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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”

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Sexuality, sin and disease - Theological and Ethical Issues Posed by HIV/AIDS to the Churches: Reflections by a Physician - Transcript

Ecumenical Review, The,  July, 1995  by T. Jacob John

Theological and Ethical Issues Posed by AIDS to the Churches: Reflections by a Physician

I offer these reflections to the theological discussion on AIDS from the perspective of a physician specializing in immunology. As a Christian - though not a formal theologian - I hope my comments will contribute to the understanding of this pandemic and suggest some ways those of us in the churches can approach it. I will concentrate on the medical but also psychological aspects of the problem, for these are an important factor in how the problem of AIDS is perceived, and in our reactions to it. I will also explore the themes of sin and guilt in relation to AIDS.

The human fascination with AIDS

If any one of you is without sin, let him be the first to throw a stone at her. (John 8:7)

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There is an old story in which a teacher of English assigned a composition. The students were to write a short story with the following standard dramatic elements: surprise, suspense, religion, sex and celebrity. While most students settled down to the long task of writing their stories, one student handed in his paper within one minute. His story in its entirety was as follows: "The queen exclaimed: Oh God! I am pregnant. Now, who dunn it?"

AIDS provides all these "dramatic elements" and more. The way physicians in the United States first identified the new syndrome and coined the term "AIDS" (acquired immuno-deficiency syndrome) was quite out of the ordinary; nevertheless this "scenario" determined our initial reaction to the disease. Young homosexual men were developing opportunistic infections or malignancies and dying. Some agent, chemical or infectious, related to homosexual behaviour was the cause. The result was suffering and death when least expected, in their youth. Homosexual acts were described in microscopic detail in the media. The news spread across the globe and the mental imagery of a mysterious illness killing homosexual men became imprinted in the minds of people everywhere.

People from different cultures and religious backgrounds responded to this imagery of AIDS with fear, aversion and condemnation. That some Christians, individually or collectively, believed that this was God's punishment on a promiscuous, perverse generation was quite natural. Many Hindus and Muslims believed the same way; indeed, it was almost a universal response to the way the illness was depicted. This response was not the result of a deep study and understanding of the issues involved, but a "knee-jerk" reaction to a stimulus. It was less a religious response than a heterosexual response. Heterosexuals had not understood or accepted homosexuals; but in light of AIDS heterosexuals could prove that they were "right" and others "wrong": they were tempted to self-righteousness, and even the hetero-sexually promiscuous were tempted to throw mental stones at those who had been "caught".

But now imagine a scenario in which the American physicians had been less clever. Suppose they had overlooked or not properly identified the adult disease, and had not linked it to homosexuality. And let us imagine that, instead, an alert paediatrician had first observed that there was some unusual immuno-deficiency disease in some children. Then in two or three years the agent was identified as the third human retrovirus to have been discovered. Next it was found in the mothers. Then it was found to be transmitted from husbands to wives. Then, from women to men. Then it was found that some men, women or children got it through blood transfusion. Then it was found that some persons got it through needle sharing among intravenous drug users. And, last of all, it was found to be shared between male homosexuals. Had the sequence of events been thus, the media would perhaps have treated the subject with more scientific interest than sexual curiosity. People of all countries and religions would have generally ignored HIV and AIDS until it affected themselves or their relatives or friends. Their response might then have been quite different, and not especially judgmental or condemnatory.

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Perhaps it was for the best that it happened in the way it did. Without the widespread and sensationalized publicity governments might not have taken quick and effective action to slow down the epidemic. Perhaps people would not have become aware of the facts as quickly as they did. Perhaps a greater epidemic was averted at the price of a smaller number suffering both AIDS and social discrimination.

The situation was otherwise in Thailand and India, and the epidemics there were not detected in their early stages. In Thailand and India, as in many African countries, the most common mode of transmission is heterosexual and not homosexual. In these regions men who have sex with commercial sex workers are the most commonly infected. Therefore in the minds of the common people HIV infection or AIDS became the tell-tale evidence of sexual promiscuity. Sexually transmitted diseases contracted as a result of sex with commercial sex workers are of course well-known, but they can be kept hidden and treated in the privacy of a doctor's clinic. By contrast the HIV infection becomes documented for all to see; and the diagnosis of AIDS can no longer be hidden from the world. Both of these, already sensationalized through the media, expose the individuals' "sexual immorality". The response is most frequently intense shame and loss of face, together with the fear of social rejection and anxiety in the face of impending death. The common reaction of colleagues and neighbours is to reject the afflicted and exclude them from social contact, partly from fear of contamination by this outwardly ordinary, but inwardly condemned person.