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From time to time, in a cyclic way, and who knows if linked to the fall of profits of the major producers of condoms, there appear in the media attacks on the Church for its opposition to the use of these instruments in birth control, or in the fight against AIDS. We offer an interesting article from the journalist Just Aznar, which appeared in the newspaper “The Provinces” of Valencia, on November 7, under the title “The Cardinal and aids”, and distributed by email by the Independent Committee against AIDS. |
| “The cardinal and aids “.
With this same title, I published in the provinces (10-03-1999) an article in defense of our countryman Charles, Cardinal Archbishop of Barcelona, who had been unfairly attacked by some statements on how to prevent the transmission of AIDS. Now something similar had happened with the Cardinal Lopez Trujillo, President of the Pontifical Council for the Family, which has also been widely criticized in various media for his statements to the BBC (12-10-2003) on the same subject. In fact, Cardinal Lopez Trujillo, reportedly said that “the sperm can easily pass through the network formed by the condom”. If these statements were true, it has to be admitted that those statements are wrong, but without a doubt, it seems reasonable to think that the idea that the cardinal wanted to convey in his interview is that the condom is not a secure method to prevent the transmission of AIDS. And to this I would like to comment on. Unsafe Method In fact, the condom is one of the least safe methods to prevent unwanted pregnancies, because according to abundant data from the medical literature has a failure rate of between 10 and 12 pregnancies per year for every 100 couples who use it. Therefore, if you fail to prevent pregnancy, with more reason may fail to prevent the spread of any sexually transmitted disease, including AIDS. And this is confirmed by the data. In fact, in the most comprehensive study to date to assess the ability of the condom to prevent the transmission of HIV, work that collects all published in the English language until 1990 (Soc Sci Med 1335; 36, 1993), it can be concluded that the condom reduces the likelihood of contagion in a 69.9%. The most recent data published by the Institutes of Health of the United States (N Engl J Med 611, 2001; 344) increase this rate of protection up to 85%, so there is always a percentage of 15% to 30% of unprotected sexual contacts. However, in my opinion, the most objective way to assess the extent to which protects the condom of the heterosexual transmission of AIDS is to study if you get the healthy person in a heterologous couple (a healthy one and other HIV positive), that have normal sexual relations and systematically use the condom. In a study with couples in which the male was a hemophiliac and HIV positive and she was not, after two years of follow-up, it was found that the 27% of the women had been infected (V International Congress on AIDS. 1989. Abstract MAO 33). These, and other similar data, have made important medical associations, not precisely related to the ideology of the Cardinal López Trujillo, clearly underlined the inadequacy of the condom to ensure the non-transmission of HIV. The Center for Disease Control and Prevention of Infectious Diseases in Atlanta says: “abstinence and sexual relations with a healthy partner are the only absolutely safe strategies to avoid AIDS. The proper use of the condom for every act of sexual intercourse can reduce, but not eliminate, the risk of transmission of sexual diseases”. (JAMA 1921; 259, 1988). The Council of the American Society of Infectious Diseases indicates that “the best advice to prevent the transmission of AIDS is to abstain from sexual relations, and for those at risk of becoming infected, follow a monogamous relationship with a healthy partner. The use of condom use in sexual relations reduces, but does not completely eliminate the risk of transmission of the infectious disease of AIDS (J 273, 1988; 158). On the increase But there is another piece that deserves to be considered. The large advertising campaigns to increase the use of condoms not only have not decreased the number of cases of sexually transmitted diseases, but have even increased them. In a recent report (BMJ 327; 62, 2003), it is noted that in the past six years, in the United Kingdom, chlamydia infections have increased by 108% and 500% a syphilis. Although this paper does not give percentages with respect to infection by HIV, it also refers to the number of people infected with the AIDS virus has increased each year. Finally, a last aspect which I consider to be of interest, because the media have insistently referred to and commented on the statements of Cardinal Lopez Trujillo, is the extent to which the Vatican attitude could affect the prevention of AIDS in Africa. In this sense, I believe that it is of interest to note that recent data unequivocally demonstrate that the large decline in HIV infection in Uganda, the country of Africa where it has fought the expansion of this virus, is attributable to the success of the educational campaign that promotes young people’s sexual abstinence. Abstinence education is not very effective when teenagers have already been initiated in the sexual practices, but it is very effective in younger adolescents and is not incompatible with a sex education that includes also contraception (Lancet 360, 1792,2002). Contrary Effect That is to say, it looks like medical evidence that the condom decreases the chances of the spread of aids, but does not exclude them totally; but if the campaigns to promote their use indirectly induce an increase in sexual contacts, the absolute increase in those infected with sexually transmitted diseases not only does not diminish, but even, as has been already found in the United Kingdom, increases. I am therefore convinced that the message of the Cardinal López Trujillo is that the condom decreases significantly, but does not eliminate the risk of HIV infection. By this, for those who want to have promiscuous sexual relations, there is no doubt that the condom greatly reduces the likelihood of contagion, but does not eliminate it totally, so to avoid the possibility of becoming infected with HIV, the only one absolutely safe method is having sex with a healthy person. |
