While flipping through the Chicago Tribune yesterday morning (yes, the actual print version), I was pleased to see an article about World AIDS Day. There was a large color photo of a Reverend offering host to a parishioner and I was curious what angle of the HIV/AIDS epidemic the article would approach the issue from. Unfortunately, I was quickly disappointed that the headline’s “search for an ideal” wasn’t for a cure, comprehensive education, or accessible resources- but abstinence.
The journalist chose to speak with ministers and caregivers who counsel HIV-positive patients in Catholic hospitals or at their churches. I appreciate attention being given to religious figures who offer care and compassion to those whose disease the Church has long stigmatized, but it made me angry that their good intentions were still laced with judgment, stereotypes, and a lack of understanding for the realities of these patients’ lives.
They acknowledge that condoms aren’t the only solution and abstinence is ideal. But all human beings are works in progress, they say, and not encouraging condoms for a promiscuous person carrying a chronic disease that can be fatal creates an almost unbearable moral dilemma.
1) I acknowledge that there are people who have been led to believe that condoms are not an option for them. But when you have an HIV-positive person who is sexually active or who wants to be sexually active, and you say that the don’t have to rely on condoms, you are leaving them with no options to realistically avoid infecting their partners.
2) Abstinence is ideal for those who choose to be abstinent. For those who are HIV-positive and wish to be sexually active, abstinence is only an option. The ideal in any sexual situation is being able to safely choose with your partner to do or not do what you want based on your interest and comfort level. Abstinence is not the ideal for most people, regardless of their HIV status.
3) It is inaccurate and stereotypical to associate condom use and an HIV-positive status with promiscuity. Some who use condoms do so with a monogamous partner and some who are HIV-positive have never had sex. The association and assumption are old, and it is partly the fault of the Church for discouraging condom use and stigmatizing sexuality that the assumptions persist.
4) In this context, saying that “human being are works in progress” implies that those who are not abstinent are imperfect. It prescribes that those who are HIV-positive should ignore or repress their natural sexual desires to be intimate with a partner and that if they don’t there’s something wrong with them. This adds shame and stigma to an already difficult diagnosis.
I was also insulted at the persistence of some to place their views or values onto patients who should have their own right to have their experience (including sexual experience) respected. Dr. Paul O’Keefe, “a Catholic practicing at a Catholic hospital,” and chairman of the HIV/AIDS task force for Chicago Catholic Charities, expressed the feelings of his colleagues this way:
“We are concerned that many of our patients are not in the frame of mind or prepared to accept Catholic Church teaching on sex outside of marriage.”
As a doctor, it is absolutely none of Dr. O’Keefe’s business if a patient is married to the person they are having sex with. When someone has sex should not be of “concern” to a medical doctor. The health and safety of their patients’ sexual activity is relevant to their care, but it’s not the business of a doctor to judge how their patient got sick. It’s also completely inaccurate and inappropriate to act as through patients at a Catholic hospital are Catholic, Christian, or of any religious affiliation or inclination at all. It is irrelevant to the facts of their condition or the needs of their care.
Rev. Pat Lee, who has ministered to HIV-positive patients since 1985, still holds the perspective that abstinence is ideal.
“I would pray that people who are HIV-positive would make that known to their partners and do something to protect their partners, abstinence being the ideal.”
He’s right that people deserve to know of any risks associated with being sexually active with their partners and that communication and honesty are important to healthy relationships. He is wrong to counsel abstinence as ideal for all patients. Does he imagine that these couples will not be using condoms or another barrier method? Does he imagine that many of these patients are not already married? Does his imagination and prejudice overlook the fact that it’s possible to be moral, sexually active, and HIV-positive at the same time and that such a scenario can be someone’s ideal, given the circumstances?
This Chicago Tribune article tells me that while HIV/AIDS has lost some of its stigma in the culture at large, certain strong prejudices still exist. If we look to institutions with a track record of limiting and stigmatizing sexuality in attempt to address an epidemic of a disease that can be passed through sexual activity, we ignore and devalue the people who need realistic, unbiased care based on the facts of their condition, not the subjective morality of their actions. We have to take HIV/AIDS seriously. Dismissing condoms as a reliable option and suggesting celibacy as an ideal is a joke. And epidemics aren’t funny.