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Adventures of a Retired Armchair Traveler - Condoms and the Church, Testing for Rape Suspects, and Musings on Microbicides
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Thu, Apr. 27th, 2006 02:55 pm
Condoms and the Church, Testing for Rape Suspects, and Musings on Microbicides

Some very interesting developments in the domain of HIV/AIDS policy and research this week, as reported by my reliable news aggregator, the Kaiser Network Daily HIV/AIDS Reports.

1) An excellent summary of articles and opinions surrounding the potential relaxing of rules regarding condom use to prevent HIV/AIDS according to the Catholic Church.

Of note: mention of a book called Catholic Ethicists on HIV/AIDS Prevention, edited by Jesuit priests James Keenan and Jon Fuller which says that the church should have relaxed its ban on condoms 20 years ago." (from above link). Also mentioned: efforts of a South African bishop, Kevin Dowling, who favors condom access to prevent HIV transmission, and a speech by Pope Benedict XVI to African bishops in which he mentions the contribution of contraceptives to a "breakdown of sexual morality," with the usual conspicuous absence of references to scientific evidence to support that assertion.

Please visit the first link for discussion of the “lesser of two evils” approach, and this link regarding the forthcoming statement on condoms and AIDS from the Vatican.

Kaiser also points to a Los Angeles Times article that quotes an HIV-positive Ugandan clergy member named Gideon Byamugisha who speaks out against HIV and had this to say about his position regarding condom use: '"I've come to understand that this disease is not from God. It's not God's plan that people die at 8 years old. Or 12. Or 30," Byamugisha said, adding, "God gives us the knowledge and skills sometimes to prevent or postpone death. He's done his part. The question is, have we done ours?" (Sanders, Los Angeles Times, 4/24).'

But according to USAID-sponsored research review by David Halperin, perhaps the Church should stick to promoting circumcision and fidelity over either condoms or abstinence.

2) In the state of Alabama, the governor signed a bill permitting a judge who rules that there is probably cause to require mandatory HIV and STI testing for people charged with rape or sexual assault. Prior to this bill, survivors or their parents could only request that such testing be done on those convicted and sentenced to 30 days or more in prison.

3) I always thought that microbicides might be the magic bullet, but others disagree. I thought it would be the perfect prophylaxis for women who don’t have the self-efficacy to negotiate condom use with partners. In Kaiser’s summary of research presented at the Microbicides Conference, however, a spokesperson for the Population Council is quoted as saying that microbicides are not a silver bullet and would provide an opportunity for women to talk openly with their partners about “sex and shared responsibilties.” I am not jumping on that bandwagon till I see the numbers.

Another perspective presented in the summary is that marketing will affect how successful microbicides may be, i.e. if they are marketed as a lubricant with protective properties, they may be more acceptable than if they are explicitly marketed as prohylaxis, which is more in line with addressing the fact that it is extremely difficult for women in many cultures and circumstances to talk to their partners explicitly about disease prevention.

A Washington Post article cites the criticism by UNAIDS, WHO and other agencies of the slow progress in developing microbicides as a preventive measure against transmission of HIV/AIDS.

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plastictao
plastictao
becca
Thu, Apr. 27th, 2006 01:12 pm (UTC)

okay. I mean the following respectfully, and am just commenting to give perspective from a more conservative lay Catholic standpoint. that said...

HIV/AIDS is an evil that has no connection to the personal sins of the vast majority of folks who suffer it. my heart breaks to think of the millions of men, women, and children who suffer unmentionable torments and ultimately die from this terrible disease. anyone with an ounce of compassion feels deep grief for their plight.

the RCC has lasted as long as it has by strongly emphasizing a set of absolute morals. the Church teaches that the use of artificial contraception (this includes condoms, hormone treatments, IUDs, diaphrams, spermicides, surgical sterilization, etc) is against the will of God for His people: it is the duty of married couples to be always open to receive God's Grace in the form of new life - children - except in extreme cases. procreation is the reason we are capable of having sex, and it is God's gift to us to make this duty a pleasurable one by making sex enjoyable. I would say, and I believe the Church would back me up on this, that a husband or wife being HIV-positive would qualify as an extreme case in which the couple would be exempt from the duty to bear children (as the wellbeing of the mother and child would be at severe risk). however, the Church recognizes only one way of preventing pregnancy - abstinence. in the case of sex for recreation between a husband and wife, one of which is HIV-positive, I would think it obvious that the only really safe way of preventing the other from being infected would be abstinence, and that the spirit of love should be enough to get a couple through that "lesser evil" in order to prevent the "greater evil" of simultaneous infection - which, if they already have children, would eventually orphan their children (to whom they have the utmost obligation) and probably impoverish and/or overburden their extended families. not to mention that human beings have it in their power to halt the spread of this terrible disease, by chosing the Godly route of abstinence.

it seems to me that if liberal laypersons and clergymen wanted to encourage the truly "lesser evil", they might consider encouraging masturbation to release sexual energy. though really, they ought to be focusing their attentions on encouraging prayer for and by the infected, and redirecting their guilt to the Western drug companies, cultures that encourage (by failing to discourage strongly enough) marital rape, sex slavers, etc.

the Church is not a government, nor a political policy machine that can (or should!) change with the tide of sentiment or science. the Church is Christ's body and consort, and She is responsible for the souls of all God's children. it is Her responsibility, therefore, to actively combat evil wherever she sees it, not to embrace any "lesser evil".

again, this isn't to say that it's not terrible what is happening to these people. but I think there's something more sinister, more pervasively evil, at work here than can be addressed by condoms. poverty, corruption, violence, subjication of women, etc, are not going to be addressed by condoms. condoms give the illusion of safety during sex between partners, when in reality they give an imperfect protection against a deadly and devastating disease. they also give the illusion, to policymakers and aid workers, that they are "addressing the problems" of Africa, Asia, inner-city America & Europe.


ReplyThread
congogirl
congogirl
congogirl
Thu, Apr. 27th, 2006 02:00 pm (UTC)
Not completely linear, but...

I agree with you about the more sinister origins of what organizations and governments are trying to prevent by promotion of condom use.

And, development programs focus on those problems as well. It's just that there is so little time and money compared with what could be done that there is little synergy between the programs that address the bigger problems and the programs that promote condoms.

In one of the links, a clergy member did emphasize that the issue is tricky specifically because if any official policy is developed, it will want to be very explicit about the fact that it is by no means intending to make risky behavior the norm. This is not all coming out exactly right, but part of the reason a policy hasn't yet been released by the Vatican is that there is no easy way to allow an exception to the set of absolute morals that you mention above.

Another tricky aspect is the fact that the Church does not act in a vacuum and neither do its members. They interact in the world with all kinds of people and organizations. The Church behaves in some ways like a government for its people, particularly when we get down to the level of individual congregations. That said, I agree with you that it should not change with the tide, but [caveat: I have worked with a Catholic organization but am not Catholic and did not grow up in the Church so I am somewhat ignorant] I can't help but observe that while the set of morals may be absolute, the Church itself is not a set of absolutes because it is run by men (read: imperfect mortals).

And, again my ignorance may show through here, but my understanding of Christianity may complement or not yours of the Church and your statement that Her responsibility, therefore, to actively combat evil wherever she sees it, not to embrace any "lesser evil," which is to say that I see mercy as playing a huge role. It is not merciful to deny people a mode of protection from an infection with such deep repercussions.

Incidentally, the issue of contraception and the Church has not gone unnoticed by the microbicide developers. Ideally, a microbicide that does NOT act as contraception would be developed so that women could protect themselves or their partners and still conceive.

I am not sure what exactly you intend by saying, [laypersons and clergymen ought to be focusing their attentions on...redirecting their guilt to the Western drug companies, cultures that encourage (by failing to discourage strongly enough) marital rape, sex slavers, etc. I don't see a direct connection between Western drug companies and discouragement or encouragement of marital rape and sex slavery. In fact, I worry that many people and organizations that claim to be affiliated with the Church or other religious affiliations that would condemn such behaviors are those that should be examined and held accountable.


ReplyThread Parent
plastictao
plastictao
becca
Thu, Apr. 27th, 2006 04:33 pm (UTC)
Re: Not completely linear, but...

I don't see a direct connection between Western drug companies and discouragement or encouragement of marital rape and sex slavery.

I didn't mean that there is one... just that those three things are connected in ways to the AIDS crisis. Western drug companies effectively withhold medications from the people who need them the most by pricing them prohibitively high, marital rape is a major reason given by condom activists for why abstinence doesn't work (women don't have control over when/if they have sex with their partners) (and is a major social problem of itself), and sex slavery is another serious social issue and a major stimulus to the HIV infection rate in Asia in particular. the three are seperate in my mind, and in reality... sorry I wasn't clear about that!


ReplyThread Parent
congogirl
congogirl
congogirl
Fri, Apr. 28th, 2006 09:31 am (UTC)
Re: Not completely linear, but...

Oh, I see, I think I misread it the first time! Right, I am on board with that thought.


ReplyThread Parent
jmtfoundling
jmtfoundling
jmtfoundling
Fri, Apr. 28th, 2006 07:08 am (UTC)

as a non catholic, I am curious to know what the biblical basis/rationale is for sex being only for procreation.


ReplyThread Parent
congogirl
congogirl
congogirl
Fri, Apr. 28th, 2006 09:37 am (UTC)

Interesting discussion here.

http://community.livejournal.com/3faithdialogue/197025.html

thanks to [info]plastictao - through her journal I found this community.


ReplyThread Parent
jmtfoundling
jmtfoundling
jmtfoundling
Fri, Apr. 28th, 2006 07:06 am (UTC)

As someone periferally involved in microbicide development and testing, I think one of the major issues is that noone so far thinks any of the microbicides will be 100% effective, and a major worry is that people will use microbicides, think they are protected, and engage in more risky behaviors - negating any benifit of the protection. Another is that It's touted as a way for women to be secretive about using a method, but research (mine included) has found that hiding a method can have some serious consequences if discovered (kicked out of the home, beaten etc) and most women prefer to tell their partners that they are using a method. Methods brought into a relationship without the male partner's permission are seen as evidence that the woman is unfaithful. What appeals about microbicides is that they can be marketed as pleasurable and used discreetly, many of the male partners in my study were fine with using a method to prevent disease as long as they approved it's use in general but didn't notice when it was used. Another concern though was thinking that a method for which the female was responsible gave them the freedom to 'do other things' because then the woman would deal with the prevention. All that aside I firmly believe that microbicides are needed and should be developed as quickly as possible.


ReplyThread
congogirl
congogirl
congogirl
Fri, Apr. 28th, 2006 09:27 am (UTC)

What appeals about microbicides is that they can be marketed as pleasurable and used discreetly

Your experience corroborates what one of the women said, which I think is interesting and a good point.

Whose concern was "thinking that a method for which the female was responsible gave them the freedom to 'do other things' because then the woman would deal with the prevention?"


ReplyThread Parent
jmtfoundling
jmtfoundling
jmtfoundling
Fri, May. 5th, 2006 09:50 am (UTC)

That concern came up because of some discussions in focus groups with the male partners of women enrolled in a female controlled method study. It was the male partners saying that they could then visit beerhalls and not worry about their behavior because the woman would have inserted a protective method.


ReplyThread Parent
congogirl
congogirl
congogirl
Fri, May. 5th, 2006 10:03 am (UTC)

Oh, the men would have the freedom to do other things. I thought it was related to the women.

But this issue seems like somewhat of a constant. Whether protection is available or not, not all people are faithful all the time. Not all people use protection all the time.

There would have to be a different approach to addressing those concerns, wehther through social marketing or otherwise. It seems odd to approach concerns about fidelity through pregnancy scares and threat of transmission of infectious disease.


ReplyThread Parent
sebsan8
tongue-in-cheek
Fri, Apr. 28th, 2006 10:38 am (UTC)

What appeals about microbicides is that they can be marketed as pleasurable and used discreetly, many of the male partners in my study were fine with using a method to prevent disease as long as they approved it's use in general but didn't notice when it was used.

yes exactly, the key is in the presentation. No prophylaxis will be effective unless it is accepted by the people it is marketed to.
I am curious, what study was this that you are referring to?


ReplyThread Parent
xmo
xmo
Xmo
Fri, Apr. 28th, 2006 12:01 pm (UTC)
circumcision

have you seen this yet?
http://www.nytimes.com/2006/04/28/world/africa/28africa.html


ReplyThread
congogirl
congogirl
congogirl
Fri, Apr. 28th, 2006 12:23 pm (UTC)
Re: circumcision

I think this is the article that someone over in [info]3faithdialogue posted. I haven't read the whole thing myself, but I posted a "Caution" note taken from a Kaiser Daily Report that cited this article, which basically said that not enough studies have been conducted to conclude anything.

Talk of circumcision as a protective factor has been going on for a long time, but it's not exactly a preventive measure. Frankly, I am all for men cutting their willies if it means fewer women contract the infection. Especially since most other factors are not in the favor of women. Besides, don't they say that it's supposed to be better for sensation for men?

My main objection to the whole business has been mentioned by people elsewhere, that folks will rely on this measure only to protect them against transmitting and acquiring HIV.


ReplyThread Parent
congogirl
congogirl
congogirl
Fri, Apr. 28th, 2006 12:27 pm (UTC)
Re: circumcision

The few programs that offer free or low-cost circumcision have been swamped with applicants

If only men reacted this way to the prospect of vasectomies as a means of taking reproductive health responsibility.


ReplyThread Parent