet the house and farm on it.” Green worries that there is little support for programs that advocate partner reduction especially among Western donors.
Still, others suggest that partner reduction programs do not sufficiently acknowledge the reality of the lives of many women. Monsignor Kevin Dowling, who has been critical of the Vatican’s stance on condoms, was not invited to the Vatican’s conference. Dowling runs an HIV-prevention and care program in Rustenburg, South Africa and feels that condoms need to be a part of prevention—not for pregnancy but for disease. He says the women he sees are engaging in “survival sex,” exchanging sex for food and shelter because there are no available jobs: “What am I to say to her? That the only 100 percent sure way of ensuring that you will not become infected is to abstain from sex before marriage, and remain faithful to a single partner in a stable marriage for the rest of your life?’” Dowling said in an email. ‘Such “choices” are totally, but totally irrelevant to such people.”