BOSTON — Boston -- A full-page ad ran recently in several newspapers, placed by the conservative Christian group Focus on the Family, and headlined "In Defense of a Little Virginity." It cites statistics in support of the thesis that condoms are ineffective in preventing the transmission of HIV disease.
Condoms, the ad says, are "only 69 percent effective in preventing the transmission of the human immunodeficiency virus (HIV) in heterosexual couples." Recommending the use of condoms to prevent HIV transmissions is thus "not much better than advocating Russian roulette." The only way to protect oneself from HIV is "abstinence before marriage, then marriage and mutual fidelity for life to an uninfected partner. Anything else is potentially suicidal."
Experts on sex and sexually transmitted disease are well aware of this, the authors of the ad say; and they imply that these experts are therefore acting in deliberate bad faith when they advocate so-called "safe sex."
Compare this with an article that appeared a few days later, reporting the results of a study on heterosexual HIV transmission recently published in the New England Journal of Medicine. The researchers in this study tracked the cases of 256 heterosexual "discordant couples;" that is, couples in which only one partner was infected with HIV.
Of those couples, 121 did not use condoms regularly, with the result that over four years, 12 of the uninfected partners became infected with HIV, giving an overall risk of infection of five percent per year. Forty-eight percent, or 123, of the couples did consistently use condoms, and of those, none of the healthy partners became infected with HIV.
So which is it? Does consistent condom usage cut risk of HIV infection to practically nothing (as the medical study reports), or is using condoms the equivalent of playing Russian roulette (as Focus on the Family would have us believe)?
I must confess to particular interest in this question. My husband has AIDS. We knew of his HIV infection before our marriage, and we were advised by our physicians that if we were careful in our sexual relations always to use condoms and spermicide, and to use them correctly, my chances of becoming infected with HIV )) would be very small.
So far, we have succeeded in protecting my health. In the three years that we have been married, I have been tested for HIV five times, and my test results have always come back negative.
I am thus inclined, on the basis of my own experience, to concur with those who would say that in fact it is possible, and very simple, to prevent transmission of HIV. All you have to do is follow the rules.
So why the furor raised by people like those behind the Focus on the Family ad? Why the eagerness to marshal statistics in opposition to what has become conventional wisdom in epidemiology? I think there are at least two currents of thought running beneath such presentations.
One involves a view of the world in which people get what they deserve. AIDS, so this train of thought goes, is a very bad thing. Anyone who has AIDS must have done something very bad to come down with it. Anyone who would have sex with anyone with AIDS must be similarly morally corrupt. Therefore, such persons deserve to get AIDS, too.
So, to suggest that it is possible, by the exercise of simple caution, to prevent the transmission of HIV, is equivalent to suggesting that people can avoid reaping the moral consequences of their actions. It is to turn the moral framework of the world upside down.
The other train of thought has to do with risk, and with what level of risk is acceptable. The authors of the ad make quite clear that, in their view, no level of risk for contracting HIV disease is acceptable. After all, they point out, AIDS is a terminal illness. To risk HIV infection is essentially the same as to commit suicide, only slower. It is therefore not enough to reduce one's risk; it must be eliminated entirely, through abstention from acts or circumstances which carry with them any risk of HIV infection.
This is an understandable view, if one grants the premise that AIDS is a deadly consequence visited upon those so foolish, and so immoral, as to run such risks. Who would want to take the slightest chance of coming down with a disease which is the contemporary equivalent of the scarlet letter, and which is fatal besides?
It is in the light of views like these that my decision to marry the man who is now my husband looks positively insane. But in my world, and in that of any thoughtful Christian, there are ends for which it is worth running certain risks.
Preservation of one's health or physical well-being is important, but it is not the highest of all ends; and to risk or actually to give one's life is not necessarily equivalent to suicide. After all, Jesus exhorts his followers to follow the example he is about to set for them, saying, "Greater love has no man than this, that he lay down his life for his friends." To the extent that I risk my life in being married to my husband, I do it because he is the best friend I could ever have, and he is worth it.
True, I could end up with AIDS. It is not a pleasant prospect. But in a Christian view, there are things in life which are worse than shame, disease and death; and, correspondingly, there are motivations to action which are stronger than the natural human desire to avoid such fates.
One would not realize this from reading the Focus on the Family ad: it assumes a world in which people get what they deserve, and outlines a corresponding morality based on self-interest and fear. But it is simply not the case that in this world, people get what they deserve, at least not in any simple sense. There are those who delight to distinguish the "guilty" victims of AIDS from its "innocent" victims. It is my observation that those who occupy themselves with such distinctions are usually so busy making sure that the guilty receive their due condemnation, that they fail to show compassion to anyone.
Genuinely Christian compassion, however, does not wait for proof of innocence to be produced; it is extended simply as a response to suffering and need. And genuinely Christian moral choices are motivated, not by fear, but by love.
Christians practice sexual purity and faithfulness not primarily as "the only . . . safe way to remain healthy in the midst of a sexual revolution." Christians practice sexual purity and faithfulness because they are disciples of a holy God whose faithfulness to his creation is unceasing, and because true humanity consists in mirroring, individually and corporately, the character of God.
If it could be shown that no untoward consequences, whether of disease or of any other sort, would ever follow upon illicit sexual behavior, Christian motivation to sexual fidelity would be not one whit less. Similarly, if it became possi- ble to know to exactly what degree people were responsible for their suffering, Christians would still care for the guilty along with the innocent. At least, that is what Jesus did.
The Focus on the Family people, in their eagerness to maintain that people who go astray are going to get what's coming to them, do not simply confuse the questions of epidemiology (can condoms prevent HIV transmission?) with the questions of Christian morality (what is good sex?). Far more important, they assume a world in which if you are good, no harm will come to you; which makes it very easy to pass judgment upon those to whom harm has obviously come.
But the truth is that everyone in this world suffers and dies, no matter how pure or impure his or her moral choices may have been. The real question for the Christian is not, "What did this person do to deserve this suffering?" nor yet, "What can I do to avoid similar suffering?" but rather, "How may we, as fellow participants in the common sorrows of humanity, best show to others the unmerited mercy and love which God has shown to us in Christ?"
A full-page ad devoted to that theme would look far different from the one published by Focus on the Family.
Margaret Kim is a Ph.D. candidate in Christian theology and ethics.