The “conventional wisdom” prevalent in the United States, European Nations, and the United Nations is that the best way to prevent HIV/AIDS in Africa (or anywhere, for that matter) is to practice “safe sex,” that is, to make use of condoms and other prophylactic devises. The Catholic Church is regularly criticized for its failure to urge the use of condoms and “safe sex” in Africa and is blamed for the AIDS “epidemic” in sub-Sahara Africa.
A new book, Affirming Love, Avoiding Aids: What Africa Can Teach the West, [1] recently published by the National Catholic Bioethics Center in Philadelphia, challenges this widely shared view. The authors of the book are Matthew Hanley and Jokin de Irala. Hanley was the HIV/AIDS technical advisor for Catholic Relief Services until 2008 and specialized in HIV prevention. Dr. de Irala is deputy director of the Department of Preventive Medicine and Public Health at the University of Navarra in Spain. The book carries a Foreword by Edward C. Green, Director of the AIDS Prevention Research Project at the Harvard Center for Population and Development Studies. [2]
Brief Synopsis of Book
The book, Hanley and Irala say, first presents “the relevant scientific data and only then examine(s) the Christian and other philosophical approaches to HIV prevention” (p. 5). Here I will first summarize the “relevant scientific data” and then look at “the Christian and other philosophical approaches to HIV prevention.”
Relevant scientific data
Thomas Flynn, L.C., has provided an overview of this book in the June 27, 2010 edition of Zenit and in doing so summarizes the “relevant data.” I now paraphrase that summary:
Early in the book Hanley and de Irala point out that "AIDS Establishment" (=conventional wisdom of the west) has concentrated on technical means rather than on behavioral change. The exception to this was the change in policy by the United States to adopt an ABC strategy following the success of Uganda in using this approach to deal with AIDS. The "A" stands for abstinence, "B" for be faithful, and "C" for condom use. The first two parts to this strategy are crucial. In Africa studies show that when a significant number of people are engaged in concurrent sexual relationships the chances of infection are much higher compared to communities where people reduce multiple partnerships. A decline in multiple sexual partnerships is crucial to bringing about a decline in HIV rates. The best example of this was in Uganda, where HIV infection rates dropped from 15% in 1991 to 5% in 2001. Kenya, Thailand and Haiti are additional countries that the authors refer to in citing evidence from studies that show how behavioral change leads to a reduction in the rates of HIV transmission. One reason behind the success in modifying conduct in Uganda was the work of Catholic nuns and doctors. Unfortunately in recent years the AIDS establishment has gained influence in Uganda and the emphasis has shifted toward promoting the use of condoms. This has been accompanied by an increase in HIV transmission.
By contrast, in South Africa, where promotion of condom use has been the main priority, the persistently high rates of multiple partnerships has helped to maintain the level of HIV infections at what the authors describe as an “alarmingly high incidence.”
Christian and other philosophical approaches
Chapter VI of Affirming Love, Avoiding AIDS, is entitled “The Christian Perspective.” It is a very long chapter, running from p. 105 to p. 159, and it includes on pp. 153-159 some 92 footnotes. Pages 105-125 are devoted to a very excellent critique of the relativism, utilitarianism, and emotivism of the AIDS Establishment. They also fault its anthropological understanding of human sexuality, one common to that Establishment and widely accepted in Western cultures today. According to this anthropology, the “person” is a consciously experiencing subject and his/her body is a tool for giving that subject the experience of pleasure. In short, it separates the “person” from his or her own body. From page 126 on the authors refer to a wide range of thinkers, including the great pre-Christian philosophers, e.g. Aristotle (see p. 125), who reduced the hedonistic “man is the measure of all things” ethics to absurdity, defended the dignity of marriage, and proposed an alternative understanding both of morality and human anthropology, including human sexuality. Among contemporary authors to whom they refer include most prominently Pope John Paul II (with his great book Love and Responsibility) and Elizabeth Anscombe, whose philosophical work brilliantly showed the superficiality of utilitarianism-hedonism and showed how human is the practice of celibate chastity prior to marriage and the practice of total fidelity to one’s spouse in marriage. They also refer to and cite from the persuasive and thought-provoking work of Anthony Fisher, O.P., a distinguished bioethicist and now a Bishop in Australia.
The authors emphasize that human sexuality permeates the being of the entire human person and is integral to his being and is not a mere accident or useful tool. They likewise affirm that it is ordered to two great goods: the good of marriage and of chaste spousal union in the marital act, and to the good of procreating new human life. The latter good, one might say in company with Pope John Paul II, is an “existential good” insofar as the continued existence of the human species depends on the generation of new human persons. Many studies show that children thrive best if generated by loving husbands and wives than if engendered by persons who are not married or “made” in laboratories by “new reproductive technologies.”
Citing Rev. Tadeusz Pacholzyck on p. 41 they write that a husband who finds out he has HIV (perhaps as a result of a blood transfusion) will not, if he loves his wife, have genital sex with her nor would he trust a condom to protect her. [3]
They do not, however, in this chapter or elsewhere in their work, go into great detail in rehabilitating, as it were, the meaning of the virtue of chastity, which is, we need to keep in mind, an integral component of the cardinal virtue of temperance, whose other components are concerned with moderating our legitimate desires for food and drink.
Recently I directed a graduate study (S.T.L., or Licentiate in Sacred Theology, a canonical degree higher than an M.A. but not as high as a Ph.D.or S.T.D.) by a student, Andrew Amaruma, a native of Uganda, whose study showed that the tradition of the Madi tribe, to which he belonged, emphasized virginity prior to marriage for both males and female and fidelity in marriage. This tribe experienced little AIDS until, under pressure from the UN and USAIDS, it began to promote condom use and also to preach that consensual sex, whether between husband and wife, unmarried males and females, members of the same sex etc. was perfectly all right and that the traditional “taboos” against promiscuity were rooted in a false understanding of human sexuality and human needs.
This in my opinion shows how accurate Stephen Moser was in his Population Control: Real Costs, Illusory Benefits, [4] in which Mosher shows (pp. 174-194) that the AIDS Establishment claim that the recent epidemic of HIV/AIDS in Africa is utterly without basis and that the real cause of most cases of AIDS is use of infected needles for injections, because funding of basic health care has tumbled while funding of antifertility programs has increased; injections by infected needles into women of contraceptives such as Dopo-Provera are among leading causes (pp. 174-194).
Hanley and de Irala’s work, which needs to be widely known, demonstrates that the Euro-American plan for preventing AIDS by accepting and even encouraging high risk behavior and by relying on technical means for stemming epidemics of HIV/AIDS has failed miserably whereas programs fostering virginity prior to marriage and fidelity in marriage have and can
effectively prevent the spread of a terrible disease.
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Notes
1. Philadelphia: National Catholic Bioethics Center, 2010, xxii+202 pp. ISBN978-0-935372-56-4.
2. In his Foreword Green emphasizes that “the global response to AIDS was developed in the US (with some help from Europe) for the type of ‘concentrated’ AIDS epidemics found in America and Europe. We then attempted to apply Euro-European solutions to problems in Africa…and indeed the rest of the world….The Euro-American approach has its flaws” (xii-xiii). “HIV in the United States…has certainly risen in recent years among homosexual men… an approach that may fit prostitutes or drug addicts or homosexuals—which is based ultimately on the self-defeating premise that the risk behavior cannot (or even should) be changed—will probably not be the best approach for married couples or most teenagers. After all, the majority of non-married teenagers in less developed countries are not sexually active, to go by our best behavioral surveys” (xiii). “In every African country where HIV infections have declined, this decline is associated with a decrease in the proportion of men and women reporting more than one sex partner, which is exactly what fidelity programs promote” (xiii-xiv).
3. On this point I, with others, disagree with Father Pacholzyck. We are not sure that in all cases a husband with HIV should permanently abstain from non-condomistic intercourse with his wife. Since intercourse allows a couple to realize and experience a unique good of marriage, it seems to some theologians faithful to the Magisterium that it could be legitimate for both spouses to agree to have intercourse and accept as a side-effect the harm that might come about if HIV is passed on. We do not say this is always justifiable, but we do not judge it intrinsically evil.
4. New Brunswick, N.J.: Transaction Publishers, 2008, x+300 pp. $29.95.
