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As we confront HIV/AIDS, we participate in the healing mission of Jesus. Read about the continuing challenges this epidemic presents to the world, and learn about the Catholic Church’s response to those affected by the disease.

Catholic Update

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AIDS and the Consistent Ethic of Life

Jesus is a healer, who came to set humanity free from diseases of all kinds. His mission of healing is a key reason for his presence among us, carried on during his earthly life and since then in the mission of the Church (see Matthew 10:1). Confronting HIV/AIDS is participating in the healing mission of Jesus himself, as each of us is called to do.

In spite of the alarm, and our own bishops’ guidance well over a decade ago, we’ve been slow to respond. “The crisis continues, but it can be met with understanding, justice, reason and deep faith,” said the bishops in their 1989 letter, Called to Compassion and Responsibility. True, there have been many life-giving expressions of understanding and reason, many hopeful signs of deep faith. During this time, however, the crisis not only continued but grew much worse.

In this Update, we will take a careful look at both the life-giving and the death-dealing realities found in this global epidemic. We will consider the continuing challenges HIV and AIDS present to the human family. In this context we will also review the rich resources that our Church offers us to help us respond with compassion and responsibility.

Signs of deep faith

Since the beginning of the epidemic, the Catholic Church has been actively involved in word and in deed. Based on the Bible and on the Church’s long tradition, the Church’s teachings have stressed 1) the value and dignity of every person, 2) the rights and responsibilities of society, 3) the compassion of God.

Many national conferences of bishops have issued statements concerning HIV/AIDS. In the United States, the Administrative Board of the U.S. Catholic Conference published The Many Faces of AIDS: A Gospel Response in 1987. The whole National Conference of Catholic Bishops published Called to Compassion and Responsibility: A Response to the HIV/AIDS Crisis in 1989. Since then individual bishops or groups of bishops have addressed their people. Similarly, Pope John Paul II has regularly spoken about HIV/AIDS, either at AIDS conferences or during his visits to nations, especially those suffering from AIDS in a critical way.

The Church has also directly responded to those suffering from HIV and AIDS. In fact, Catholic-church-related organizations offer more AIDS care than any other institution in the world. This gift of faith is often overshadowed in the popular media by the debate concerning the morality of using condoms. This focus actually leads many people to develop a negative impression about the Church’s response to the crisis.

Many other expressions of deep faith, of course, are found in other individuals, institutions and religions.

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Gifts of reason

Since 1981, when AIDS was first discovered, AIDS researchers have made remarkable advances in understanding HIV and AIDS and in developing treatments for the infection. The most successful treatment is a combination of antiretroviral drugs (called HAART—highly active antiretroviral therapy). For many persons these drugs stop the virus from replicating, transforming the infection into a chronic disease. This combination of drugs, however, does not completely eliminate the virus, so for the present, ongoing treatment remains necessary.

Some people experience very serious side effects from HAART. Another limitation, due to cost and corporate policies, is the harsh reality that this treatment is not available for the great percentage of the world’s people infected with HIV. Also, work on an AIDS vaccine continues, but has not been successful because of the different strains of HIV and because the virus mutates so easily.

Human reason has also increased the understanding about the spread of HIV, not just from a scientific perspective but also from economic and cultural perspectives. Experts now recognize that crushing poverty, oppression of women, racism, war and other forms of structural violence and injustice create the perfect breeding grounds (risky sexual situations and the use of drugs) for the flourishing of the HIV/AIDS epidemic.

Understanding these structural causes opens up the possibility of creative responses. Our Catholic tradition (more on this later) offers penetrating light for this area in particular, giving guidance for the creation of cultures of life.

Crisis intensifies

The spread of HIV and AIDS is staggering. While Africa has been hardest hit, the epidemic is now ominously moving into the world’s most populous countries: China and India.

Statistics constantly change, but the following numbers give some sense of the magnitude of this global epidemic. In 2004 an estimated 40 million people were living with HIV/AIDS. More than twenty million persons had already died, including 2.6 million just in 2003. Worldwide, the main cause of infection has been heterosexual intercourse. In some countries the epidemic begins with injecting drug use and then spreads through sexual contact.

HIV/AIDS is devastating the developing countries. Over 90 percent of persons with HIV live in these countries. Because of AIDS, nations already reeling from other hardships face many more deaths, reduction in the number of workers and greater economic/political instability. In the United States, HIV/AIDS is especially attacking the African-American and Hispanic communities.

Such sobering statistics have led AIDS researchers to conclude that wherever HIV enters a population, it always moves to those peoples who are already experiencing poverty, oppression, disease and marginalization. In the haunting words of Paul Farmer, M.D., HIV/AIDS has a "preferential option for the poor."

Light for our path

In this context of global suffering, especially of the poor, the Church offers sound guidance. The Scriptures give us a solid foundation for our vision and action: 1) by reminding us that AIDS is not a punishment sent by God; 2) by giving Jesus as an example of care and compassion; 3) by challenging us to question and change structures of society that oppress people.

1. Deeply embedded in some streams of Hebrew thought was the sense that good deeds led to blessing and evil deeds to suffering. If a person was experiencing sickness or other trials, then that person must have sinned in the past. The Book of Job, however, challenges this tradition; Job suffers despite his innocence (Job 31 especially).

Jesus too challenges this belief. In the exquisite scene described in chapter nine of John’s Gospel, Jesus heals a blind man. Jesus declares that the man’s blindness was not due to his or his parents’ sin (John 9:2-5). Neither Job nor Jesus explains away the pain of suffering, but neither views sickness as a punishment from God.

2. Mark’s Gospel (1:40-42) describes Jesus healing a leper (see also Matthew 8:1-4 and Luke 5:12-16). This event reveals not only Jesus’ care for an individual in need but also his concern about structures of society. Jesus steps across the boundaries separating the unclean and actually touches the leper. In doing so, Jesus enters into the leper’s isolation and becomes unclean. Human care and compassion, not cultural values of honor and shame, direct Jesus’ action.

3. Jesus’ compassionate act of healing already points to societal issues. In this act, Jesus stands firmly in the prophetic tradition of the Bible. Again and again, the prophets challenged the people not to separate justice concerns from true religion. Isaiah powerfully expressed this conviction: “This, rather, is the fasting that I wish: releasing those bound unjustly, untying the thongs of the yoke; sharing your bread with the hungry…” (see Isaiah 58:1-12).

Jesus embodied and expressed this vision in his parables about God’s reign and in his healings and table fellowship. His encounter with the leper is just one example of many.

Past to present

The consistent ethic of life helps us to embody this biblical vision and recent social teachings in our personal and political lives today. The late Cardinal Joseph Bernardin articulated this perspective in the early 1980s, and it became a centerpiece of the U.S. Catholic bishops’ moral teaching. Pope John Paul II affirmed similar themes in his 1995 encyclical The Gospel of Life.

What is the consistent ethic of life? It is a comprehensive ethical system that links together many different issues by focusing attention on the basic value of life. This comprehensiveness makes this moral framework especially appropriate for responding to the complex issues of the AIDS epidemic.

The consistent ethic of life rules out contradictory moral positions about the unique value of human life—and it would be contradictory, for example, to be against abortion but for capital punishment or to work against poverty but to support euthanasia. This linkage challenges us to move beyond the contradictions we may find in our own convictions about morality. Often these convictions seem to cluster around “conservative” or “liberal” viewpoints—as in the above examples—but the consistent ethic of life cuts across such divisions.

We ought not underestimate the challenge of being pro-life. The contradictions reveal that politics, media, money or class—and not our faith—may well be the real source of our values.

Cardinal Bernardin, the conference of bishops, and Pope John Paul have necessarily discussed the relationship between moral vision and political policies. Indeed, the consistent ethic of life was developed to help shape public policy. Political decisions and economic structures provide means to create a societal environment that promotes the flourishing of human life or, as we have already seen, to create the perfect conditions for the spread of HIV and AIDS.

As we face this threat to our world, the consistent ethic of life provides both a solid foundation and a powerful challenge to live as faithful disciples and involved citizens. It urges us to speak and act concerning sexism and racism, maximization of profits and forced migration, trade agreements and sweatshops, the buying and selling of women for prostitution, and many other issues—all connected to HIV and AIDS.

Foundational issues

Personal sin is not the only cause of the spread of HIV/ AIDS. In fact, its role pales in comparison to the structures of poverty and gender discrimination that placed most HIV-infected persons at risk." These strong words of moral theologian Lisa Sowle Cahill may startle many of us. Surely we must be responsible for our choices concerning sex and drugs.

Indeed, we must. Cahill’s statement, however, can help us appreciate that in some situations, freedom is severely limited by cultural and economic conditions. In many countries, for example, women may be forced into sex with unfaithful and infected husbands or into prostitution to support their family.

Again, the great percentage of the earth’s HIV-positive people do not have access to the life-saving antiretroviral drugs. The roots of this situation lie in political and economic choices and structures. Some countries have chosen to violate international patent laws or to work out some kind of compromise in order to produce generic forms of the drugs at a much lower cost. Other countries are too poor even to do that.

What most of us take for granted—food, clothing, shelter, education, participation in politics—is lacking in the lives of hundreds of millions of the human family. The power of economic and social structures perpetuates poverty and limits personal freedom. Pope John Paul II has named such conditions “structures of sin.”

The consistent ethic of life recognizes the necessity of personal responsibility and also emphasizes the pervasive influence of these political, economic and social structures that contribute to the spread of HIV and AIDS. Only if the developed world addresses the global structural issues will conditions be changed so that personal freedom can truly be exercised and life can flourish throughout the world. This political and economic task may well be the most challenging, for the consistent ethic of life, with its emphasis on justice and the common good, calls into question some of the basic practices of the United States, especially economic ones.

What can we do?

Our reflections have led us to three specific points concerning HIV and AIDS.

1) We resist the temptation to judge and condemn people. HIV/AIDS is not a punishment sent by God. This change of attitude is where we start. This respect does not mean, of course, denying responsibility. Prevention is still the key to dealing with HIV and AIDS, so creative and culturally sensitive educational programs must encourage people to take responsibility for their actions.

2) We respond with care and compassion to those infected and affected by HIV, crossing the boundaries of fear and prejudice. With the attitude of Jesus, we reach out to these sisters and brothers. This means action, perhaps starting a parish support group or helping a local agency that assists those living with AIDS—or at least supporting those who do this.

3) We recognize the need for societal change as well as behavioral change. The consistent ethic of life helps us translate the vision of the prophets and Jesus into just working and living conditions. This too means action—systemic action. We accept personal responsibility to challenge and change political platforms, economic strategies and governmental decisions that foster a culture of death.

Getting information, from the National Catholic AIDS Network or UNAIDS for example, is a first step. Attention to politics is vital, by informed voting and pressuring leaders to support fully the Global Fund to Fight AIDS, Tuberculosis and Malaria. For some people, actual participation in political and economic decisions is possible. Joining and/or supporting advocacy groups that promote local and global justice expresses one’s solidarity with the poor. Economic issues deserve special work: promoting debt relief for poor countries and resisting free-trade agreements (that do not treat the poor justly but do increase profits for the wealthy).

HIV/AIDS may rarely make the headlines these days, but it is devastating the lives of individuals and families, communities and countries. Reason and faith offer gifts of healing and light, challenge and hope. "HIV/AIDS brings with it new anguish and new terrors and anxiety, new trials of pain and endurance, new occasions for compassion. But it cannot change one enduring fact: God’s love for us all" (Called to Compassion and Responsibility). With trust in our God we can recommit ourselves to Jesus’ healing mission, which includes a caring response to one of the greatest challenges of our time: the growing crisis of HIV/AIDS.

Kenneth R. Overberg, S.J., is professor of theology at Xavier University, Cincinnati. He holds a Ph.D. in social ethics from the University of Southern California and is the author of numerous articles and books, including the award-winning Conscience in Conflict: How to Make Moral Choices (St. Anthony Messenger Press).

Next: Day by Day Stillness in Lent (by Phyllis Zagano)

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