Info on condoms in HIV programs must be ‘accurate’

HUNTINGTON, Ind. – Catholic Relief Services, the U.S. bishops’ overseas aid and development agency, is requiring its foreign partners to give “complete and accurate” information on condoms in all HIV/AIDS programs.

“CRS wants to ensure that partners are not giving inaccurate, misleading or no information at all on condoms – and that the focus and priority remain on abstinence and fidelity,” according to a new internal policy document sent to CRS country representatives.

The document warned the agency may cut funding from partners who refuse to comply. Top CRS officials told Our Sunday Visitor, a national Catholic newspaper based in Huntington, that the provision would be used only as a “last resort.”

The agency’s newly formulated HIV policy, obtained by Our Sunday Visitor, is laid out in a six-page position paper dated December 2007, with the heading “CRS’ Position on the Prevention of Sexual Transmission of AIDS.”

It was accompanied by a one-page Jan. 11 memorandum to CRS country representatives from Jennifer Overton, the agency’s senior technical adviser for HIV who prepared the position paper.

The Overton memo says the position paper was “approved by the ELT” – the agency’s executive leadership team – and reflects input from “technical staff and colleagues external to the agency.”

The Catholic Church worldwide provides care for an estimated one of every four people with HIV/AIDS. CRS is among the largest church agencies in the field, currently supporting more than 250 HIV/AIDS projects that directly serve about 4 million people in 52 countries.

Partners of the Baltimore-based agency, which devoted $120 million to HIV/AIDS programs in 2007, include local Catholic churches as well as other faith-based and secular groups.

Ken Hackett, CRS president, told Our Sunday Visitor the purpose of the new position paper was to ensure a unified HIV-prevention approach that is consistent with church teaching among the agency’s 5,000 employees and tens of thousands of partners, many of whom are not Catholic.

“We have to keep our people up to date,” he said.

Mercy Sister Phyllis Hughes, manager of CRS’ HIV/AIDS unit, told Our Sunday Visitor the new position paper conformed to a 1989 U.S. bishops’ document on AIDS, “Called to Compassion and Responsibility,” which she called the “bible” for CRS’ HIV/AIDS prevention policy.

The CRS document said that “all HIV programs supported by CRS promote abstinence until marriage and mutual fidelity within marriage.”

“These behaviors are the only means that completely avoid exposure to the risk of sexually transmitted HIV infection. These specific behaviors have always been the cornerstone of the Catholic Church’s teaching with respect to human sexuality,” it said.

“Additionally, CRS does not finance, distribute or promote the use of condoms. However, in line with its HIV policy, CRS provides full and accurate information about condoms as part of its HIV activities through implementing partner agencies,” it said.

Describing what it wants to see communicated, the position paper said condoms are “highly effective” in preventing the transmission of HIV when used “consistently and correctly.”

It cites studies showing that, when condoms were used in this manner, the HIV infection rate among noninfected partners was less than 1 percent a year.

But, the document noted, there are “many obstacles to consistent and correct condom use” related to the attitudes and behavior of users as well as issues of supply and distribution.

“Even apart from the church’s ethical concerns,” it cautioned that “overly enthusiastic promotion” of condoms “could generate an excessive feeling of security.”

“HIV programs must avoid giving vague prevention messages to clients like ‘be careful’ or ‘be safe,’ as these statements can lead to confusion and, in the end, more harm than good,” it said.

The document also cited evidence contrasting the proven effectiveness of “prevention education” campaigns with condoms-only approaches in reversing HIV infection rates.

“Many countries that have not experienced a decline in HIV have seen increases in condom use, but in every country worldwide in which HIV has declined there have been increases in abstinence and/or be faithful behaviors,” the document says.

Bishop Hugh Slattery of Tzaneen, South Africa, told Our Sunday Visitor the experience of his country bears that out: It has the world’s highest HIV infection rate and among the highest rates of condom distribution.

“Condoms are not the solution. They are part of the problem,” said the bishop, who recently helped produce a series of DVDs promoting abstinence and fidelity.

The CRS-funded programs in Bishop Slattery’s diocese include the distribution of antiretroviral drugs, which combat the debilitating effects of AIDS, to about 700 people. He said program directors have discovered it is critical that the medical treatment be accompanied by prevention education, including the facts about condoms and their inability to completely prevent HIV transmission.

He cited the example of a severely ill man with AIDS who was helped by the program. “This man was dead, and the treatment brought him back to life,” he said. “But then come to find out that he’s taken three girlfriends,” effectively spreading the disease further.

Although the CRS policy warns it may “discontinue support” for AIDS projects that give inaccurate or no information about condoms, it provides for a period of “private” discussion to bring the partner agency around.

“We just don’t cut people off when they’re providing lifesaving services,” said Hackett.

Information on condoms should not bear the CRS name or logo, the policy said.

Catholic Review

Catholic Review

The Catholic Review is the official publication of the Archdiocese of Baltimore.