AFRO-NETS> Condoms confirmed safe; catholicism starts condonig use?

[Claudio Schuftan <aviva@netnam.vn>]

Condoms confirmed safe; catholicism starts condonig use?
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Study Panel Confirms Condoms Are Effective Against HIV/AIDS 

In July 2001, a National Institutes of Health (NIH) study panel in 
the United States issued its report on condom effectiveness in pre-
venting sexually transmitted infections, including HIV/AIDS. Family 
Health International is distributing this concise list of typical 
questions and answers about the report to health providers and scien-
tists worldwide to help explain key findings. The 48-page report is 
available over the Internet at:
http://www.niaid.nih.gov/dmid/stds/condomreport.pdf.

Q: What were the report's major findings?

A: The NIH report concluded that correct and consistent use of male 
latex condoms effectively reduces transmission of HIV/AIDS in women 
and men, and gonorrhea in men; and prevents pregnancy. The report 
also found that evidence is insufficient to determine the effective-
ness of condoms in preventing the six other sexually transmitted in-
fections (STIs) it reviewed.

Q: What did the panel say about these six other STIs?

A: The panel concluded that epidemiological evidence is currently in-
sufficient to provide an accurate assessment of the effectiveness of 
condoms in preventing spread of gonorrhea in women, or chlamydial in-
fection, syphilis, chancroid, trichomoniasis, genital herpes and 
genital human papillomavirus (HPV) infection in women and men. "Be-
cause of limitations in study designs," the report says, "there was 
insufficient evidence from the epidemiological studies on these dis-
eases to draw definite conclusions" about the effectiveness of con-
doms. However, it noted that "the absence of definitive conclusions 
reflected inadequacies of the evidence available and should not be 
interpreted as proof of the adequacy or inadequacy of the condom" to 
reduce the risk of these other infections.

Q: What is FHI's professional opinion about the study's implications?

A: "The data clearly show that condoms prevent HIV/AIDS, which is the 
most deadly STI, and gonorrhea, the most easily transmitted infec-
tion," says Willard Cates Jr., MD, MPH, president of FHI. "We believe 
the male latex condom is also highly effective in preventing preg-
nancy, when used correctly and consistently. These are three excel-
lent reasons for actively promoting the use of male latex condoms. 
Also, lack of research data on some STIs does not mean condoms are 
ineffective against these diseases. When used correctly and consis-
tently, we should expect male latex condoms to be highly effective in 
preventing the risk of the other discharge diseases -- gonorrhea in 
women, chlamydia and trichomoniasis. Condoms should also be effec-
tive, but not necessarily highly effective, in reducing the risk of 
genital ulcer diseases -- genital herpes, syphilis, chancroid -- and 
HPV infection. However, the study concluded that 'condom use might 
afford some reduction in risk of HPV-associated diseases, including 
genital warts in men and cervical neoplasia [cancer] in women.'"

Q: Was any significant recent research not included in the panel's 
report?

A: Yes. In a study published June 27, 2001 in the Journal of the 
American Medical Association, scientists concluded that condom use 
during more than 25 percent of coital acts was associated with pro-
tection against genital herpes transmission to susceptible women. 
Other encouraging recent studies that are nearing publication include 
research in Peru that found consistent condom use protected sex work-
ers against gonorrhea and, to a lesser extent, against chlamydia. And 
more recent follow-up data have become available from an important 
study that led the panel to conclude that consistent condom use pro-
tects men against gonorrhea. The more recent findings also suggest 
substantial protection against chlamydia.

Q: How was the panel selected, and how did it reach its conclusions?

A: Co-sponsored by the National Institutes of Health, the Centers for 
Disease Control and Prevention, the Food and Drug Administration, and 
the U.S. Agency for International Development, a 28-member panel of 
scientists and other experts analyzed more than 138 peer-reviewed 
studies on the properties and user patterns of the male latex condom 
during penile-vaginal intercourse.

Q: What are the long-term health consequences from STIs?

A: In addition to death and other serious illnesses associated with 
HIV/AIDS, many of the other STIs can cause infertility, problems with 
pregnancy, and can be passed from a mother to her infant. Long-term 
infection with certain types of HPV can cause cervical cancer if not 
diagnosed (through annual pap smears) and treated. In addition, most 
STIs increase substantially the likelihood of transmitting HIV infec-
tion. While most STIs can be treated successfully, no vaccine is cur-
rently available to prevent infection by organisms that cause STIs, 
except for hepatitis B.

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Catholic Theologian Explains How Theology Allows for Condom Use 
Against HIV

Fr. James Keenan, an American Jesuit theologian, told a media forum 
sponsored by the AIDS Society of the Philippines that it is "morally 
acceptable" for sexual partners to use condoms "if only" to prevent 
HIV transmission, the Philippine Daily Inquirer reports. Keenan, who 
teaches moral theology at Ateneo de Manila University's Loyola School 
of Theology and has edited a soon-to-be-released book, "Catholic Eth-
ics on HIV/AIDS Prevention," told the forum that the principles of 
"double effect and lesser evil" support the use of condoms to prevent 
HIV transmission. "Condoms for HIV are the same [as] condoms for con-
traception. Here we can see the principle of double effect," he said, 
adding that the same principle is used to justify civilian deaths 
when bombing military targets. "If a husband violates his marital 
vows and sleeps with other women he must make sure that he does not 
transmit the virus to his wife, else he would be violating the prin-
ciple of justice. This is where the principle of lesser evil comes 
in," he explained, saying that the man "might as well keep his wife 
from getting the virus" by using condoms. Keenan said he was stating 
his theory "not to convince the Catholic Church to relax its strict 
rule against the use of prophylactics but to contribute to a healthy 
dialogue on the subject." He also added that Bishop George Courtier, 
the Pope's theological adviser and head of the International Council 
on Theology, considered the "lesser evil" argument and condom use to 
be a "legitimate issue." The South African Bishops Conference issued 
a statement last month outlining "the narrowest of exceptions on con-
dom use" to aid the country in combatting its AIDS epidemic (Borda-
dora, Philippine Daily Inquirer, 8/8). 


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