Friday, November 27, 2009

Self Destructiveness Seems Like a Strange Quality in a Church

I've had time to read UNAIDS's 2009 HIV Epidemic Update and it's interesting, but perplexing in many ways. Take, for example, the issue of unprotected sex with multiple partners. As a result of research into different modes of transmission and their relative importance in different countries, it was found that Kenya has a particular problem with people having unprotected sex with several different partners.

This didn't come as a big shock, of course. Many people, all over the world, have unprotected sex with several different partners. But the risk of transmitting or being infected with HIV is much higher in a country with high prevalence of HIV and certain other sexually transmitted infections (STI). And Kenya is such a country, with 7-8% HIV prevalence, high prevalence of STIs known to make one more susceptible to transmitting and contracting HIV (such as herpes simplex virus), very poor education and health services and an attitude towards condom use that is, I suspect, strongly influenced by conservative religion and politics.

The shocking thing is how many people are willing to take such risks with their sexual partners while refusing to use condoms, coupled with the fact that tens if not hundreds of millions of dollars have been spent on HIV prevention campaigns that advocate the use of condoms. A recent campaign by the extremely wealthy, powerful and conservative Population Services International (PSI) aims at stopping relationships on the side or multiple relationships. The campaign mentions condoms too but concentrates on stopping the relationships.

The trouble is that after many years of some parties campaigning for safer sex, others have been campaigning for no sex at all or no sex except inside marriage. The volume of this sort of campaigning is high and usually advocates against the use of condoms or suggests condom use only in difficult circumstances (such as where one's partner is already infected with HIV). Aside from the fact that in Kenya, Uganda and other countries, the chances of becoming infected by one's marital partner is higher than becoming infected by a casual partner, many people are not married, are no longer married or have not, as yet, been able to get married. So lecturing them about abstaining till marriage can be a rather pointless exercise.

One of the apparent results of all these campaigns that have a pseudo-moral political and religious agenda is that people have internalised the message about not using condoms but they haven't given up having sex with a number of different people. Many of the people who engage in multiple partnerships are married, so they are in danger of infecting their partner or being infected by their partner. And yet the religious and political zealots keep ranting on about condoms and how they are not the solution.

The Catholic pope is quite right when he says that HIV cannot be overcome by relying exclusively or primarily on the distribution of condoms. They need to be used, all the time, and properly in order to reduce the transmission of HIV. He may also be right about the importance of conjugal fidelity, but conjugal fidelity appears to be rather rare, perhaps more so among those married in the Catholic church than in many others. As for sexual abstinence, it appears to be rare in the Catholic church and is not even a foregone conclusion among those who profess to have taken a vow of chastity.

If we lived in the sort of world the pope is talking about, where everyone did only what they were supposed to do with regard to sexual behaviour, there would be no need for condoms or many of the other things that he and his ilk object to so strongly. But then, nor would there be HIV or other sexually transmitted infections. Maybe people shouldn't have sex except within marriage and for the purpose of procreation, according to some moral code. But people have sex, defecate, eat, drink, sleep and play.

According to the moral code of some people, having sex or exercising many other forms of human behaviour are not, in themselves, moral or immoral. Which is not to say it is not wrong to have sex with one person when you are in a relationship with someone who thinks that they are your only partner, for example. But the pope sees having sex outside the strict bounds of Catholic teaching as absolutely wrong. And using a condom to avoid an unplanned pregnancy or to protect oneself from HIV or any other STI is also wrong. Yet, in a world where people only had sex within those strict bounds, it would seem strange to even have to make a pronouncement about contraception.

Maybe the pope will keep going on about abstinence until marriage and the evils of contraception. If he does, all the worse for the Catholics who choose to listen to him. And I'm talking about the Catholics who live in this world, in Africa in particular. Because a lot of them don't seem willing to take all of his advice, preferring to select the bits they like and leaving out the bits they don't like. The pope is surprisingly influential and as a result of his influence, HIV continues to spread rapidly in Kenya and other countries. It infects innocent people, through various means, young and old people, religious and non-religious people and especially people who have sex. And that's most people, as far as I know.


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