More on AIDS in Africa

This article in Zenit interviews Matthew Hanley, long-time technical expert on AIDS/HIV for the Catholic Relief Service. He is also author of a new book on AIDS in Africa, Avoiding Risk, Affirming Life: Science, Love, and AIDS. His conclusions have significant overlap with those of Helen Epstein, whose book I reviewed earlier. She argued that a reduction in the number of sexual partners, not an increase in the use of condoms, accounts for the most significant drops in new HIV infection rates. According to Matthew Hanley:

Actual changes in patterns of sexual behavior have led to the most significant reductions in HIV prevalence. Take the well-known case of Uganda, where the prevalence rate dropped from 15% in 1991 to a little over 5% in 2001. Behavior change was so thorough in Uganda that by the mid-1990s, 95% of adults in that country said they had only one partner or none at all. But it is not only Uganda.

The most important factor in recent HIV declines observed in several other countries, such as Kenya, Zimbabwe and Haiti has been an increase in fidelity or "partner reduction." This should not be altogether surprising, considering that in a large swath of southern Africa, where over half of new infections globally come from, the AIDS epidemic is being driven by the dynamics of multiple and often concurrent sexual partnerships.

In other words, changing behavior is more important than reducing the risk associated with a given set of behavior.
Hanley also talks about the uniquely Catholic aspects to his work. Not only is the Church trying to prevent disease, she is also trying to promote a healthy way of life, that integrates love and sexual activity within the context of married life.

We try to articulate what the Church actually proposes, abstinence and fidelity, in a positive manner. I have found in my trips to Africa that there is a real thirst for something different, something hopeful. We all know that people yearn for more than the satisfaction of their appetites. In other words, they yearn for love, for respect and for meaning in life. In his first encyclical, "Deus Caritas Est," Benedict XVI reminded us of long-standing Christian tradition, namely that human beings are a "union of body and soul," that love is characterized by exclusivity, or fidelity, and that love contains a quality of permanence over time.

When we conducted training recently with five dioceses in Ethiopia, one of the participants, a wife and a mother, spoke for the group by saying how much she appreciated the emphasis on fidelity and related human values such as respect and communication. She was puzzled as to why such basic themes are not more routinely promoted in the context of HIV prevention, adding: "Why hasn't anyone explained it like this before?"

So we try to address the whole human person, their deeper aspirations, and in proposing love, affirm basic Christian sexual ethics. It is on this level that the Church then encounters the wider culture, which as Pope John Paul II suggested in "Familiaris Consortio," often holds "fundamentally irreconcilable views of the human person and of human sexuality," leading many to aggressively reject these first principles.

Money quote from Matthew Hanley:

Perhaps one of the most helpful means that I have seen of expressing the moral significance of the issues involved comes from the Kenyan bishops. In their pastoral letter on AIDS, they hit upon the crux of the matter: The Church proposes the same sexual morality even "when and where AIDS poses no danger." The central issue with respect to the Church's consistent teaching on sexual matters is thus not the risk of HIV, but the lack of chastity, and "this is not easy for 'the world' to grasp.

What a concept.
I look forward to seeing his book.