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Prophylactics or Family Values

Prophylactics or Family Values

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Published by CBCP for Life

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Published by: CBCP for Life on May 20, 2011
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Mons. Jacques Suaudeau, Pontifical Council for the Family
 Prophylactics or Family Values?
Every year, towards the end of December, the world rediscovers the harsh reality of theHIV/AIDS epidemic following the annual international conference on the subject. This year theUNAIDS report on the growth of the epidemic was perhaps even more worrying than in pastyears, particularly because of the grave projections for sub-Saharan Africa implied by this reportand for its survival in the new century.At the end of the 20th century, according to the data provided by UNAIDS, 2.6 million people inthe world died this year because of AIDS.(1) This is the highest total recorded since the beginning of the HIV/AIDS epidemic, despite the development of the antiretroviral therapywhich has controlled the spread of the disease in wealthier countries. 5.6 million new cases werereported in the world this year. There are 32.4 million adults and 1.2 million children infected byHIV/AIDS in the world today; 95% of them live in poor or developing countries.These figures are particularly shocking when we consider that today the AIDS tragedyspecifically affects sub-Saharan Africa. The conference in Lusaka, Zambia, held from 12 to 16September 1999, drew attention to the unfortunate deterioration of the situation.(2) In fact, 70%of the world's seropositive
that is, 23.3 million people
live in sub-Saharan Africa, although itsentire population accounts for only 10% of the world's total. The majority will die in the next 10years. There is an 8% prevalence in the adult population (0.25% for Western Europe, 0.13% for  North Africa and the Middle East). Since the start of the epidemic, 34 million people in sub-Saharan Africa have been infected with HIV. Of these, 11.5 million are already dead (83% of.those who have died of AIDS since the beginning of the global epidemic). In 1998 AIDS wasresponsible for 2.2 million deaths in sub-Saharan Africa
in comparison with the 200,000 caused by war.(3) Life expectancy at birth, which in South Africa had risen from 44 years in the 1950sto 59 in the 90s, will drop to 45 years between 2005 and 2010.(4) These deaths represent theyounger sector of the population, which was educated, professionally trained or taught inschools.(5) They were the hope of these poor countries. Many of them were young mothers withsmall children. Today it is they who are the cause of the terrible problem of AIDS orphans. 95%of the 11.2 million AIDS orphans are African.(6)
Church has cared for AIDS patients from the start
If 7 out of 10 individuals infected with HIV this year live in sub-Saharan Africa, the proportionof children increases to 9 out of 10. 570,000 children under 14 years of age have been infectedwith HIV/AIDS this year in sub-Saharan Africa, and 90% of these were born of seropositivemothers.These data give a true picture of the tragedy: the HIV/AIDS epidemic is devastating Africa and jeopardizing the continent's future. On 10 January this year, the UN Security Council metspecifically to discuss the problem(7) and called the HIV/AIDS epidemic the most serious factor in the economic and political destabilization of Africa, "a security crisis", in the words of Vice-
President A. Gore.(8) "The epidemic has become more destructive than a war", said Dr Peter Piot, Director of UNAIDS.The Catholic Church has not been indifferent to this situation. Far from it. Since the start of theepidemic, the Catholic Church has been present with her hospitals, treatment centres, parishes,the service of men and women religious, local aid organizations for the sick and concern for their  problems. In Africa she has been in the forefront of the fight against HIV/AIDS. For this reason,the Pontifical Council for the Family, during its courses on family and ethical issues, with thecollaboration of the Episcopal Conferences, has held several meetings with the doctors andnurses involved in the fight against AIDS. Most of these meetings were held in the countries of sub-Saharan Africa affected by the epidemic.We must remember that the Catholic Church's commitment has, as always, been discreet andeffective. We must recognize, above all, the admirable dedication and extraordinary generosityof the many people we have seen
in Uganda, Kenya, Tanzania, Ghana, Cote d’Ivoire, Benin,Central African Republic, Burkina Faso
visiting AIDS patients in their homes, bringing themhuman assistance, medical treatment and, frequently, food and drink. To understand the reality of AIDS in these countries, one must follow the volunteer workers on their rounds, as we did, andsee them entering dark houses, bending with compassion over a poor emaciated woman on theverge of death, surrounded by three or four children who will have nothing left tomorrow, noteven their mother.We must pay due respect to those women religious who have taken in so many childrenorphaned by AIDS and provided them with shelter, food, education and professional training by begging funds right and left and relying on a minimum of public assistance and the meagrecontributions of international institutions. We must respect these lay men and women, often fromother continents, who have given hope, dignity of life and food to so many women infected withAIDS and rejected by everyone as "dirty". Here we have seen Christ suffering, Christ despised,stigmatized and rejected, Christ sick and visited by no one, Christ dying of hunger and thirst. Wesensed their horrible loneliness and the terrible feeling of being given up for lost. But we alsosaw Christ visiting the sick, comforting the suffering, embracing AIDS victims and takingresponsibility for, their children who are now orphans.Recalling the serene and smiling faces of so many African men and women we saw each dayinvolved without fanfare in this harsh struggle against the devastation of the HIV/AIDSepidemic, we were saddened by the recent statements several people made to the press, which provoked such an outcry during their brief trips to a few African countries. In these statementsthe Catholic Church was basically accused of being "indifferent" to the AIDS tragedy in Africa.It is true that when someone sees the appalling reality of the AIDS problem in Africa for the firsttime with his own eyes, it is natural to feel shocked and indignant. A guilty party is sought, and itis often those involved in remedying the situation who are blamed, while others are content tocriticize.
Family values guarantee true human victory
Thus the Catholic Church has been accused of lacking a sense of reality and of beingirresponsible about the HIV/AIDS epidemic in Africa because of her position regarding the useof prophylactics to prevent sexual contamination.At various meetings the Pontifical Council for the Family has continually recalled the CatholicChurch's message about this difficult question of preventing HIV/AIDS. This message is based,in a few words, on "the value of the family". What is at stake here is a vision of man and woman,of their dignity, of the meaning and significance of sex, as presented in this Council's documenton human sexuality.(9) Wherever there is true education in the values of the family, of fidelity,of marital chastity, the true meaning of the mutual gift of self 
and this seriously involves theState as well
and wherever the intrusive forms of promiscuity are overcome, man will achieve ahuman victory, even over this terrible phenomenon.In the prevention of any epidemic a distinction can be made between means that are properly preventive and those of "containment". With malaria, for example, a disease comparable toHIV/AIDS because of its effect on the population and the number of deaths it causes, the preventive measures developed over the years
especially in combatting the anopheles mosquito
were those of "containment", because they did not go to the roots of the disease. Effective intheory, these measures proved ineffective in practice because it is impossible to destroy all thelarvae, drain all the lakes or prevent people from having uncovered water supplies.Another example is typhoid fever. Prevention was effective here, because it was possible toconvince people to be careful about their sources of drinking water. This was real prevention, because the mistaken attitude that had been responsible for people's contamination could becorrected.If people really want to prevent AIDS, they must be convinced to change their sexual behaviour,which is the principal cause of the infection's spread. Until a real effort is made in this regard , notrue prevention will be achieved.The prophylactic is one of the ways to "contain" the sexual transmission of HIV/AIDS, that is, tolimit its transmission.. However everyone recognizes that "perfection" in this area does not andcannot exist. Without going into the possibility of latex, condoms splitting
or slipping which isalways possible during the sexual act
, it is clear that the prophylactic is only effective "when itis used correctly",(10) and only then: an optimal condition that in fact leaves ample room for lessthan optimal conditions.(11) Details on the numerous cases of prophylactic failure have beenwidely publicized elsewhere.(12) The truth is that for various reasons "prevention" has beenequated with "the proper use of prophylactics", without their effectiveness in the HIV/AIDSepidemic having been statistically proved or 
 being provable, because of the multiplefactors influencing the spread of the epidemic.This "decision of principle" has deliberately obscured what has been known for some time aboutthe relative effectiveness of the prophylactic as a contraceptive.(13) In fact, statistics in this areaindicate almost 15 failures per 100 sexual acts "protected" by condoms. We are asked to believethat the HIV virus, 450 times smaller than spermatozoa, can almost always be magically blocked by a condom, without taking into account that spermatozoa themselves can pass through the

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