Family Values vs. Safe Sex

The BBC used an interview they conducted with Cardinal Trujillo in order to launch an attack on the Catholic Church for her opposition to condoms in their hit piece, Sex & the Holy City. PRI President Steve Mosher refused a similar interview with the BBC because they completely lack journalistic integrity. We publish below an excerpt from Cardinal Trujillo’s response to the BBC program.

The mass media have circulated news that I granted an interview to the BBC, which was broadcasted last October 12, 2003, on the eve of Pope John Paul II’s 25th Anniversary in his service as Bishop of Rome. On that occasion, I answered different questions for more than an hour, especially those dealing with the family. But, surprisingly, what was shown from the whole interview on the BBC Panorama’s film, Sex & The Holy City, were merely three questions of less than half a minute each, the answers to which were certainly much more complete. The program apparently tried to deliberately and systematically criticize the Catholic Church for supposedly contributing to the death of people by not allowing the use of condoms to prevent the spread of HIV/AIDS.

In that interview I warned about “safe sex,” stating that one cannot truly speak of objective and total protection by using the condom as a prophylactic, when it comes to the transmission not only of HIV/AIDS, but also of many other STDs (Sexually Transmitted Diseases). I emphasized that in order to control the pandemic, it is necessary to promote responsible sexual behavior that is inculcated by means of authentic sexual education, that respects the dignity of man and woman, and that does not consider others as mere instruments of pleasure and thus objects “to be used.” I also said that such responsible sexual behavior takes place only in conjugal love, assuming the responsibilities of marriage as a reciprocal, exclusive, and total self-giving of a man and a woman in a community of love and life.

Therefore, my position was absolutely clear against promiscuity that is fueled today by certain permissive political measures and certain means of communication. That is why I reminded the audience that the Church teaches a moral position that is valid for all, both believers and non-believers.

Church Criticizes Condom in AIDS-Prevention

The Catholic Church has repeatedly criticized programs promoting condoms as a totally effective and sufficient means of AIDS prevention. The different Bishops’ Conferences all over the world have expressed their concern regarding this problem. The Catholic Bishops of South Africa, Botswana and Swaziland categorically “regard the widespread and indiscriminate promotion of condoms as an immoral and misguided weapon in our battle against HIV/AIDS for the following reasons:

• The use of condoms goes against human dignity.
• Condoms change the beautiful act of love into a selfish search for pleasure — while rejecting responsibility.
• Condoms do not guarantee protection against HIV/AIDS.
• Condoms may even be one of the main reasons for the spread of HIV/AIDS. Apart from the possibility of condoms being faulty or wrongly used they contribute to the breaking down of self-control and mutual respect.”1

The Sub-commission for Family and Life of the Spanish Episcopal Conference said that the campaigns that promote the condom in Spain to supposedly stop HIV/AIDS are gravely irresponsible for three reasons: “because they tend to be deceitful, because they hide information, and because they do not contribute towards prevention, but rather to a greater spread of risky behavior.”2

The Catholic Bishops’ Conference of the Philippines maintained that “[t]he moral dimension of the problem of HIV/AIDS urges us to take a sharply negative view of the condom-distribution approach to the problem.”’3

Even earlier. the bishops of the United States of America affirmed in their 1987 statement: “abstinence outside of marriage and fidelity within marriage as well as the avoidance of intravenous drug abuse are the only morally correct and medically sure ways to prevent the spread of AIDS.”4

I am quite concerned because people, especially the young, are misled when total protection is seemingly offered to them, while in fact there is no such total protection, Aware of the immensity of the pandemic, while at the same time maintaining the different but complementary levels of what is moral and what is merely hygienic. I wanted to speak out regarding the need not only to contain the continuous expansion of this pandemic, but also the need to prevent condom users from getting an infection that they previously thought was impossible to get.

There are persons at risk of being contaminated, even though they think that their sexual relations, from the hygienic point of view, are totally safe. How many fall victim to this error? They would have taken a different attitude, at least to a certain extent, had they been given more valid and objective information. The reader is invited to reflect why, despite the invitation to promiscuity made by the “safe sex” campaign and the distribution of an enormous quantity of prophylactics where the pandemic is more widespread, the problem of infection has become even greater.

The position of the Church is truly human and responsible: it is a call to fully respect the human person’s freedom and dignity. The fact that families and youth are oftentimes misinformed and given false security should not be tolerated any longer.

As a Father of the Church said, “We should not be ashamed of the things that God has created.” Not only should we not be ashamed of things created by God, we should also defend them, for everything that he has created is good. Human sexuality, conjugal love, responsibility, freedom, bodily health: these are God’s gifts to us that we have to treasure.

Concern from non-Ecclesiastical Circles

The concern that condoms do not provide total protection against AIDS and STD’s is not limited to Church circles. Dr. Helen Singer-Kaplan., who founded the Human Sexuality Program at the New York Weill Cornell Medical Center, wrote in her book, The Real Truth about Women and AIDS: “Counting on condoms is flirting with death.”5 A Dutch medical journal also stated that. “Practice shows that there is a great need for a method that prevents both HIV as well as pregnancy. Sad to say, the people still have not become aware that this method cannot be the condom.”6 In the 1980’s and the 1990’s, questions on the real protection provided by condoms arose from electron microscopic studies on the latex material, a concern related to the fact that the AIDS virus is about 25 times smaller than the sperm cell’s head, and 450 times smaller than the sperm cell’s length.7

In 1939, the Los Angeles Times published an article entitled, “4 Popular Condoms Leak AIDS Virus in Clinical Tests.” It stated that “Four of the nation’s most popular condom brands permitted the AIDS virus to escape in laboratory tests conducted for UCLA, prompting researchers to warn users they should not assume that all condoms work equally well in preventing spread of the disease…Overall, among the thousands of condoms tested, the study found that 0.66% of condoms — more than one of every 200 — failed, either allowing water or air to escape, breaking in tensile strength tests or leaking the AIDS virus.”8

A British newspaper reported that “the organization [World Health Organization] says ‘consistent and correct’ condom use reduces the risk of HIV infection by 90%. There may be breakage or slippage of condoms…”9 The International Planned Parenthood Federation even gave a higher failure rate, stating that “use of condoms reduces by approximately 70% the total risk between unprotected sex and complete sexual abstinence.”10

It should be stated that the remaining 10–30% from these figures, which represent the failure range, is relatively high when one deals with a potentially mortal disease such as AIDS, especially if there is an alternative that provides absolute protection against the sexual transmission of the same: namely, abstinence before marriage, and fidelity to one’s spouse.

Given that AIDS is a serious threat, any inadequate information based on false security offered by condoms used as prophylactics would be a grave irresponsibility.

The Workshop Summary

The above cited medical literature and many others have opened several questions regarding condom effectiveness in preventing sexually transmitted diseases. On June 12–13, 2000, four U.S. government agencies responsible for condom research, condom regulation, condom use recommendations, and HIV/AIDS and STD prevention programs co-sponsored a Workshop precisely “to evaluate the published evidence establishing the effectiveness of latex male condoms in preventing HIWAIDS and other STDs.” The four agencies were the U.S. Agency for International Development (USAID), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDC), and the National Institutes of Health (NIH). The Workshop Summary: Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention was published on July 20, 2001.11

The Workshop’s focus was on “the latex male condom for the prevention of HIV/AIDS and STDs during penile-vaginal intercourse.”12 The Workshop Summary explains that available scientific evidence indicated that the condom reduces the risk of AIDS/HIV by 85%.13 There is then a 15% risk that remains.

The Workshop also studied the transmission of other genital infections, and the usual conclusion is that studies demonstrated either no or some protection through condom use, or that there is insufficient data to confirm risk reduction. The diseases studied individually are the following: Gonorrhea, Chlamydial infection, Trichomoniasis, Genital Herpes, Chancroid, and Syphilis. The Human papillomavirus (HPV) is given some more attention, with the conclusion stating clearly that “[t]here was no evidence that condom use reduced the risk of HPV infection…”14 HPV is a very important STD associated with cervical cancer, which in the U.S. kills many more women than the HIV.15

There is no such thing then as 100% protection from HIV/AIDS or other STD’s through condom use. This data should not remain unnoticed, since many users, including youth, think that the condom provides total protection. In their article, Fitch et al emphasize that the cumulative risk factor is very significant. “For example, an intervention that is 99.8% effective for a single episode of intercourse can yield an 18% cumulative failure rate with 100 exposures.”16 Likewise, based on an International Planned Parenthood Federation (IPPF) article, “the risk of contracting AIDS during so-ca11ed ‘protected sex’ approaches 100 percent as the number of episodes of sexual intercourse increases.”17

What has to be considered therefore is not only the risk of each single condom use, but also of its continued use, a risk which dramatically increases in the long run.

Condom Failure and Pregnancy

Most probably related to the condom’s efficiency in preventing the transmission HIV/AIDS and STD’s is its efficiency in preventing pregnancy. The WHO explains that perfect use of the condom does not prevent pregnancy all the time. “Estimated pregnancy rates during perfect use of condoms, that is for those who report using the method exactly as it should be used (correctly) and at every act of intercourse (consistently), is 3 percent at 12 months.”18 Needless to say, the condom’s typical use, which includes perfect and imperfect use (i.e. not used at every act of intercourse, or used incorrectly), is much less effective in preventing pregnancy. “The pregnancy rate during typical use can be much higher (10–14%) than for perfect use.”19

Indeed, pregnancy in spite of condom use is well documented, with the Pearl index placed at around 15 failures per 100 women years within the first year of use.”20 If pregnancy may occur in spite of condom use, wouldn’t it be only logical to conclude that the condom also allows transmission of HIV and STD’s, given that the disease-causing organisms may be present with the sperm cells, in the seminal fluid, and even elsewhere, such as on skin surfaces not covered by the condom? Moreover, one must consider that a woman can become pregnant only during her fertile days (approximately 5–8 days in a cycle, taking into account the sperm’s lifespan inside her body), while the HIV and STD’s may be transmitted on any day.

Condom Failure and Latex Material

Cardinal Eugenio De Araujo Sales, Archbishop Emeritus of the Archdiocese of Rio de Janeiro, recently stated in a newspaper article that several lots of condoms (some from leading brands) were recalled from the market in Brazil in 1999, 2000 and 2003, due to failure in different tests and to the discovery of counterfeit products.21 According to Cardinal Sales, the 1999 recall, for example, involved 1,036.800 units of the condom Prudence, the third leading brand in Brazil, because it failed the test done by the government’s Ministry for Development, Industry and Exterior Commerce. Condoms, in addition to having possible manufacturing defects, could undergo deterioration during shipping, handling and storage, and even further degradation after purchase by the end user. Factors such as the following have been proposed as possibly contributing to the degradation of latex (and thus to condom failure): exposure to sunlight, heat (including body heat when placed in pockets or wallets), humidity, pressure, certain spermicides and even to atmospheric ozone.22 Besides, the condom may still suffer last-minute physical damage immediately prior to or during actual use, such as contact with fingernails.

User-Related Condom Failures

The typical, real-life use of condoms is far from perfect. This is not difficult to understand, given that consistent use requires an enormous amount of self-discipline (and memory), and correct use requires a relatively meticulous 7-step process, if one follows the guidelines laid clown by the Centers for Disease Control and Prevention.23 In one of their brochures, the Medical Institute (Texas) says, “When given a basic list of procedures for correct condom use, less than half of sexually active adolescents report they use condoms correctly.”24 The Medical Institute explains the results of inconsistent condom use in the most simple terms: “What if I use them most of the time? You’re at risk. In fact, the CDC says, ‘Used inconsistently (less than 100% percent of the time), condoms offer little more protection than when they are not used at all.’”25

HIV/AIDS Increase and Decrease with Condoms and Chastity, Respectively

That condoms do not provide total protection against the transmission of HIV and STD’s is compounded by the fact that the “safe sex” campaigns have led not to an increase in prudence, but to an increase in sexual promiscuity and condom use.26 In fact, there are studies showing that HIV/AIDS cases increase as the number of condoms distributed also increases.27 Human behavior is an important factor in the transmission of AIDS. Without adequate education aimed at abandoning certain risky sexual behavior in favor of well-balanced sexuality, as in pre-marital abstinence and marital fidelity, one risks perpetuating the pandemic’s disastrous results.

There are reports supporting the idea that where abstinence before marriage and fidelity to one’s spouse have been successfully promoted, the HIV/AIDS pandemic has dramatically decreased. For instance, Uganda has pushed for a chastity-based program, and there the incidence of HIV/AIDS is managed relatively better than in other countries. “As AIDS sweeps across Africa, Uganda remains a lone success story, as millions of Ugandans have embraced traditional sexual morality, including sexual abstinence outside of marriage and fidelity within marriage, in order to avoid infection. But the international AIDS community has been reluctant to promote this strategy elsewhere, continuing, instead, to place its faith in condoms.”28

In connection with this, the U.S. Agency for International Development states that. “prevalence declines in Uganda relate more to reduction in sex partners than condom use.”29 Similarly, the Joint United Nations Programme on HIV/AIDS (UNAIDS) AIDS epidemic update of December 2003 states: “HIV prevalence continues to recede in Uganda, where it fell to 8% in Kampala in 2002 — — remarkable feat, considering that HIV prevalence among pregnant women in two urban antenatal clinics in the city stood at 30% a decade ago…To date, no other country has matched this achievement — at least, not nationally.”30

In Thailand and in the Philippines the first HIV/AIDS cases were reported in 1984; by 1987, Thailand had 112 cases, while the Philippines had more, with 135 cases. Today, in the year 2003, there are around 750,000 cases in Thailand, where the 100% Condom Use Program had relatively great success. On the other hand, there are only 1,935 cases in the Philippines31 — and this, considering that the Philippines’ population is around 30% greater than Thailand’s! Relatively low rates of condom use by the people in general, and staunch opposition from the Church32 and a good number of government leaders against the condom program and sexual promiscuity, are well-known facts in the Philippines.

As to the transmission of HIV in general, even though the WHO affirmed in 2002 that 99% of HIV infections in Africa were due to non-protected intercourse, one should also consider what some authors have recently expressed, that is, the possibility that the majority of new HIV/AIDS cases in Africa are not due to sexual relationships, but rather to the reuse of needles for injections, given the inadequate sanitary infrastructure in the continent.33 In this sense, the present orientation of the anti-AIDS efforts focusing exclusively or heavily on condom distribution is obviously insufficient and questionable.

The Right to Correct and Complete Information

AIDS represents a serious danger for which there is still no cure, Condom users should be guaranteed their ethical and juridical rights to be correctly and completely informed of the risks involved in the sexual transmission of this disease, and of the true effectiveness of the prophylactic, What the Church aims for is not mere risk reduction (which is actually transformed into risk augmentation if the real risks of transmission are not explained to the public), but rather risk elimination; not partial protection, but total protection; not relative protection, but absolute protection. It is truly misleading to say that one promotes “safe sex,” when in fact one is actually promoting “safer sex,” that is, sex that is safer than not using a condom at all, but it is still far from being total protection. To claim that it is “technically correct” to say that the condom “provides protection,” when in fact one actually means that it “provides partial protection,” or “85–90% protection” is to lead many to their deaths.

To advertise that the condom is “effective in preventing transmission of HIV and many other STDs,” when one actually means that it is “up to a certain degree effective in preventing HIV and some STDs but not totally, and that there is no evidence that it reduces the risk of HPV infection,” then this is not only a lack of respect for women’s rights; it is outright anti-woman, and anti-man as well. To encourage “behavior change” among adolescents in sex education pro-grams, when one actually means “to encourage them to use a condom when they engage in pre-marital sex,” while at the same time encouraging pre-marital sex itself, is to destroy not only adolescent reproductive health, but also their emotional, mental, health, and spiritual health, and indeed their future and entire lives.

The false security generated by the “safe sex” campaigns are hindrances to this right to correct, complete information. Appeals from true, sincere consumer and health advocates to fully and clearly reveal available information on condom effectiveness (or rather, ineffectiveness), have been frequently falling on deaf ears. Such appeal is based on the right of the consumer to know the true characteristics of the product he or she is using — even more if such characteristics have a bearing on the consumer’s health and life. The public has to be informed that the condom does not guarantee total protection against AIDS and other STDs. In the same way that cigarettes carry the warning that they are dangerous to the health of the smoker and those nearby, perhaps condoms should also be required to carry warning labels, on their packaging and on the shelves and apparatus where they are displayed, stating that they do not guarantee total protection against HIV/AIDS and STDs, or that they are not safe.

The HIV/AIDS and STD pandemics continue to grow, in spite of the great efforts to curb their growth. Taking into account the data presented in different studies and experiences on the field, the idea of “safe sex,” as it has been presented in condom campaigns, seems false, and thus has to be submitted to scrutiny. What is more, since there is a certain level of risk. it is also a grave responsibility of national and international institutions, both public and private, as well as of the mass media, to contribute to providing correct, complete information about the existence of these risks, which could lead people to their death.

Church Promotes Life

The statements reflecting the hard fact of condom failure by no less than international and national agencies, along with the scientific studies and real-life experiences, go totally against the accusations made against the Church: namely, that the Church contributes to the death of millions by not promoting or allowing the use of condoms in the fight against the pandemic. Indeed, shouldn’t it be the opposite: that is, that those promoting the condom without properly informing the public of its failure rates, have led to and will continue to lead to the death of many? Are there not many who fall victim to a false sense of security generated by campaigns promoting “safe sex,” oblivious to the fact there are multiple factors that lead to condom failure?

Victims of the “safe sex” fallacy tell us, in the numerous centers caring for HIV/AIDS patients promoted by the Catholic Church, that if they had only known the real risks beforehand, if only they had been properly informed, they would not have engaged in promiscuous sexual behavior, they would not have entered into sexual relationships outside of marriage, and they would have remained faithful to their families.

The Church is ready to help. Through the generosity of millions of people, the Catholic Church is able to provide 25% of services for HIV/AIDS patients, and to run a great number of hospitals, clinics and other health care facilities worldwide. The Church continues to undertake the promotion of authentic reproductive health and women’s health, which includes complete information using unambiguous terminology, and a truly safe sexual practice based on authentic human sexuality.

Need to Rediscover Truly Responsible Sexual Behavior

The Church does not propose the development of condoms with better quality that would assure 100% effectiveness against the transmission of HIV and STDs. What is being proposed is to live one’s sexuality in a way that is consistent with one’s human nature and the nature of the family. It has to be mentioned too that the WHO admits that abstinence and marital fidelity is a strategy capable of completely eliminating the risk of infection from HIV and other STDs; condoms, on the other hand, reduce the risk of infection.34

The CDC has informed that, “the only strategies of prevention that are truly effective consist in (sexual) abstinence and sexual relations with a non-infected partner, while respecting reciprocal fidelity.”35 This is why one of the most important Italian infectious diseases experts. Prof. Mauro Moroni, affirms that, “AIDS is a typical behaviorally spread epidemic…If those behaviors are removed, AIDS could be stopped without any specific prophylactic intervention.”36

The Need to Strengthen Marriage and the Family

A lifestyle that is disordered and corresponds neither to the totality of the human person nor to the will of God, cannot be a true good. We have seen how different peoples have been wounded by such trivialization of sex. Some might say that this is an excessive demand. But we have to be confident that the Lord, “will not let you be tempted beyond your strength.”37 In several places there is an emergence of youth movements whose members publicly promise to maintain a responsible attitude towards sex, and to remain chaste, abstaining before marriage, and to be faithful to their spouses. The fight against the HIV/AIDS pandemic also has to tackle disordered sexual behavior.

Marriage has to be presented as something precious, something that will help bring happiness and fulfillment to a person, as couples undertake a life-long project of mutual, exclusive, total, irrevocable, and sincere self-giving. “In the ‘unity of the two.’ man and woman are called from the beginning not only to exist ‘side by side’ or ’together,’ but they are also called to exist mutually ‘one for the other’…This mutual gift of the person in marriage opens to the gift of a new life, a new human being, who is also a person in the likeness of his parents.”38

The Holy Father Pope John Paul II said, “A pastoral proposal for the family in crisis presupposes, as a preliminary requirement, doctrinal clarity, effectively taught in moral theology about sexuality and the respect for life…At the root of the crisis one can perceive the rupture between anthropology and ethics, marked by a moral relativism according to which the human act is not evaluated with reference to the permanent, objective principles proper to nature created by God, but in conformity with a merely subjective reflection on what is the greatest benefit for the individual’s life project. Thus a semantic evolution is produced in which homicide is called ‘induced death’, infanticide, ‘therapeutic abortion’ and adultery becomes a mere ‘extra-marital adventure.’ No longer possessing absolute certainty in moral matters, the divine law becomes an option among the latest variety of opinions in vogue.”39

It is true that where there has been no education towards a serious responsibility in love: where the dignity especially of women is not given sufficient importance; where a faithful monogamous relationship is ridiculed; where condoms are distributed to the youth in parties and to children in schools; where immoral lifestyles are diffused and all forms of sexual experience are regarded as positive; and where parents are not allowed to give adequate formation to their children: such “impossibility” turns into a serious, limiting condition, The end result is not only alarming in terms of the spread of HIV/AIDS, but in that man and woman can no longer have full confidence in each other. What will become of these children’s future, without the proper information and the necessary parental guidance?

But the greatest help that the Church, and perhaps all people of good will, could offer to curb this terrible pandemic, relying on Divine Providence, is to strengthen the family.40 The family is the Domestic Church and the basic unit of society, the school of virtues, the first environment where children receive their education from their first educators, their parents. Catholic families should become examples of holiness, letting their close relationship with God in their life of prayer and in the sacraments overflow into a genuine concern for others. The Holy Father has repeatedly insisted, “Family, become what you are!” May the family truly become what it really is, after the example of the Holy Family, the model for all families.