Vatican: Everyone Can Use Condoms to Prevent HIV
Vatican City (AP) - Using a condom is a lesser evil than transmitting HIV to a sexual partner - even if that means a woman averts a possible pregnancy, the Vatican said Tuesday, signaling a seismic shift in papal teaching as it explained Pope Benedict XVI's comments.
The Vatican has long been criticized for its patent opposition to condom use, particularly in Africa where AIDS is rampant. But the latest interpretation of Benedict's comments about condoms and HIV essentially means the Roman Catholic Church is acknowledging that its long-held, anti-birth control stance against condoms doesn't justify putting someone's life at risk.
"This is a game-changer," said the Rev. James Martin, a Jesuit editor and writer. "By acknowledging that condoms help prevent spread of HIV between people in sexual relationships, the pope has completely changed the Catholic discussion on condoms."
The change came on a day when U.N. AIDS officials announced that the number of new HIV cases has fallen significantly - thanks to condom use - and a U.S. medical journal published a study showing that a daily pill could help prevent spread of the virus among gay men.
"This is a great day in the fight against AIDS ... a major milestone," said Mitchell Warren, head of the AIDS Vaccine Advocacy Coalition
In Africa, AIDS activists, clerics and ordinary Africans alike applauded the pope's revised comments.
"I say hurrah for Pope Benedict," exclaimed Linda-Gail Bekker, chief executive of South Africa's Desmond Tutu HIV Foundation. She said the pope's statement may prompt many people to "adopt a simple lifestyle strategy to protect themselves."
Worldwide, 33 million people live with HIV.
In Sierra Leone, the director of the National AIDS Secretariat predicted condom use would now increase, lowering the number of new infections.
"Once the pope has made a pronouncement, his priests will be in the forefront in advocating for their perceived use of condoms," said Dr. Brima Kargbo.
Vatican spokesman the Rev. Federico Lombardi said Benedict knew full well that his new comments would provoke intense debate. Conservative Catholics have been trying to minimize the scope of what he said since excerpts were published this weekend in the Vatican newspaper.
Lombardi praised Benedict for his "courage" in confronting the problem.
"He did it because he believed that it was a serious, important question in the world of today," Lombardi said, adding that the pope wanted to give his perspective on the need for a greater humanized, responsible sexuality.
Benedict said, in a book released Tuesday, that condom use by people such as male prostitutes was a lesser evil since it indicated they were moving toward a more moral and responsible sexuality by aiming to protect their partner from a deadly infection. On Tuesday, the Vatican expanded the comments to include women.
Benedict received a copy of the book "Light of the World" during an audience Tuesday with the author, Peter Seewald, who conducted several hour-long interviews with the pontiff last summer.
"I hope that this book is useful for the faith of many people," Benedict said.
The pope's comments in the book implied that he was referring primarily to homosexual sex, when condoms aren't being used as a form of contraception. Questions arose immediately about the pope's intent, though, because the Italian translation of the book used the feminine for prostitute, whereas the original German used the masculine.
Lombardi told reporters Tuesday that he asked the pope whether he intended to refer only to male prostitutes. Benedict replied that it really didn't matter, the important thing was the person in question took into consideration the life of the other, Lombardi said.
"I personally asked the pope if there was a serious, important problem in the choice of the masculine over the feminine," Lombardi said. "He told me 'no.' The problem is this ... It's the first step of taking responsibility, of taking into consideration the risk of the life of another with whom you have a relationship."
"This is if you're a man, a woman, or a transsexual. We're at the same point. The point is it's a first step of taking responsibility, of avoiding passing a grave risk onto another," Lombardi said.
The clarification is significant.
UNAIDS estimates that 22.4 million people in Africa are infected with HIV, and that 54 percent - or 12.1 million - are women. Heterosexual transmission of HIV and multiple, heterosexual partners are believed to be a major cause of the high infection rate in Africa.
UNAIDS on Tuesday announced a nearly 20 percent drop in new HIV infections around the world over the past decade - largely due to increased condom use.
Benedict drew the wrath of the United Nations, European governments and AIDS activists last year when he told reporters that Africa's AIDS problem couldn't be resolved by distributing condoms. "On the contrary, it increases the problem," he said then.
In the book, the pope was not justifying or condoning gay sex, condoms as a means of artificial contraception or heterosexual sex outside of a marriage. He reaffirms the Vatican opposition to homosexual acts and artificial contraception and reaffirms the inviolability of marriage between man and woman.
But by broadening the condom comments to also apply to women, the pope is saying that condom use is a lesser evil than passing HIV onto a partner even when pregnancy is possible.
"We're not just talking about an encounter between two men, which has little to do with procreation. We're now introducing relationships that could lead to childbirth," Martin said.
While the lesser evil concept has long been a tenet of moral theology, the pope's comments mark the first time a pope had ever publicly applied the theory to condom use as a way to fight HIV transmission.
Individual bishops and theologians have applied that theory, but it had previously been rejected at the highest levels of the Vatican and theologians have been disciplined for voicing it, Martin said.
Monsignor Jacques Suaudeau, an expert at the Vatican's bioethics advisory board, said the pope was articulating the theological idea that there are degrees of evil.
"Contraception is not the worst evil. The church does not see it as good, but the church does not see it as the worst," he told The Associated Press. "Abortion is far worse. Passing on HIV is criminal. That is absolute irresponsibility."
He said the pope broached the topic because questions about condoms and AIDS persisted and the church's teaching hadn't been clear. There is no official Vatican policy about condoms and HIV, and Vatican officials in the past have insisted that condoms not only don't help fight HIV transmission but make it worse because it gives users a false sense of security.
The late Cardinal Alfonso Lopez Trujillo famously said in 2003 that the HIV virus was small enough that it could "easily pass through" a condom - setting off furious criticism by AIDS activists.
Suaudeau said Benedict deliberately raised the issue in the interviews.
"He was not foolish," Suaudeau said. "It was intentional. He thought that this was a way of bringing up many questions. Why? Because it's true that the church sometimes has not been too clear."
Lombardi said the pope didn't use the technical terminology of "lesser evil" in his remarks in the book because he wanted his words to be understood by the general public. Vatican officials, however, said the concept was what he meant.
"He spoke with caution and courage of a pragmatic way through which missionaries and other ecclesial workers can help to defeat the pandemic of AIDS without approving but also without excluding - in particular cases - the use of a condom," said Luigi Accatoli, a veteran Vatican journalist.
Scientists, meanwhile, reported Tuesday that a pill already used to treat HIV infection turns out to be a powerful weapon in protecting healthy gay men from catching the virus.
Daily doses of Truvada cut the risk of infection by 44 percent when given with condoms, counseling and other prevention services, a global study found.
The results are "a major advance" that can help curb the epidemic in gay men, said Dr. Kevin Fenton, AIDS prevention chief at the U.S. Centers for Disease Control and Prevention. But he warned they may not apply to people exposed to HIV through male-female sex, drug use or other ways. Studies in those groups are under way now.
Associated Press reporters Victor L. Simpson in Rome, Jason Straziuso in Nairobi, and AP Medical Writer Marilynn Marchione contributed to this report.