Earlier in March this year, Dr Julio Montaner, director of the British Columbia Centre for Excellence in HIV/AIDS, met with Pope Francis. The announcement that followed that meeting could be one of the biggest steps in slowing down the spread of HIV. Yes, that’s correct, the Roman Catholic Church may become a huge player in prevention!
For years, the Church has probably been one of the biggest causes for the spread of this virus and has undoubtedly been complicit in the deaths of thousands, perhaps over a million. Their dogmatic approach to the use of condoms has been immoral. While there has been a slight crack in that dogma in recent years, with Pope Benedict saying that the use of condoms by male prostitutes may actually be a step towards a moral life (he tells us he’s an expert on that subject), this was an exception and no changes in Church doctrine occurred.
This is not to say that the Church has been evil in its totality. When it comes to treatment, the Church is the largest provider of healthcare to people living with HIV and AIDS worldwide and many of the individuals working for it have provided compassionate and even inclusive care. The Church has 5,000 hospitals and 18,000 dispensaries worldwide, with a huge concentration in the developing world.
And this is why this recent news is so big. The Vatican has endorsed the Treatment as Prevention (TasP) strategy pioneered by Dr Montaner in British Columbia. Putting people on treatment as soon as they test positive is now a solid strategy to bring a person’s viral load down to an undetectable level, reducing the risk of people passing on the virus by at least 96%, and possibly 99%. As one of the largest providers of treatment worldwide, the Church’s network has the ability to dramatically reduce new infections. As well, the political clout it has worldwide to get countries to adopt this strategy may also be a game changer.
So the next question is… what about pre-exposure prophylaxis (PrEP), the use of a daily pill that negative people can use to prevent HIV infection? The Church’s opposition to condoms is partly predicated on that fact that it facilitates fornication and prevents procreation. However, PrEP actually enables the latter. Between TasP and PrEP, the risk of transmission is reduced to a near zero probability and this enables serodiscordant straight couples to have children. And while that would be great in and of itself, would the Church also be willing to provide it to anyone that is high risk, especially two of the largest groups at risk, men who have sex with men and sex trade workers? Or would that be too close to enabling fornication?
If the Church were to endorse both TasP and PrEP, between its network and its clout, we could have the end of the epidemic in sight. Don’t hold your breath that the Catholic Church is about to begin handing out Truvada as PrEP like it does communion wafers. But certainly all can see the positive news in its endorsement of TasP.