Guest ColumnistThe Catholic Church and HIV and AIDS

The world has been living with the AIDS epidemic for more than 25 years and it has caused untold suffering. The scope of the AIDS epidemic is greater than the bubonic plague. Its destructive impact is particularly painful on families. In Africa it is known as "the grandmother’s disease," because it kills mothers and fathers in the prime of their life when they are at the center of providing care for their family both in terms of financial productivity and tender loving care. The burden of taking care of children then falls on the grandmothers. Although extraordinary progress has been made in the treatment of HIV the progress in prevention has been much slower.

In activist AIDS circles, the Catholic Church has been blamed for not responding to the AIDS crisis or even abetting the spread of AIDS due to its principled stand against wide scale condom distribution and the "condom solution." Is this charge true? Where does the Catholic Church stand with regards to HIV and AIDS and has it "put its money where its mouth is?" In countries where the AIDS epidemic has slowed is it due primarily to the efficacy of the "condom solution?"

First off, the charge that the Catholic Church has not responded to the AIDS crisis is not true. Institutions that are directly affiliated with the Catholic Church and supported by the Catholic Church are the largest care providers of HIV and AIDS in the world. The burden of AIDS has fallen most unfairly upon sub-Saharan Africa which is the poorest continent in the world. Throughout Africa there is a network of mission hospitals that is staffed by catholic nuns as care providers and supported by the Catholic Church. These mission hospitals are extraordinary and really exemplify faith in action. There institutions have stepped forward in a heroic fashion to respond to the AIDS crisis. Catholic Relief Services, which is based in the United States, has been an extraordinary conduit of direct HIV and AIDS support through the provision of medications that has been funded through the President’s Emergency Program for AIDS Relief (PEPFAR). This is no surprise because Catholic Relief Services is linked closely to many of these mission hospitals.

In addition to the direct care and support provided by hospitals, there is extraordinary work that is done to provide home support for people living with HIV and AIDS. In South Africa it is very common to see a nun visiting a village by bicycle or a dilapidated jalopy to walk into a small hut and provide food or tender loving care to a young woman or man dying with HIV and AIDS. The care is often in the form of a few encouraging words, holding a hand, giving a bath, providing clean clothes, or dropping off a food basket. Although this care is not "high tech" it is heroic. The Missionaries of Charity, founded by Mother Teresa of Calcutta, have exemplified this tender loving care. Throughout the world they have provided homes for the care of persons with HIV and AIDS which stretch from Washington, DC to Bombay, India to Durban, South Africa to Central and Latin America. In the face of every individual suffering the ravages of AIDS, they see the face of their brother or their sister who is Christ suffering. Their goal is to provide care and love to that person who is their Savior and Lord in the guise of a suffering person.

The Catholic Church in its many forms is at the forefront of providing care for HIV and AIDS. John Paul II made it a point to reach out and hug individuals with AIDS to show that first and foremost he cares for them as a person who has the unconditional love of Christ.

What about prevention though? Just because the Church provides care, if it doesn’t help to prevent HIV and AIDS, then isn’t it being delinquent? Certainly the adage that an ounce of prevention is worth a pound of cure makes sense with the AIDS epidemic.

To answer that question, we have to look to countries that have successfully made progress against AIDS. One good example is Uganda. In the early 90s the HIV virus was spreading unchecked. Over 25 percent of pregnant women in Kampala, the capital of Uganda, were HIV infected. Illness and death from AIDS was horrifying. The most common social gatherings in many families were funerals. President Museveni at the time joined hands with bishops and priests, as well as business leaders and even rock stars to combat this epidemic. The message was that this was a Ugandan problem, a crisis in the Ugandan community so great that it threatened every family, every village, every young man and young woman and one that had to be addressed up front and in clear language.

The message was that HIV was totally preventable. For youth that meant not having sex until they entered marriage. Sex at a younger age often caused harm — emotional harm and sometimes physical harm including sexually transmitted diseases and HIV. The message was also that if you are married or in a serious relationship, one should not have sex with someone else. "Zero grazing" was one of the terms used to convey the message that it was "not OK" to have different girlfriends in different towns. This was destructive to the family, and through the spread of HIV, was killing many young people. The emphasis was on sex being part of a lifelong committed relationship that was healthiest for children and families. It was acknowledged that men would at times have sex outside of marriage and, although it was not condoned, men were told that if they were going to do it any way, then they should use a condom.

The Ugandan solution as articulated by Museveni was that sexual responsibility was key and had to be firmly stated and promoted by every member of the family and every member of the community. Using condoms was only a small part of the response to the epidemic. This "community mobilization" worked to a great degree. The rates of HIV among pregnant women in Kampala fell from over 25 percent to under five percent. A dramatic change in sexual behavior was also noted with more young men and women not having sex at a younger age, and with fewer individuals that were having sex, having multiple partners. The use of condoms increased, but to a much smaller degree than the increase in abstinence or monogamy. The holistic message of sexual responsibility was termed ABC (abstinence, be faithful, condoms). It has now been further refined to include HIV testing so that everyone can know their HIV status to prevent further spread of the virus.

This message of sexual responsibility is entirely consistent with the Church’s teaching that sex within a lifelong committed relationship is most fulfilling and leads to the greatest health and happiness. The Church has played a strong role in speaking out against HIV and making it clear that sexual responsibility, which means above all abstinence and fidelity by men and women, is a key part of promoting human dignity and the health and happiness of individuals.

If you tune in to the up-and coming World AIDS conference this August, you will hear many strident calls for the Catholic Church to change policy regarding condom use. You will also hear the implication that the Catholic Church is "responsible for the spread of AIDS." This open hostility to the Catholic Church is very common among HIV and AIDS activists. It is not entirely surprising since most HIV and AIDS activists in the United States are very sympathetic to the gay lifestyle which is prohibited by the teachings of the Catholic Church. This undercurrent of hostility is extraordinarily common and comes out in different ways.

Catholics should know, however, that institutions affiliated with the Catholic Church provide outstanding care for HIV infected persons throughout the world particularly in those places that are the most poor and most destitute. Members of the Catholic Church including bishops, priests and of course John Paul II have spoken about the importance of providing tender loving care and decreasing stigma around HIV and AIDS. Church members in Southern Africa and in Asia have spoken openly about the need for testing and about the importance of sexual responsibility, which has been part of many campaigns which have successfully resulted in a decrease in HIV spread. Therefore, it is wrong to say that the Catholic Church is "responsible for the spread of HIV." More, of course, can always be done. We have no time to sit back. Catholics can hold their heads high because our Church continues to respond generously and effectively to this terrible epidemic.

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