In Defense of a Little Compassion

September 06, 1994|By MARGARET KIM

Boston -- A full-page ad ran recently in several newspapers, placed by the conservative Christian group Focus on the Family, and headlined ''In Defense of a Little Virginity.'' It cites statistics in support of the thesis that condoms are ineffective in preventing the transmission of HIV disease.

Condoms, the ad says, are ''only 69 percent effective in preventing the transmission of the human immunodeficiency virus (HIV) in heterosexual couples.'' Recommending the use of condoms to prevent HIV transmissions is thus ''not much better than advocating Russian roulette.'' The only way to protect oneself from HIV is ''abstinence before marriage, then marriage and mutual fidelity for life to an uninfected partner. Anything else is potentially suicidal.''

Experts on sex and sexually transmitted disease are well aware of this, the authors of the ad say; and they imply that these experts are therefore acting in deliberate bad faith when they advocate so-called ''safe sex.''

Compare this with an article that appeared a few days later, reporting the results of a study on heterosexual HIV transmission recently published in the New England Journal of Medicine. The researchers in this study tracked the cases of 256 heterosexual ''discordant couples;'' that is, couples in which only one partner was infected with HIV.

Of those couples, 121 did not use condoms regularly, with the result that over four years, 12 of the uninfected partners became infected with HIV, giving an overall risk of infection of five percent per year. Forty-eight percent, or 123, of the couples did consistently use condoms, and of those, none of the healthy partners became infected with HIV.

So which is it? Does consistent condom usage cut risk of HIV infection to practically nothing (as the medical study reports), or is using condoms the equivalent of playing Russian roulette (as Focus on the Family would have us believe)?

I must confess to particular interest in this question. My husband has AIDS. We knew of his HIV infection before our marriage, and we were advised by our physicians that if we were careful in our sexual relations always to use condoms and spermicide, and to use them correctly, my chances of becoming infected with HIV )) would be very small.

So far, we have succeeded in protecting my health. In the three years that we have been married, I have been tested for HIV five times, and my test results have always come back negative.

I am thus inclined, on the basis of my own experience, to concur with those who would say that in fact it is possible, and very simple, to prevent transmission of HIV. All you have to do is follow the rules.

So why the furor raised by people like those behind the Focus on the Family ad? Why the eagerness to marshal statistics in opposition to what has become conventional wisdom in epidemiology? I think there are at least two currents of thought running beneath such presentations.

One involves a view of the world in which people get what they deserve. AIDS, so this train of thought goes, is a very bad thing. Anyone who has AIDS must have done something very bad to come down with it. Anyone who would have sex with anyone with AIDS must be similarly morally corrupt. Therefore, such persons deserve to get AIDS, too.

So, to suggest that it is possible, by the exercise of simple caution, to prevent the transmission of HIV, is equivalent to suggesting that people can avoid reaping the moral consequences of their actions. It is to turn the moral framework of the world upside down.

The other train of thought has to do with risk, and with what level of risk is acceptable. The authors of the ad make quite clear that, in their view, no level of risk for contracting HIV disease is acceptable. After all, they point out, AIDS is a terminal illness. To risk HIV infection is essentially the same as to commit suicide, only slower. It is therefore not enough to reduce one's risk; it must be eliminated entirely, through abstention from acts or circumstances which carry with them any risk of HIV infection.

This is an understandable view, if one grants the premise that AIDS is a deadly consequence visited upon those so foolish, and so immoral, as to run such risks. Who would want to take the slightest chance of coming down with a disease which is the contemporary equivalent of the scarlet letter, and which is fatal besides?

It is in the light of views like these that my decision to marry the man who is now my husband looks positively insane. But in my world, and in that of any thoughtful Christian, there are ends for which it is worth running certain risks.

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