The pope and Aids

September 11th, 2010 by Ben Goldacre in africa, bad science, religion | 159 Comments »

This week the pope is in London. You will have your own views on the discrimination against women, the homophobia, and the international criminal conspiracy to cover up for mass child rape. My special interest is his role in the 2 million people who die of Aids each year.

In May 2005, shortly after taking office, the pope made his first pronouncement on Aids, and he took the opportunity to come out against condoms. He was addressing bishops from: South Africa, where somebody dies of Aids every 2 minutes; Botswana, where 23.9% of adults between 15 and 49 are HIV positive; Swaziland, where 26.1% of adults have HIV; Namibia (a trifling 15%); and Lesotho, 23%.

This is ongoing. In March 2009, on his flight to Cameroon (where 540,000 people have HIV), Pope Benedict XVI explained that Aids is a tragedy “that cannot be overcome through the distribution of condoms, which even aggravates the problems.” In May 2009, the Congolese Bishops’ Conference made a joyful announcement: “in all truth, the pope’s message which we received with joy has confirmed us in our fight against HIV/AIDS. We say no to condoms!”

This is not a remote problem. The pope’s stance has been supported, in the past year alone, by Cardinal George Pell of Sydney, Australia, and Cardinal Cormac Murphy O’Connor, the Archbishop of Westminster. “It is quite ridiculous to go on about AIDS in Africa and condoms, and the Catholic Church,” says O’Connor. “I talk to priests who say, ‘My diocese is flooded with condoms and there is more AIDS because of them.’”

Some have been more imaginative in their quest to spread the message against condoms. In 2007, Archbishop Francisco Chimoio of Mozambique announced that European condom manufacturers are deliberately infecting condoms with HIV to spread AIDS in Africa. Out of every 8 people in Mozambique, one has HIV.

It was cardinal Alfonso López Trujillo of Colombia who most famously claimed that the HIV virus can pass through tiny holes in the rubber of condoms. Again, he was not alone. ‘The condom is a cork,’ said Bishop Demetrio Fernandez of Spain, ‘and not always effective.’

In 2005 Bishop Elio Sgreccia, president of the Pontifical Academy for Life, explained that scientific research has never proven that condoms ‘immunise against infection’. He’s right, they don’t. They stop the virus which kills you from being transmitted during sex. Which is very, very useful of them.

How effective are condoms? It’s wise not to overstate your case. The current systematic review of the literature on this question published by Cochrane found 14 observational studies (because it’s unethical to do a randomised trial where you actively stop people using condoms, since you know that they work, but just want to find out how well they work).

These studies generally looked at HIV transmission in stable couples where only one partner has HIV. Many of them looked at transfusion patients and haemophiliacs. Overall, rates of HIV infection were 80% lower in the partners who reported always using a condom, compared to those who said they never did. 80% is pretty good. I’d like 100%, for everyone’s sake. I have 80% (although condoms do also protect against cervical cancer, gonorrhea, chlamydia, and more).

In fact, there is no single perfect solution to the problem of Aids: if things were that easy, it wouldn’t be killing 2 million people every year. Telling people to abstain doesn’t make everyone abstain, and telling people to use condoms won’t make everyone instantly and consistently use condoms.

You do everything all at once, urgently, because 2 million people are dying every year. ABC is a widely used prevention acronym in Africa: abstain, be faithful, use a condom. Picking one effective measure out and actively campaigning against it is plainly destructive.

Ratzinger has proclaimed that “The most effective presence on the front in the battle against HIV/AIDS is in fact the Catholic Church and her institutions.” This is a ludicrous claim. They’re the only major influential international political organisation that actively tells people not to do something that works, on a huge scale.  Their own figures show that their numbers are growing in Africa, even faster than the population does.

I don’t mind what anyone believes, I’m happy for you to suggest abstention. But sabotaging an effective intervention which prevents a disease that kills 2 million people a year makes you a serious global public health problem.


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159 Responses

  1. thammond65 said,

    September 28, 2010 at 4:12 pm

    But many of you seem to be missing two key points that oldandrew and others made. Firstly, Catholics are a minority in those countries with the worst infections. Seems a bit odd to blame the Pope for the high rates of infection there. Secondly, if Catholics obey the Pope, the issue of condoms is largely irrelevant. They don’t have sex before marriage or outside marriage and so on. So Ben’s hypothesis is that Catholics in Africa are quite happy to break the Church’s key teachings on sex, but are not willing to break the rather minor teaching on condoms. Perhaps you think the Pope should say, “When you do wrong, please wear a condom.” This just teenage silliness mixed with paternalism bordering on racism and propogated by the smugly self-righteous who thinks it’s somehow daring and clever to bash the Pope. And I’m an atheist!

  2. oldandrew said,

    September 28, 2010 at 6:01 pm

    “You state that there is “no evidence” that abstinence only education poses a public health risk.”

    No, I didn’t.

    And since when were we talking about high income countries?

  3. hen3ry said,

    September 29, 2010 at 4:41 pm

    Yes you did, in post 149, where you said:

    There is no evidence that discouraging condom use *in this way* (i.e. a religion which prohibits polygamy, anal sex, homosexual acts prostitution, adultery, pre-marital sex also prohibiting contraception) is “a public health risk” or even that it is something that makes a marginal difference to public health.

    Now, the studies I have posted are comparing abstinence only and abstinence plus education in America, where the abstinence only programs are highly religiously motivated, and also prohibit “polygamy, anal sex, homosexual acts prostitution, adultery, pre-marital sex”

    I have shown you evidence that discouraging condom use has an impact on public health, in that populations are more healthy when condoms use is taught. If you read either of the studies, rather than just glancing at the titles you might find that the authors have answered your questions. Frankly, all I can say at this point is Fuck The Pope. (In the nicest, and most non-sectarian way, of course.)

  4. oldandrew said,

    October 2, 2010 at 8:20 am

    “Yes you did”

    Stop making stuff up.

    The moral teaching of the Catholic church is not a public health program. Evidence that government health programs which promote a particular religious line to people who don’t follow that religion are ineffective, is no evidence whatsoever as the the effect that the moral teaching of a religion has on the followers of that religion.

  5. Ely said,

    October 2, 2010 at 3:08 pm

    I’m a Roman Catholic, educated in a Roman Catholic School.

    My religion classes were taught by a very devote nun who was a theologist.

    I say this because what follows next is actually quite interesting (if not shocking) for people. YOU DON’T HAVE TO PAY ATTENTION TO WHAT THE POPE SAYS, ONLY THE CHURCH’S HIERARCHIC BODY (priests and such). According to the Church, the only absolute truth a Christina must believe is the creed. Hence the Pope’s claim doesn’t have to be heeded (and hence why I deduce that Africans haven’t been informed of this).

    The reason the Pope opposes condom use is because, according to some teachings within the Church, this promotes extra-marital sex or sex before marriage and, in the case of married couples, undermines the objective of marriage which is to have (and raise) children.

    Well, I think the reason above to not use condom is rather stupid. As my mother says “when the Church gives me money to help me raise the 20 or so children I could’ve had, I’ll stop using birth control”.

    And there’s also the AIDS issue. How can we justify not using condoms with such primitive reasoning when millions of people die? It’s a global epidemic, and actively campaigning against it isn’t going to help mankind much. God, the Pope should just shut his mouth. Catholics don’t even need to listen to him, anyway.

  6. anentropic said,

    October 5, 2010 at 7:02 pm

    ‘My diocese is flooded with condoms and there is more AIDS because of them.’

    My god, they must be *used* condoms… that’s awful!

  7. hatter said,

    October 14, 2010 at 1:14 pm

    I haven’t had time to read all the posts, so maybe someone has already pointed this out, but it is irrelevant whether the people in a particular country are Catholic. If there are missionaries there and they’re spreading this drivel about condoms then they are having a negative influence on one of the ways of reducing infection. Why would people be listening? Well I have never met someone who tells me they love condoms so much they never want to have sex without one. Would you pop one on every time if it had no contraceptive or disease-preventing benefits? These priests go to places like Africa and tell the locals condoms are worthless, so people don’t use them. It says a lot that they don’t feel confident enough to try discouraging condom use by simply saying it is purely religious, but instead find it necessary to lie about condoms. You Catholics who support the Pope’s stance, if you want to look credible let’s see you vocally condemning the lies, and telling people that condoms are protective, but that they shouldn’t use them because the Pope is against them for purely religious reasons.

  8. baratron said,

    November 22, 2010 at 12:18 am

    Apparently the Pope was listening to you?!

    Pope condones condom use in exceptional cases

    Pope Benedict on the use of condoms: book excerpt

    Pope’s condom comments welcomed by campaign groups


  9. joey89924 said,

    November 16, 2012 at 2:40 am

    That’s a bit of an understatement.