Morality vs. Reality
In light of the recent inflammatory comments made by the Pope, there is an important discussion to be had about the discourse of morality with respect to HIV. The Pope’s statement was not surprising knowing the position taken by the Catholic church on artificial contraception. However, it is still extremely shocking for many of us to hear recognizing the toll that HIV/AIDS continues to take on our continent. With all due respect to the Papacy and the Catholic community that has been hard at work alleviating the impact of the disease, there are serious problems with an anti-condom message.
First of all, if we are going to make a moral issue about condom use, we have to talk about how HIV/AIDS has been constructed as a disease of ‘immorality.’ No matter how one contracts the virus — whether it is through sex work, intravenous drug use, rape, male to male sex or by any other non-stigmatized way — the disease is just so loaded with this discourse of immorality and deviance. This is one of the major barriers to dealing with AIDS in the first place, and it is a major barrier in sub-Saharan Africa where Christianity is so strong. It affects how those who are infected are treated, and it affects the way HIV interventions are carried out. One of former Pres. George W. Bush’s most positive legacies was the PEPFAR (US President’s Fund for Emergency AIDS Relief) program which has made great contributions towards AIDS relief in Africa. Despite its successes, PEPFAR has been criticized for its strong abstinence approach. The countries outside Africa which have had the most success in controlling HIV infection are the ones who have separated the discourse of morality from the discourse of harm reduction. This is something that we in Africa need to seriously focus on if we are going to be more effective in tackling the disease.
Secondly, we cannot have a discussion about HIV without talking about vulnerability: women remain the most vulnerable group on the continent. It is a well-known fact that one of the most significant risk factors for HIV infection among women and young girls in Africa is marriage. This is a fact which the church cannot ignore and in my opinion, demands more attention than a message on abstinence before marriage. Sooner or later the Pope will also have to make an important verdict on whether serodiscordant couples where one person is already infected should use condoms or not. The interesting thing is that if he rules this to be okay (for harm reduction purposes), the whole condom debate will turn into a complete paradox.
As it is, it is difficult to get those who need to be using (male or female) condoms to let go of any related stigmas they may have and to use them correctly and consistently. That is an important area of work for many social marketing organizations who continue to press the message of consistent safe sex practices. More importantly, the negotiation of condom use between men and women is even more complicated and that is a problem that women within marriages are often faced with as research in this area has shown. From a human rights perspective, to say that condoms aggravate HIV infection is an assault on those who are trying to protect themselves from infection, sub-Saharan women in particular. The implications of unsafe sex extend beyond HIV infection and the sexual health of African women will continue to deteriorate if such anti-safety messages are taken seriously.
Of course abstinence only programs can have their successes but they will only work if the church wants to change the entire moral and social fabric of society, such that being married does not make you more susceptible to HIV infection in the first place, because clearly even marriage does not protect everyone from infection. In the end, we cannot rely on ‘morals’ to translate into safe behaviour in every case. The reality is that there are people having unsafe sex with multiple partners and the goal of practical interventions such as condoms is to promote safety and reduce harm for all regardless.
More articles of interest:
~ by misswretched on March 21, 2009.
Posted in Commentary
Tags: abstinence, Africa, AIDS awareness, Catholic church, condoms, contraception, culture, discourse, disease, education, gender, harm reduction, HIV/AIDS, human rights, inequality, marriage, maternal health, media education, morality, PEPFAR, Pope Benedict, public health, research, safe sex, sex, sexual health, social marketing