Is Condom Distribution Smart Health Policy?

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I plan to address this question from the standpoint of Pope Benedict’s XVI’s recent comments that condom use isn’t helping and is, in fact, worsening the HIV crisis in Africa. It’s hard to jump into the middle of this issue, since there is a long tradition of Roman Catholic moral theology behind the pope’s statement. (John Paul II was especially good at explicating what he called the “theology of the body.”) However, I don’t think the question really means to engage Catholicism’s teachings about the dignity of human beings, the importance of family, or the proprieties of sexuality. The word “smart” in the question suggests a consideration of the effectiveness of condom distribution as a matter of public health. (I hope we’re not considering commending condoms as a mere political expedient.)

So why even bring up the pope? Well, it has partly to do with the media firestorm that blazed after Benedict said what he said, which he did en route to Africa onboard the papal jet, Shepherd One. His comments reverberated in the media echo chamber throughout the apostolic journey—and since—and angered many people, although the million people who attended the pope’s Mass in Angola seemed downright joyful. Africans weren’t angry at Benedict’s message of restraint, perhaps because they know firsthand that in “every African country in which HIV infections have declined, this decline has been associated with a decrease in the proportion of men and women reporting more than one sex partner over the course of a year -- which is exactly what fidelity programs promote.” This quote comes from an article (from the website of the Catholic magazine First Things) by Edward C. Green and Allison Herling Ruark. Green is director of Harvard’s AIDS Prevention Research Project and Ruark is a research fellow there. They also write that abstinence programs aimed at teens have also been shown to cut down the incidence of infection.

There are no studies that show an association between increased condom use and a decrease in the incidence of HIV in Africa, which is another reason to treat the pope’s point of view with a little more respect.