Published November 17, 2014
The head of the U.N. AIDS agency told a Vatican conference Saturday that the pope had opened the door to greater dialogue with his groundbreaking comments on condoms and HIV prevention — even as Vatican officials stressed abstinence and marital fidelity as the best prevention.
Dr. Michel Sidibe, executive director of UNAIDS, was invited to speak to the conference on preventing HIV and caring for HIV-positive people, a significant event in and of itself, given that the Vatican usually only invites like-minded outsiders to its conferences and UNAIDS has not been like-minded on this issue at all.
UNAIDS holds that condoms are an "integral and essential" part of HIV prevention programs, which it says should also include education about delaying the start of sexual activity, limiting sexual partners and marital fidelity. The Catholic Church opposes condom use as part of its overall opposition to artificial contraception.
The Church does, however, play a crucial role in caring for HIV-positive people, particularly in Africa where some two-thirds of the world's 22 million infected people live. It runs hospitals and hospices, orphanages and clinics and has played a critical role in helping to de-stigmatize those with the virus and stress the need for changes in sexual behavior to stop its spread.
But the Church has long been accused of contributing to the AIDS crisis because of its opposition to condoms.
That was why Pope Benedict XVI made headlines last year when he said in the book "Light of the World" that a male prostitute who intends to use a condom might be taking a first step toward greater responsibility because he is looking out for the welfare of his partner.
"This is very important," Sidibe told the conference. "This has helped me to understand his position better and has opened up a new space for dialogue."
At the same time, however, the Vatican officials speaking at the conference either glossed over or made no reference whatsoever to Benedict's condom remarks — evidence of a certain "one step forward, two steps back" mentality that often characterizes developments in the Catholic Church.
Monsignor Silvano Tomasi, the Vatican's envoy to the Geneva-based U.N. agencies, cited several other Benedict quotes from the book, but not the condom comments. Monsignor Zygmunt Zimowski, head of the Pontifical Council for Health Care Workers, which hosted the meeting, didn't mention Benedict at all, citing instead Pope John Paul II about the "crisis of values" behind the AIDS crisis. Monsignor Jacques Suaudeau of the Vatican's bioethics advisory board briefly showed a slide with the remarks but didn't mention them.
The discrepancy reflects to some degree the way in which the pope's remarks were received. Progressives saw his comments as a justification of condom use in a break with church teaching; conservatives insisted he wasn't altering doctrine and that the opposition to condoms remained. After three attempts at clarification, the Vatican eventually issued a definitive ruling saying the pope hadn't changed church teaching.
Nevertheless, the impression left at least within the AIDS community was that he had made an opening — and Sidibe latched onto that Saturday.
Sidibe said previously the AIDS community and Catholic Church were "talking over" one another and often worked in opposition to one another in dealing with the AIDS crisis. But he said Benedict's words had opened a new possibility for working together, particularly in agitating for greater access to anti-retroviral treatments for the world's poorest patients.
"Yes, there are areas where we disagree and we must continue to listen, to reflect and to talk together about them. But there are many more areas where we share common cause," Sidibe said.
Increasing access to treatment has become an even greater rallying cry following the recently published results of a nine-nation study showing that HIV-positive patients who received early treatment were 96 percent less likely to spread the virus to their uninfected partners.
Sidibe called the research a "game-changer" in the fight against AIDS, particularly for couples where one person is HIV-positive.
Zimowski concurred, saying it even gives hope to such couples who want to have children — in other words, sex for procreation in keeping with church teaching.
That said, all 1,763 couples in the National Institutes of Health study, where one partner had HIV and the other didn't, were urged to use condoms and the study's authors stressed that condoms remain crucial for protection.
The Vatican's emphasis on the need for changes in sexual activity has been boosted by studies showing that at least in Africa, prevention programs focusing on condom promotion aren't working and that what works is male circumcision and reducing the number of sexual partners.
Yet Dr. Edward Green, former director of the AIDS research project at Harvard University, said there is little financial support for programs that advocate partner reduction, particularly among Western donors who uniformly insist on condom distribution as part of prevention efforts.
Green says he belongs to no particular church and bases his findings on empirical evidence, not morality.