Is Condom Use Morally Justified for Serodiscordant HIV Couples?

HIV/AIDS has continued to ravage developing countries of the world especially Sub-Saharan Africa. Sub-Saharan Africa generates no more than 1 percent of the total wealth produced in the world. Yet it is the home of 10% of the world’s population, lives on 1% of the global economy, and carries 68% of the world’s HIV/AIDS burden. WHO estimates that in 2014 only about 41% of people living with HIV were able to access life-saving medications. Given the epidemic nature of this disease and the lack of cure, is condom use morally justified to prevent the spread of the disease in serodiscordant couples? The Church teaches that condoms and all other related methods of birth control sever the unitive and procreative significance inherent in the marital act. Humanae Vitae prohibits “any action which either before, at the moment of, or after sexual intercourse, is specifically intended to prevent procreation” (no. 14). In addition, the U.S Catholic Bishops assert that “The use of prophylactics to prevent the spread of HIV is technically unreliable. Moreover, advocating this approach means in effect, promoting behavior which is morally unacceptable. Campaigns advocating ‘safe/safer’ sex rest on false assumptions about sexuality and intercourse.”

However, Pope Benedict XVI, in his 2010 book-length interview, “Light of the World,” hypothesized that use of a condom to prevent infection could be a first step toward moral responsibility. He used the example of a male prostitute. The Pope’s remarks have been criticized by some as a deviation from the Church’s position on contraception and supported by numerous moral theologians and ethicists. On Dec 21, 2010 Congregation for the Doctrine of Faith (CDF) expounded on the Pope’s remarks and stated that “those who know themselves to be infected with HIV and who therefore run the risk of infecting others, apart from committing a sin against the sixth commandment are also committing a sin against the fifth commandment – because they are consciously putting the lives of others at risk through behavior which has repercussions on public health.” The Note concludes that “those involved in prostitution who are HIV positive and who seek to diminish the risk of contagion by the use of a condom may be taking the first step in respecting the life of another – even if the evil of prostitution remains in all its gravity.” Similarly, the Southern African Catholic Bishops Conference (who carry the greatest burden of HIV/AIDS) asserted in the 2001 pastoral letter that in a case of a married serodiscordant couple, the use of condom to prevent the spread of the disease to the spouse was acceptable. This position was based on the principle that everyone has the right to defend one’s life against mortal danger. Furthermore, moral theologians and ethicists argue that “a married man who is HIV-infected and uses the condom to protect his wife from infection is not acting to render procreation impossible, but to prevent infection. If conception is prevented, this will be an –unintentional – side-effect and will not therefore shape the moral meaning of the act as a contraceptive act” (Rhonheimer, 2004). These views are anchored on two moral principles: Lesser of Two Evils and Double Effect. Finally, the Church has always taught that individuals can follow their well-formed consciences in difficult situation:  “Catholics with a well-formed conscience can decide to use contraceptives ‘in cases of particular emergency.'” This decision must follow only after a “serious discernment of conscience” (National Catholic Reporter, Feb, 2016).