Cardinal Pell continues to insist that
condoms increase HIV transmission, describing them as "a significant cause of the problem".
Specifically, he states that:
"Condoms give users an exaggerated sense of safety, so that they sometimes engage in 'risk compensation'. In one Ugandan study, gains in condom use seem to have been offset by increases in the number of sex partners."
I think he's referring to this:
Is sexual risk taking behaviour changing in rural south-west Uganda? Behaviour trends in a rural population cohort 1993–2006This report from the journal
Sexually Transmitted Infections states: "In some cases, trends in condom use were the opposite of trends in casual partners. For example, among those aged 35+ years, casual partners rose between 2000 and 2005, indicating more risky behaviour, but condom use also rose, indicating less risky behaviour." The report says nothing about "risk compensation" or about condoms encouraging promiscuity, nor anything about condom use being "offset" by an increase in partners - in fact, the authors state: "The data reported in the paper presented here do not link reported sexual risk factors and incident HIV infection." Assuming I have the correct study, it's irrelevant.
Pell further comments:
"Earlier this year, the British Medical Journal reported: "In numerous large studies, concerted efforts to promote use of condoms has consistently failed to control rates of sexually transmitted infection", even in Canada, Sweden and Switzerland."
This statement is
part of a debate between scientists about sexually transmitted infections
other than HIV. Far from linking condoms to increased promiscuity, the writer Pell is quoting complains that: "Only a minority of people engaging in risky sexual behaviour use condoms consistently."
The scientists Pell
doesn't quote
have this to say:
"One theoretical concern is that condom promotion could lead to risk compensation—men who use condoms may feel safer and consequently engage in more frequent sex or sex with more partners, thus increasing the risk of transmission. The most recent review of 174 condom related prevention approaches, however, concluded that sexual risk reduction interventions do not increase unsafe sexual behaviour. In addition, a recent systematic review showed adding condom promotion to interventions focusing on abstinence does not undermine the abstinence message." (My emphasis)
Clearly, Pell has yet to provide any evidence whatsoever that promoting condom use increases HIV transmission. (You can read the above references in their entirety by registering for free. Pell should.)
An important mistake Pell makes is to suggest that those promoting condom use are not also promoting other risk reduction strategies. (All of the scientists in the BMJ debate agree that condoms are only part of the picture.) He refers to Uganda's unusual success in reducing the transmission of HIV, but attributes this solely to a reduction in casual sex, when in fact it's due to multiple strategies,
including promoting condom use. In Thailand, HIV rates dropped sharply because men's visits to sex workers dropped by half, but also because of the government's policy of 100% condom use for sex workers. Clearly, there's no incompatibilty between Pell's "traditional Christian moral teaching", promoting abstinence and faithfulness, and promoting safe sex -
all of these strategies are part of successfully reducing AIDS.
ETA: Further reading for his Eminence:
Condoms and HIV prevention: Position statement by UNAIDS, UNFPA and WHOETA: More on
Uganda from livescience.com.