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Catholic health care advocates and providers will be carefully reviewing Pope Benedict XVI’s recent remarks about the use of condoms to prevent the transmission of H.I.V. to decide what the practical implications are of this apparent policy shift. The issue is of particular importance in Africa and other parts of the developing world where H.I.V./AIDS remains a devastating threat.

In the book Light of the World: The Pope, the Church and the Signs of the Times, which the Vatican newspaper, L’Osservatore Romano, excerpted on Nov. 20, Pope Benedict said focusing exclusively on condoms damages human sexuality, making it “banal” and turning it into a kind of “drug.” But he went on to say that in particular cases—he mentioned male prostitutes—condom use may be justified as a first step toward taking moral responsibility for one’s actions.

Responding to widespread confusion generated by the comment and its various translations in the media, the Vatican spokesman, Federico Lombardi, S.J., said, “I asked the pope personally if there was a serious or important problem in the choice of the masculine gender rather than the feminine [in the German original], and he said, ‘no,’ that is, the main point…is [condom use may be] the first step of responsibility in taking into account the risk to the life of another person with whom one has relations.”

Father Lombardi added, “Whether a man or a woman or a transsexual does this, we’re at the same point. The point is [taking] the first step toward [moral] responsibility, to avoid posing a grave risk to another person.”

Lesley-Anne Knight, secretary general of Caritas Internationalis, said, “The pope’s reported comments in this book illustrate the importance of compassion and sensitivity in dealing with the complexities of H.I.V./AIDS prevention. Caritas delivers its H.I.V./AIDS programs in line with church teaching and we will consider, in close consultation with the Holy See, whether there are implications for our work in these reported comments of Pope Benedict.” Caritas Internationalis is the Vatican-based umbrella organization for 165 national Catholic charities.

Dr. Leonardo Palombi, who works with the Sant’Egidio Community’s Dream program of AIDS prevention and treatment in Africa, said, “Condoms aren’t the response to everything.” He explained that Africa has been virtually flooded with condoms, yet the disease continues to spread because of a lack of responsibility on the part of men, a lack of respect for women and the lack of antiretroviral treatment for all who need it. “A thousand boxes of condoms won’t help if a woman has no power to insist her partner use them,” he said. Dr. Palombi said antiretrovirals are even more effective in preventing spread of the disease because “they reduce the viral load in the body and in all body fluids—reducing the risk of mother-to-child transmission at birth or through breastfeeding and reducing the risk of transmission sexually as well.”

Msgr. Robert Vitillo, special representative on H.I.V./AIDS for Caritas Internationalis, said the pope’s remarks do not lessen the church’s insistence that both the morally correct use of one’s sexuality and the safest sexual practice from a health standpoint is “abstinence outside of marriage and faithfulness inside marriage.” Father Vitillo said the bishops’ conferences of Chad and of Southern Africa have issued pastoral letters saying church workers must support married couples where one or both spouses are H.I.V.-positive, helping them make a conscientious decision regarding the use of condoms to prevent disease while also understanding church teaching that every sexual act should be open to new life.

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