Crusading for change in the Catholic Church

Editor—Arie reports that some Catholic organisations and priests working in AIDS ravaged areas have called for the church to change its stance on condoms.¹ The Catholic Church's message is that a policy of marital fidelity is more likely to help reduce the HIV epidemic than advocating condoms because condoms are not 100% effective in preventing the transmission of HIV infection.

The evidence concurs: a Cochrane review concluded that condoms are only 80% effective.² Other studies report effectiveness rates of 60-96%.³ A Cochrane review on population based interventions found two studies that showed no impact and one with a 38% reduction in infectivity rates.⁴ A Zambian study showed that the more often condoms were used the lower the chance of HIV transmission, but even when couples reported consistently using condoms, a very small risk remained.⁵

To argue that the Catholic Church's stance on condoms is causing deaths is illogical. The church is telling people not to be promiscuous. When one partner has become infected because of extramarital sex or a blood transfusion, I have not come across any Catholic priest recommending that the couple ignore medical advice and not use condoms. Condoms have a place in special situations, and the church has focused on policy and left it to its clergy to deal compassionately and confidentially with exceptional cases.

Condom usage is the third best option. Even the South African emphasis has changed to ABC—abstain, be faithful, and (if not possible) “condomize [sic].” Whether the HIV epidemic would have looked different if the first message had been marital sex only, with a lesser emphasis on condoms, is impossible to determine.

Medical practitioners need to accept that both messages, in appropriate circumstances, have a place and that the major religions need to be enlisted to overcome the HIV pandemic.