Prevention Matters

The recent controversy over the pope's declaration that condoms could make the AIDS epidemic worse, not better, in Africa, prompted RTI Chief Scientist Douglas Kamerow to take a stab at closing the chasm between Catholic orthodoxy and public health science.

"One possible approach to the seemingly irresolvable conflict between condoms and religious dictums might be to separate the disease prevention attributes of condoms from their contraceptive effect," Kamerow, a former assistant surgeon general, writes in BMJ.

"There is precedent for this, at least in the United States: many Catholic hospitals and doctors here prescribe oral contraceptives to women not to prevent pregnancy but instead to prevent heavy, painful periods," he continues. "So it wouldn’t be too much of a stretch to imagine the Catholic church tacitly condoning condom use as part of an overall disease prevention programme to decrease the spread of HIV, even if only within marriages."

Kamerow notes that much of the spread of the AIDS epidemic in Africa occurs within marriage, making the pope's encouragement of abstinence a moot point in such cases.

"If condoms are not available, these women are forced to make the impossible choice between refusing to have sex with their husbands (and risking abuse) or consenting to sex (and risking HIV infection)," he concluded.