Religious Restrictions:
HIV/STI Prevention Counseling

Some religious hospitals are governed by doctrine that prohibits the offering of “safer sex” counseling to help patients prevent transmission of HIV/AIDS and sexually-transmitted infections (STIs)

Despite rising rates of sexually transmitted infections among young people and the continued presence of HIV/AIDS as a serious health threat, some religiously-affiliated hospitals and their affiliated outpatient clinics do not permit “safer sex” prevention counseling of patients determined to be at risk of transmitting or acquiring STIs or HIV. The prohibitions are particularly problematic at the more than 500 hospitals affiliated with the Roman Catholic Church.

What does Catholic doctrine say about
“safer sex” counseling?

The U.S. Conference of Catholic Bishops has released a publication on caring for AIDS patients entitled “Called to Compassion and Responsibility: A Response to the HIV/AIDS Crisis.” In a section titled “AIDS and the Use of Prophylactics,” the publication rejects the use of condoms based on the belief that “the “safe sex” approach…compromises human sexuality and can lead to promiscuous sexual behavior… The document goes on to state that advocating safe sex promotes “morally unacceptable behavior.”

How has this doctrine affected care
at Catholic health facilities?

In New York, some Catholic facilities treating people with HIV/AIDS refused to provide counseling on safer sex practices, including the use of condoms, because such practices are “morally unacceptable.”1

How has doctrine affected public awareness
of “safer sex” prevention methods?

The World Health Organization and the European Union have criticized the Catholic Church for spreading false information about the effectiveness of condoms in preventing the transmission of the HIV virus. Despite studies showing that latex condoms block transmission of the HIV virus, some Church officials continue to spread false information, claiming that the HIV virus can pass through the latex of condoms, making them ineffective in preventing HIV.2  

More recently Pope Benedictine XVI conceded that there can be single cases in which the use of a condom may be justified, such as by male prostitutes in order to lower the risk of HIV infection. Later Vatican officials downplayed the statement but did not fully retract it.

How are patients affected when HIV/STI
prevention counseling is prohibited?

Preventing physicians, nurses, midwives and other health care practitioners from teaching patients how to prevent the transmission of HIV and STIs is detrimental to community health. When patients present at hospital emergency departments or outpatient clinics for treatment of unrelated health problems, they may be identified as being at risk of transmitting or contracting a sexually transmitted disease. The health care provider then has an opportunity to provide prevention information. That opportunity is lost if the patient must be referred elsewhere.

Many advocates for people with HIV/AIDS believe the most optimal form of care for this patient population involves the delivery of comprehensive services in a sole facility able to meet all of their health care needs. When a critical component of health care is banned, this comprehensive delivery of services is impossible, creating a fragmented system of care that is difficult for those living with HIV/AIDS to negotiate. Even if a patient is offered a referral to another provider (which is also banned by many religiously-restricted facilities), a barrier to care that not all will be able to overcome is unnecessarily created. Susan Dooha, former Director of Policy for the Gay Men’s Health Crisis, has said, “If you ask people to jump extra hurdles to access essential services that should be part of a package, then you can expect that someone will be harmed when they don’t get the care they need.”3

Which patients are the most affected
by these religious restrictions?

At least half of all new HIV infections are among people under the age of 25 and the majority of these young people are infected through sexual contact.4 Young African Americans are especially affected when information on preventing the spread of HIV/AIDS is withheld. 56% percent of all new HIV infections in people aged 13-24 were African Americans.5

Religious restrictions on HIV/AIDS prevention counseling can have harsh impacts on urban communities of color, which have high rates of new HIV infections. Although African Americans make up about 12% of the US population, about half of all new HIV infections occur in this population.6 Hispanics, who make up about 13% of the US population, constitute 19% of new HIV infections.7

  1. Navarro, M., “Ethics of Giving AIDS Advice Troubles Catholic Hospitals.” New York Times, Jan. 3, 1993. 
  2. Associated Press. “EU Rejects Vatican Claim that Use of Condoms does not Protect Against AIDS,” October 20, 2003. 
  3. Kelly Safreed Harmon, “When Conscience Limits Care,” Treatment Issues, Gay Men’s Health Crisis, September, 2001. 
  4. Centers for Disease Control. Young People at Risk: HIV/AIDS Among America’s Youth.
  5. Centers for Disease Control. HIV/AIDS Among African Americans. 
  6. Id. 
  7. Centers for Disease Control, HIV/AIDS Among Hispanics in the United States.