Bioethics, healthcare policy, and related issues.
The Vatican appears to have launched an offensive against condom use to prevent AIDS, based on grossly distorted claims (and apparent ignorance of facts) regarding their efficacy against HIV transmission. The degree of falsity is so breath-taking, and the stakes so high, that the official Brazilian National Program on HIV/AIDS labeled it a “crime against humanity“. On the bright side, one highly-placed church official has shown a tiny bit of sanity on the matter.
Distortions to Create a Scare Over Sex and Condom Use
From a BBC “Panorama” program:
The Vatican has published a document which says condoms have holes in them, allowing HIV – the virus that causes AIDS – to pass through. . . .
Its author, Cardinal Alfonso Lopez Trujillo, serves as the President of the Pontifical Council for the Family and is known for his hard line stance against contraception.
It goes so far as to suggest that condoms may even be one of the main reasons for the spread of HIV/AIDS.
The document claims that so-called safe sex using condoms is like playing “Russian Roulette.”
“Leading people to think they are fully protected…” the document says, “is to lead many to their death.” . . .
In his paper, Cardinal Trujillo quotes Dave Lytle – who was a senior researcher at the US Food and Drug Administration in the 1980s and 90s.
Lytle led a team at the FDA which looked at the question of HIV and condoms in the 1980s.
Lytle’s most conclusive work was conducted with actual viruses – but not HIV, that was too dangerous.
His team tested 470 condoms and found twelve of them “allowed some virus penetration.”
In his document Cardinal Trujillo uses this statement to endorse his case that the AIDS virus HIV can pass through condoms.
“My reaction is one of disappointment,” Dave Lytle told Panorama. “[Cardinal Trujillo] didn’t pay attention to the paper, he took a number out of it, and basically misused it.”
Lytle points to important differences between his laboratory test and real life. The viruses he used were a fifth size of HIV. Lytle used easy-flowing water – not as viscous as semen. The pressures he used to test condoms were higher.
And he’d tested the whole condom surface – any hole might have been in a different place to the semen. . . .
He concluded that only one condom out of all those he tested might conceivably leak any infectious HIV . . .
Lytle also says the worst case condom he found would have been a “water leaker.”
Under international regulations imposed by bodies like the FDA in the USA and the WHO, batches of condoms have to be sampled by testers who inflate them with water and roll them over a blotter to see if there are damp spots that would indicate the presence of holes or ruptures.
Most international standards allow such condoms to pass through these “water leaker” quality tests with a permitted failure rate of 1 in 400.- though manufacturers we spoke to said they exceeded this quality rate, in the case of one famous brand name by a factor of ten.
There are other tests too – manufacturers use an electronic test of every individual condom which can show up any flaws.
But in Lytle’s judgement even taking “water leakers” into account there is no risk to worry about.
“The latex condom is a very effective barrier,” he said, “A few may allow minimal exposure to virus and if I were to give my children or grandchildren advice about whether to use condoms, I’d say absolutely.” . . .
The Cardinal cites other sources for his claim that condom latex has holes which let HIV pass through and pose a serious health risk.
Panorama has checked all the sources cited by Cardinal Trujillo and we cannot substantiate his claims.
The world’s leading experts on AIDS and condoms believe the findings and the conclusions of Lytle’s work at the FDA. All the authoritative AIDS specialists cited by the Cardinal do in fact support the use of condoms against HIV. . . .
Some scientists we spoke to believe that under normal circumstances – given the conservative nature of Lytle’s assumptions – no HIV would pass through even Lytle’s worst case condom in practice. . . .
The views of scientists like Lytle and Vernazza have been widely endorsed in the scientific community.
The World Health Organization describe any risk from intact condoms or water leakers as negligible – and they’re not alone.
Dr Penny Hitchcock, was the Chief of the STD Branch in the US National Institute of Health from 1992 to 2001. Four years ago she chaired a conference of internationally recognized experts on condoms, STDs, HIV and bio-statistical evaluation of clinical studies – the US Condom Effectiveness Taskforce. Their report is the most authoritative to date. . . .
“The data are consistent, there are no holes in condoms that present a risk of infection,” Dr Hitchcock told Panorama.
“No one should not use a condom because they think it’s going to leak,” she said. . . .
Brothels like Sheri’s Ranch in Pahrump are legal in some counties in Nevada. The law says they must use condoms.
At Sheri’s they reckon they use over 15,000 a year – for vaginal, oral and manual sex.
“They’ve done over 66,000 tests on ladies that worked in our brothel. There’s never been one reported or documented case ever of any HIV,” Laraine Harper, the Madame at Sheri’s, told Panorama.
And it’s not just Sheri’s Ranch. Sixteen years ago Nevada started mandatory HIV tests for all legal sex workers.
There is no long-term follow-up. But according to state records no prostitute working in a legal Nevada brothel has ever tested positive for HIV.
Dr Steve Pinkerton is Professor of Behavioural Medicine at the Medical College of Wisconsin and has referred to the Nevada Brothels in his studies of HIV.
He told Panorama, “So far today there have been no documented cases of brothel workers in one of the legal Nevada brothels becoming infected with HIV.”
“Brothel workers obviously have a lot of sex with a lot of sex partners, some of whom probably are infected with HIV. Yet none of those brothel workers have become infected. Why? Well for one reason they use condoms 100% of the time.”
Let’s pause to note that again: The world’s leading experts on AIDS and condoms believe the findings and the conclusions of Lytle’s work at the FDA. All the authoritative AIDS specialists cited by the Cardinal do in fact support the use of condoms against HIV.
The Vatican has been spreading this nonsense far and wide – 100,000 copies in Brazil alone. But it’s not just false and incompetent – the boob who is making these claims does not appear even to understand the data he is using.
Cardinal Lopez Trujillo, President of the Pontifical Council for the Family, made the controversial claim on Panorama’s “Sex and the Holy City” programme last year.
He was asked if it was the Vatican’s position that the HIV virus can pass through a condom. . . .
“Yes, yes, because this is something which the scientific community accepts, and doctors know what we are saying,” he replied.
“You cannot talk about safe sex,” he added, insisting that holes in condoms are a significant health risk. . . .
“Leading people to think they are fully protected is to lead many to their death,” the [Trujillos's report] says.
Cardinal Trujillo claims that condoms have a “ten to fifteen per cent inefficacy” – or failure rate – because tiny “AIDS viruses are much more able to pass through” condoms than the sperm.
There could be “millions of leaking condoms,” he says.
He appears to be referring to the commonly-cited figure of 85% “practical efficacy” of condoms in preventing pregnancy – that is, their efficacy as actually used by couples in real life. (They have a 95% or better “theoretical efficacy” – that is, when used correctly every time. In other words, their actual failure rate is fairly low, but couples forget or do not use them correctly much more often.) He cannot be referring to a 15% rate of transmitting HIV, since, as shown above, there is no such data. But he has either deliberately, or simply incompetently, assumed that the practial inefficacy of condoms was due to leakage (it’s almost all due to failure to use them), and that that would translate directly into an equal (in another place he says greater: “15%, 18% , or 20%”) rate of transmission of HIV, because the virus particle is smaller than a sperm cell and presumably could get through even smaller holes. But since condoms don’t fail by letting sperm leak through holes, and since actual tests of actual condoms demonstrate they do not pass virus, this is all worthless anyway. But it is the “factual” heart of his claim about the risks of condom usage. And as also noted above, the scientists he cites to bolster this supposed “fact” explicitly repudiate him.
The rest of the report is even worse. Among his touted “87 footnotes” are several references to latex surgical gloves (which are not constructed the same way condoms are, and have thinner rubber), including the fact that surgeons sometimes double-glove as supposed “proof” that the gloves are body-fluid permeable and thus condoms would be also (unless you’re having sex with a scalpel, using a single-layer surgical glove as a condom, this seems like rather shoddy thinking).
But, as I note, this report became a mainstay of the Vatican’s assault on condom usage – a program that has considerable significance for the hundreds of millions who live in countries where the Catholic church controls or influences access to sexual healthcare. To their credit, the Brazilian government has decisively repudiated, and acted to counter, this dangerous disinformation, but other parts of the world have less protection.
The implications this has, for the health of so many who are being misled by an organization that not only bars their access to basic sexual services, but to treatments for some of the problems that result as well, are infuriating. I think “crimes against humanity” hardly puts it too strongly.
Bans on Condoms When HIV is Actually Present
The Catholic church officially bans condom use even between married couples when one is HIV+. That’s right: the Catholic church officially prohibits people who are required to have sex (without birth control) from protecting one another from an incurable, devastating disease! It’s almost impossible to imagine such a thing could be true, but it has always been official policy within the Catholic church – a fact that I have always been amazed to note is rarely mentioned.
Lately, one Catholic Cardinal has taken it on himself to let a tiny bit of light into the church’s reproductive-autonomy stance – to predictable opposition from the Vatican, of course.
One of the Roman Catholic Church’s most distinguished cardinals has publicly backed the use of condoms among married couples to prevent Aids transmission.
Cardinal Carlo Maria Martini said that in couples where one had HIV/Aids, which could pass to the partner, the use of condoms was “a lesser evil”.
The Vatican says condoms should never be used, even to stop Aids spreading from one married partner to another. . . .
The Vatican has made no official comment on the article, in which the cardinal also raises the possibility of single mothers adopting abandoned children.
So, one step forward, how very many steps back. The article mentions that this Cardinal was considered a close runner-up to be Pope, before ultra-reactionary Cardinal Ratzinger got the job. Just think: a Pope who’s less than a century out of date . . . how refreshing that might have been . . .
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