epidemiology

Papal epidemiology

March 24th, 2009  |  Tags: , , ,  |  Leave a comment

Shortly after the death of Pope John Paul II, I went out to lunch with some grad school classmates, as I often did when I was younger and had more free time. This lunch in particular was memorable because the entire lunchtime conversation was devoted to the topic of who would succeed him as Bishop of Rome. As a confessional Lutheran, I had regarded the elevation of a new pontiff as a matter of some minor interest — as the decision would affect a great swath of Western Christendom and many of my close friends — but primarily as a matter internal to the Roman church and not really any of my business.

I was especially amused by this lunchtime conversation because all of the other principals were secular materialists, who surely had even less of a stake in the matter than I. I asked the loudest participant why he was so concerned about the workings of the College of Cardinals, and he suggested that a new pope could greatly help “Africa, because they need condoms.” I suggested that the HIV epidemic in sub-Saharan Africa was almost certainly not attributable to individuals’ overly-rigid adherence to Catholic moral teaching, but I believe that this point was rather too subtle for the discussion.

As it turns out, the truth is almost the opposite: adherence to the traditional dictums about chastity and fidelity is actually just about the only thing that reliably prevents HIV transmission “at the population level,” argue Edward Green and Allison Herling Ruark, of the AIDS Prevention Research Project at Harvard. Their article includes the following fascinating special case of what is surely a reliable general observation about human behavior:

It has been clearly established that few people outside a handful of high-risk groups use condoms consistently, no matter how vigorously condoms are promoted. Inconsistent condom usage is ineffective—and actually associated with higher HIV infection rates due to “risk compensation,” the tendency to take more sexual risks out of a false sense of personal safety that comes with using condoms some of the time. A UNAIDS-commissioned 2004 review of evidence for condom use concluded, “There are no definite examples yet of generalized epidemics that have been turned back by prevention programs based primarily on ­condom promotion.”

If Green and Ruark are correct, then it’s better for sub-Saharan Africa that Benedict hasn’t revised John Paul’s position on promoting contraception. However, their article is not merely negative; indeed, they are able to suggest a variety of tactics for fighting against the HIV epidemic that are shown effective and that don’t preclude the vigorous involvement of traditional churches.

RIYL: “A pope who will matter”