Condoms and the Church, Testing for Rape Suspects, and Musings on Microbicides

Some very interesting developments in the domain of HIV/AIDS policy and research this week, as reported by my reliable news aggregator, the Kaiser Network Daily HIV/AIDS Reports.

1) An excellent summary of articles and opinions surrounding the potential relaxing of rules regarding condom use to prevent HIV/AIDS according to the Catholic Church.

Of note: mention of a book called Catholic Ethicists on HIV/AIDS Prevention, edited by Jesuit priests James Keenan and Jon Fuller which says that the church should have relaxed its ban on condoms 20 years ago." (from above link). Also mentioned: efforts of a South African bishop, Kevin Dowling, who favors condom access to prevent HIV transmission, and a speech by Pope Benedict XVI to African bishops in which he mentions the contribution of contraceptives to a "breakdown of sexual morality," with the usual conspicuous absence of references to scientific evidence to support that assertion.

Please visit the first link for discussion of the “lesser of two evils” approach, and this link regarding the forthcoming statement on condoms and AIDS from the Vatican.

Kaiser also points to a Los Angeles Times article that quotes an HIV-positive Ugandan clergy member named Gideon Byamugisha who speaks out against HIV and had this to say about his position regarding condom use: '"I've come to understand that this disease is not from God. It's not God's plan that people die at 8 years old. Or 12. Or 30," Byamugisha said, adding, "God gives us the knowledge and skills sometimes to prevent or postpone death. He's done his part. The question is, have we done ours?" (Sanders, Los Angeles Times, 4/24).'

But according to USAID-sponsored research review by David Halperin, perhaps the Church should stick to promoting circumcision and fidelity over either condoms or abstinence.

2) In the state of Alabama, the governor signed a bill permitting a judge who rules that there is probably cause to require mandatory HIV and STI testing for people charged with rape or sexual assault. Prior to this bill, survivors or their parents could only request that such testing be done on those convicted and sentenced to 30 days or more in prison.

3) I always thought that microbicides might be the magic bullet, but others disagree. I thought it would be the perfect prophylaxis for women who don’t have the self-efficacy to negotiate condom use with partners. In Kaiser’s summary of research presented at the Microbicides Conference, however, a spokesperson for the Population Council is quoted as saying that microbicides are not a silver bullet and would provide an opportunity for women to talk openly with their partners about “sex and shared responsibilties.” I am not jumping on that bandwagon till I see the numbers.

Another perspective presented in the summary is that marketing will affect how successful microbicides may be, i.e. if they are marketed as a lubricant with protective properties, they may be more acceptable than if they are explicitly marketed as prohylaxis, which is more in line with addressing the fact that it is extremely difficult for women in many cultures and circumstances to talk to their partners explicitly about disease prevention.

A Washington Post article cites the criticism by UNAIDS, WHO and other agencies of the slow progress in developing microbicides as a preventive measure against transmission of HIV/AIDS.