Behind the Pope's condom 'gaffe'

During a press conference with journalists, on a plane bound for his first visit as Pope to Africa, Benedict XVI was faced with the suggestion that the 'position of the Catholic Church on the way to fight AIDS is often considered unrealistic and ineffective'. Any answer would have generated headlines. As it was, a fragment of the Pope's reply instantly launched a media frenzy which left many perplexed, saddened and even outraged.

Having pointed towards the Church's holistic program and distanced himself from the necessarily narrower approach of public policy, Benedict critiqued the further reduction of public policy to a single means and method: 'The problem cannot be overcome by the distribution of prophylactics: on the contrary, they increase it.'

In Europe and North America, where condoms are culturally accepted by many, people responded with incredulity: 'Why does the Church oppose the promotion of condoms as a means of preventing the spread of AIDS?' Some with muddled thinking even accused Popes John Paul II and Benedict XVI of presiding over an AIDS genocide.

There is widespread belief that condom-use programs are effective in reducing HIV infection rates. But this is  true only outside Africa and among identifiable sub-groups (e.g. prostitutes, gay men), but not in a general population.

There is no evidence that condoms as a public health strategy have reduced HIV levels at the level of the whole population. Indeed, greater availability and use of condoms is consistently associated with higher HIV infection rates, perhaps because when a person uses a risk reduction 'technology', such as condoms, they take greater chances than they would without the technology.

The promotion of condoms as the strategy for reducing HIV infection in a general population is based on statistical probability and intuitive plausibility. It enjoys considerable credibility in the Western media and among Western opinion makers. What it lacks is scientific support.

Some specialists in the prevention of HIV assume that, since vast numbers of people do not know whether or not they are infected, condom use should be automatic, mandatory and universal. Yet 95 per cent of Africans between 15 and 49 years of age are not infected (UNAIDS 2007).

Knowing your status is a crucial step towards taking responsibility for your actions. Several Africans have told me that once they tested positive, they made a firm option for abstinence, rather than risk infecting someone else.

At the public level, how does an aggressive condoms policy 'increase the problem'? It deflects attention, credibility and resources from more effective strategies like abstinence and fidelity — or in secular language, the postponement of sexual debut and a reduction in the proportion of men and women reporting multiple sexual partners.

Abstinence and fidelity win little public support in dominant Western discourse, but they are vindicated by solid scientific research and are increasingly included, even favoured, in national AIDS strategies in Africa. Two countries with the worst HIV epidemics, Swaziland and Botswana, have both launched campaigns to discourage multiple and concurrent partners, and to encourage fidelity.

The fact is, culture counts. A condom is more than a piece of latex. It also makes a statement about the meaning of life. While in Europe and North America the idea is quite acceptable (although not to all), in Africa fertility is highly valued and the condom seems foreign and strange, and the values it embodies alien. A Jesuit in South Africa wrote to me, 'Most people here think that "the Pope and condoms" is a side-show, stoked up by the media, and not an issue on which we want to spill more ink or destroy more forest.'

So when Benedict XVI affirmed that 'the distribution of prophylactics ... increase[s] the problem', it was not a casual remark or a gaffe; he had good grounds for saying so. In concluding, the Pope said, 'It seems to me that this is the proper response, and the Church [offers] an enormous and important contribution.'

According to my experience, most Africans, Catholic or not, agree. To them, what the Pope said is profound and true. He is reiterating what they have been experiencing for years and what they continue to expect.