Catholic Church and HIV/AIDS
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.[1][2][3] It believes that chastity should be the primary means of preventing the transmission of AIDS.[4][5] The Church's stance has been criticized as unrealistic, ineffective, irresponsible and immoral by some public health officials and AIDS activists,[4][6][7] who note that condoms prevent the transmission of HIV.[8][9][10][11][12][13]
The use of condoms specifically to prevent the spread of AIDS has involved Catholic theologians arguing both sides.[14][15][16] 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."[17] 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.[18][19][17]
1980s
In 1988, a debate within the Catholic Church over the use of
In the 1980s, Catholic hospitals received a waiver from the
1990s
Pope
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.[22] John Paul II said that condoms were a sin in any circumstance.[22] He lauded family values and praised fidelity and abstinence as the only true ways to combat the disease.[22] 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."[23]
2000s
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.[24]
In 2005, a senior research scientist at the
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:
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, on the way toward recovering an awareness that not everything is allowed and that one cannot do whatever one wants. But it is not really the way to deal with the evil of HIV infection. That can really lie only in a humanization of sexuality.[26]
This explanation was interpreted by many as a change of tack by the Vatican[27] 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.[28] Due to confusion over a translation, it was later clarified that Benedict's comments did not just refer to men, but women and transexuals as well.[29]
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".[30]
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.[31] An annoyed Francis said the church's views on condom usage was a small issue compared to a lack of clean water and malnutrition.[31]
Dissent
There have been a number of Catholics and theologians who have dissented from the Church's position on the use of condoms.[32]
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."[33][34] 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..."[35]
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".[36][37] But he quickly noted that the church should not acknowledge these considerations publicly because of "the risk of promoting an irresponsible attitude."[38]
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.[41] 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.[42][43][44] Research has found that abstinence only education fails to decrease people's risks of transmitting STDs in the developed world.[45]
The Church's stance has been criticized as unrealistic, ineffective, irresponsible and immoral by many public health officials and AIDS activists.[4][6][7] Empirical evidence suggests that condoms reduce the numbers of those who are infected with an STD, including HIV.[8][9][10][11][12][13] Some researchers claim that the primary challenge is getting people to use condoms all the time.[46]
Medical care for AIDS patients
The Catholic Church, with over 117,000 health centers, is the largest private provider of HIV/AIDS care.[47] While not allowing the use of condoms,[48] Catholic Church-related organizations provide more than 25% of all HIV treatment, care, and support throughout the world,[49][47][50] with 12% coming from Catholic Church organizations and 13% coming from Catholic non-governmental organizations.[51]
According to the Vatican, care providers include 5,000 hospitals, 18,000 dispensaries, and 9,000 orphanages located both in rural and urban environments.[49][52][48] Much of the Church's aid effort is concentrated in developing nations – in Africa, Asia, and Latin America.[53][54] 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[55][56] in the early 1980s.[57]
United States
By 2008, Catholic Charities USA had 1,600 agencies providing services to people with AIDS, including housing and mental health services.
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.[61] 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.[62]
Africa
The
The Community of Sant'Egidio is "among global leaders on HIV/AIDS"[66] with a large presence in Africa. Its Drug Resource Enhancement against Aids and Malnutrition (DREAM) program is one of the most studied approaches to HIV / AIDS treatment in the world, with many of the roughly 100 papers attesting to its efficacy.[67] DREAM takes a holistic approach, combining highly active antiretroviral therapy (HAART) with the treatment of malnutrition, tuberculosis, malaria, and sexually transmitted diseases while emphasizing health education at all levels.[68] The program was initiated in Mozambique in March 2002 and has spread throughout the continent in dispersed health centers.[69] Funding has come from various international organizations[70] including the World Bank and the Bill & Melinda Gates Foundation,[71] as well as from Italy's winegrowers.[72]
Ministry to people with HIV/AIDS
With the advent of AIDS, the Church initially responded nervously but soon began actively providing ministry and medical care to people with AIDS.[73]
Parishes and dioceses have instituted various forms of paid and volunteer pastoral care and special activities for people with AIDS[74][75][76][77] and in the 1980s, some dioceses began hiring staff[78] and commissioning priests for AIDS ministry.[79] In 1989, the top services provided in the United States were health and hospice care, AIDS advocacy, and education and prevention;[80] others were drug treatment programs, housing, legal services, advocacy on behalf of those with AIDS, financial assistance, information about the disease and referrals for services, psychological and emotional support for both patients and family members, meals and groceries, and transportation services.[81][74]
Saint Aloysius Gonzaga is the patron saint of those with AIDS and their caregivers.[82]
Popes
During a 1987 visit to San Francisco, a city hit hard by the pandemic,
United States bishops
While insisting that there was a personal responsibility to avoid risky behavior, the United States Conference of Catholic Bishops rejected the notion that there may be "innocent" or "guilty" victims of the virus.[92] Anyone with the disease, whether acquired through a tainted blood transfusion, hetero- or homosexual sex, drug use, or otherwise, should be afforded the same care and compassion.[92]
The Conference was the first church body to address the pandemic in 1987 with a document entitled "On "The Many Faces of AIDS: A Gospel Response".[86] In the document they said the church must provide pastoral care to those infected with HIV as well as medical care.[93] It called discrimination against people with AIDS "unjust and immoral".[93] It also rejected extra-marital sex and the use of condoms to halt the spread of the disease.[93] They reiterated the Church's teaching that human sexuality was a gift and was to be used in monogamous marriages.[93]
In
Others
With the spread of the disease to North America, the Church in the United States established the National Catholic AIDS Network to provide care to AIDS patients, their families and loved ones.[92] The Network hosted conferences and served as a clearinghouse of information to Catholic AIDS ministries.[92] The National Catholic Educational Association published materials beginning in 1988 for use in elementary, secondary, and college classes.[92][95]
Vatican AIDS Conferences
1989 conference
In 1989, the Vatican held a conference on AIDS.[96][97][93] The three day affair drew over 1,000 delegates, including church leaders and the world's top scientists and AIDS researchers, from 85 countries.[96][89] It included Robert Gallo, the co-discoverer of HIV, Nobel Prize winners, theologians, hospital administrators, and psychologists.[98][99]
At the opening session of the conference, Cardinal John O'Connor urged the public to be treated with respect and not as public health hazards, as outcasts, or shunned and left to die.[96][89][97] This included, he said, those in prison who were often put in solitary confinement until they died.[96] O'Connor also reiterated his opposition to condoms as a method to prevent the transition of HIV.[96]
At the closing of the conference,
2000 conference
The
At the conference, a draft of a
2011 conference
In May 2011, the Vatican sponsored another international conference with the theme of "The Centrality of Care for the Person in the Prevention and Treatment of Illnesses Caused by HIV/AIDS", during which church officials continued teaching that condoms were immoral and ineffective"[105][106] Due to sometimes conflicting comments by Benedict, who did not attend the conference, AIDS activists had hoped for a change in the Churches outlook on the use of condoms but they were disappointed.[106] Experts in the field discussed 'people-centered approaches' to prevent HIV transmission, treatment and care of those infected with it, and economic support to those in greatest need.[105] Attendees included theologians, health officials and AIDS researchers.[106]
Zygmunt Zimowski, President of the Pontifical Council for the Pastoral Care of Health Care Workers, stressed victims behavior as a cause. "Were promiscuity not endemic, HIV wouldn't be an epidemic."[105][106] He said it could not simply be considered a medical or public health issue and that a holistic approach should be used for AIDS prevention and treatment.[105]
Church officials also condemned the fact that those in poorer parts of the world receive substandard medical care.[106]
Social justice
Across the globe, Catholic authorities have spoken out and written about the need for the Church to address the AIDS pandemic in a manner consistent with its mission.[93] Archbishop Fiorenzo Angelini, the convener of the 1989 Vatican Conference on AIDS, said "victims are our brothers and we should not sit in judgement of them."[99]
During a 1990 visit to Dar es Salaam in East Africa, which had one of the highest rates of AIDS infections in all of Africa, John Paul II urged the world to work on behalf of AIDS patients and to promote "the true well-being of the human family".[107] Likewise, he condemned the public authorities, which, out of either indifference, condemnation, or discrimination, did not act to alleviate their suffering.[107] During the 2001 Special Session of the United Nations on HIV/AIDS, John Paul II raised special concern about the transmission of the virus from mother to child and access to medical care and life-saving medications.[108]
Cláudio Hummes, then-Archbishop of São Paulo, speaking at the 2003 Plenary Session of the United Nations on the Implementation of the Declaration of Commitment on HIV/AIDS, criticized pharmaceutical companies for making medications prohibitively expensive for many of the world's poorest.[108]
Ethicist Lisa Sowle Cahill has said that the "primary cause of the spread of this horrendous disease is poverty. Related barriers to AIDS prevention are racism; the low status of women; and an exploitative global economic system which influences the marketing of medical resources."[109] Medical anthropologist and physician Paul Farmer and David Walton, along with the priest and moral theologian Kevin T. Kelly, have all argued that to address the AIDS crisis that society must also address poverty and the low status of women.[109] Their arguments, along with others published in Catholic Ethicists on HIV/AIDS Prevention, examined the issue of HIV/AIDS in the context of social justice considerations.[50][110]
In 1989, the United States Bishops Conference, in an attempt to move the discourse around AIDS from a medical context to a social one, said AIDS was "a product of human actions in social contexts ... shaped by larger cultural and social structures."
2016 meetings with pharmaceutical companies
According to the
Church officials recognized that there was not a great deal of profit to be made in selling drugs to this demographic, so they instead made moral arguments for why the companies should work in this area.[113][114] Following those meetings in April and May 2016, new targets were written into a document signed at the United Nations' High-Level Meeting on Ending AIDS in June.[113] The targets called for getting medications to 1.6 million children within two years.[113]
The President's Emergency Plan for AIDS Relief, a United States government agency that funds global AIDS response efforts, and the World Council of Churches credited the series of meetings with making progress in an area where previous efforts had stalled.[114] Within a year the program expanded to include getting diagnostic equipment into poor and remote areas of sub-Saharan Africa so that children and their parents could learn their HIV status.[114]
Priests with AIDS
In the 1980s, dioceses in the United States varied in how they responded to clergy with AIDS.[115][116] Some were compassionate while others ostracized those infected.[116][115] There was no national policy on how to handle priests with AIDS at the time, but a spokesman for the bishops' conference said the church should not be punitive but rather provide them with the same care and support as any other sick person.[115] In 1998, evidence suggested that the vast majority of priests with AIDS were treated with dignity and provided ample medical care.[117] In 2005, most dioceses offered health care and housing to priests with AIDS until their deaths.[118] There is no global policy on how to handle priests with AIDS.[118]
By 1987, at least 12 of the 57,000 priests in the United States had died of AIDS.
Many priests acquired the disease by having sex with other men.[119][118] Others became infected while working as missionaries in parts of the world with poor health practices and systems.[118] In the past, seminaries did not teach anything to seminarians how to handle their sexuality.[118] This was, according to Auxiliary Bishop Thomas Gumbleton, a "failure on the part of the church" that led to priests dealing with it in unhealthy ways.[118] A 1972 report found that most a large majority of priests did not have a healthy sexual identity and were psychologically underdeveloped.[118] Many dioceses and religious orders now require applicants to take an HIV test before being admitted as a seminarian.[118]
One of the first priests to gain widespread attention because of his AIDS status was Michael R. Peterson.[118] The month before he died, Peterson and his bishop, James Hickey, sent a letter to every diocese and religious superior in the United States.[118] Peterson said that by coming forward he hoped to gain compassion and understanding for himself and others with AIDS.[118] Hickey said Peterson's diagnosis was a call to reach out with compassion to others with the disease.[118]
The first (and perhaps only) Catholic bishop publicly known to have died of AIDS was Auxiliary Bishop Emerson John Moore of New York in 1995.[121]
Relationship with homosexuality
The church's condemnation of homosexuality, even while it provides care to AIDS patients, has been a locus of controversy with regard to its relationship to AIDS.[117] Instances of homophobia, and related AIDS-phobia, within the Church have led to harmful practices and attitudes among some members of the clergy and laity.[92] Catholic teaching on condoms and opposition to homosexuality, seen as exacerbating the pandemic, has led groups such as ACT UP to hold protests such as Stop the Church.[117] Most mainstream AIDS organizations, however, have worked with the Church to bring an end to the pandemic.[117]
See also
- Islam and AIDS
- Religion and AIDS
Notes
- ^ For the full text of the letter, see: On "The Many Faces of AIDS". See also Karol Wojtyla's Love and Responsibility
- ^ The first was in New Orleans in 1985.[60]
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- National Research Council; Division of Behavioral and Social Sciences and Education; Commission on Behavioral and Social Sciences and Education; Panel on Monitoring the Social Impact of the AIDS Epidemic (1 February 1993). The Social Impact of AIDS in the United States. National Academies Press. ISBN 978-0-309-04628-2. Retrieved 21 May 2020.
- O'Rourke, OP, Kevin D. (13 April 2011). Medical Ethics: Sources of Catholic Teachings, Fourth Edition. Georgetown University Press. ISBN 978-1-58901-756-6. Retrieved 25 May 2020.
- Petro, Anthony Michael (2015). After the Wrath of God: AIDS, Sexuality, and American Religion. Oxford University Press. ISBN 978-0-19-939128-8. Retrieved 11 May 2020.
- Smith, Raymond A. (27 August 1998). Encyclopedia of AIDS: A Social, Political, Cultural, and Scientific Record of the HIV Epidemic. Routledge. ISBN 978-1-135-45754-9. Retrieved 21 May 2020.
External links
- Vatican.va: Family values Versus Safe Sex: A Reflection by His Eminence, Alfonso Cardinal López Trujillo
- Caritas Internationalis: HIV & AIDS
- Catholics for AIDS Prevention and Support, a UK based Charity