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					Catherine Bateson October 2, 2003 BA Theology Class of ’03 In the years following the first reported case of AIDS, the African continent has witnessed the deaths of thousands of men, women, and children from the disease, far more than the deaths caused by the virus on other continents. The ravages of the epidemic go largely unchecked while national governments, medical specialists, and human aid organizations provide no respite. According to John Paul II’s anthropology of the human person set forth in Theology of the Body, an inadequate understanding of human sexuality promotes a permissive ethos that contributes to the spread of the virus; hence, according to the Holy Father, the epidemic is understood most basically as a physical consequence of a sexually permissive ethos that stems from concupiscence. In order to check the spread of the virus, therefore, it is necessary to foster a culture that proclaims human dignity and a proper view of human sexuality. Only by seeking to promote such a culture, rather than relying upon the symptomatic “band-aid” of distributing condoms, will this task be accomplished. In this paper, I will provide evidence for the connection between human concupiscence and AIDS on the African continent, focusing primarily on the epidemic’s history in Uganda and the ways in which the Ugandan government and medical community has addressed the epidemic. It is necessary to trace the development of John Paul II’s anthropology in order to establish the connection between a lack of human dignity and corresponding sexual permissiveness which promotes the spread of HIV. In his Theology of the Body, the Pope begins his reflections with an analysis of the Genesis creation account. He presents the view of the human person, male and female, before original sin as one in which the body

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fully expresses the person. Because the human heart is untouched by sin, it has no capacity for lust and shame; the first woman and first man are naked together without shame and experience full communion of persons through their nakedness. The Holy Father writes, “[The body] was the direct and visible source of the experience that arrived at establishing their unity in humanity. It is easy to understand that nakedness corresponds to that fullness of consciousness of the meaning of the body, deriving from the typical perception of the sense.”1 Man and woman experience mutual knowledge of and appreciation for the other through their nakedness. In this state of original innocence, the sexual union of man and woman fulfills its purpose as an experience of mutual self-gift. Sexual intercourse is a vehicle of blessedness for the couple which enables each to fully experience their humanity. John Paul asserts, “The fact that they become one flesh is a powerful bond established by the Creator. Through it they discover their own humanity, both in its original unity, and in the duality of a mysterious mutual attraction.”2 He notes further, “Precisely this unity, through which they become one flesh, has right from the beginning a character of union derived from choice…In fact, [the one flesh union] bears within it a particular consciousness of the meaning of that body in the mutual self-giving of the persons.”3 This, then, is the intended purpose of every act of sexual intercourse according to the original design of God; through the giving of oneself and reception of the gift of the other in mutual freedom, each is fulfilled as a human person, in a sense, more deeply humanized.

1 2

John Paul II: Theology of the Body. Pauline Books and Media, 1997, 12/19/79 Ibid, 11/21/79 3 John Paul II: Theology of the Body, 11/21/79

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However, original sin enters, which causes a rupture between the body and spirit of the man and woman such that their bodies no longer adequately express their persons. John Paul II writes,
“A certain constitutive break within the human person is revealed, which is almost a rupture of man’s original spiritual and somatic unity. He realizes for the first time that his body has ceased drawing upon the power of the spirit, which raised him to the level of the image of God.” 4

The couple’s sin fundamentally distorts their relationship. Because of the rupture between the body and the spirit due to original sin, the body no longer expresses the person and can become merely an object for the other’s pleasure. The capacity for lust now enters into human relationships. Hence, the sexual union of man and woman becomes a vehicle for mutual objectification rather than self-gift. This relating to the other as an object promotes sexual permissiveness. Because the other is seen as an object for one’s pleasure, there is no value in fidelity to one person or humanizing sexual encounters; what is of importance is one’s personal gratification. The Holy Father notes, “Concupiscence in itself drives man toward possession of the other as an object. It drives him to enjoyment, which brings with it the negation of the nuptial meaning of the body. In its essence, disinterested giving is excluded from selfish enjoyment.”5 Thus, a loss of personal dignity due to original sin is responsible for a sexually permissive ethos. We have established the theological understanding of true sexual self-gift and the consequences of its distortion, according to the Holy Father‘s anthropology. Let us now reflect upon the relation between the Pope‘s anthropology and medical data regarding the ravages of the epidemic in Uganda, which mirror those experienced by the larger continent. Here, it is helpful to delve into the information compiled by medical research

4 5

Ibid, 5/28/80 Ibid, 7/30/80

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facilities to illuminate the severity of the AIDS epidemic in Uganda from 1989 to approximately 1992. There are various cultural factors which have contributed to the spread of HIV in Uganda during these years, such as lack of knowledge regarding sexual health, neglect of basic nutritional and sanitation needs, poor clinical care, and practices like tattooing and piercing with an unsterilized and pre-used needle.6 In particular, however, the cultural norm of young men engaging in sexual intercourse with numerous partners from early teenage years weighs heavily in the increase of the virus. Anne Nasimiyu-Wasike, LSOSF, states in her paper The Scourge of AIDS: African Women and Children in Kenya, ―After circumcision and during seclusion periods, the young men are introduced to early sexual activities. They are encouraged to have sex with many partners to prove their virility.7 Wasike notes further, ―It has been established that more than 50% of women contract HIV/AIDS from their husbands or their only boyfriends…Society encourages men to have multiple partners even in marriage. This has made marriage one of the main risk factors for women in sub-Saharan African with regard to HIV/AIDS.‖8 Thus, the virus in Uganda has been spread primarily through heterosexual contact, in which women often contract the virus as a result of their husbands‘ sexual exploits; in a certain sense, Ugandan women suffer acutely from objectification, even victimization, within Ugandan society. This pattern of the virus‘ rapid spread is clearly related to the Holy Father‘s explication of the inter-personal objectification caused by lust in the human heart; concupiscence is largely responsible for the AIDS epidemic in Uganda.

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The World Health Organization: www.who.int Wasike, Anne Nasimiyu: The Scourge of Aids: African Women and Children in Kenya. www.skk.uit.no/WW99/papers/nasimiyu_wasike-anne.pfd, p. 3 8 Ibid, p. 5

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While the seriousness of the epidemic is apparent, it is important to note the decline in HIV/AIDS in Uganda. In fact, Uganda has become the first country on the African continent to successfully curb the spread of the virus. Kerry Culligan of the University of Pretoria Center for the Study of AIDS states, ―Uganda is poor, rural, and in sub-Saharan Africa. These three factors alone should condemn it to being a helpless case in the eyes of the developed world. Yet…this small country has managed to cut its HIV prevalence rate by half and slash the number of new HIV cases by 37 %.‖9 The fact that Uganda is the only country with declining HIV rates among all those of the African continent has garnered the attention of the international community. Like other African countries who receive foreign medical aid, Uganda does distribute condoms to prevent the spread of the disease. But unlike other African countries, Uganda also encourages its citizens to consider abstinence as an option. What is most notable about the Ugandan approach to curbing the AIDS epidemic is its focus on education regarding the value of fidelity to one‘s spouse and promotion of abstinence from sexual intercourse among those with the virus. Uganda is the only country on the African continent that includes abstinence education and the value of fidelity in its treatment of the epidemic; this multi-pronged approach is referred to as the ABC program—abstinence, be faithful to your partner, and condom use. House Majority Leader, Tom Delay, states in his address to the United States House of Representatives on May 1, 2003, ―The facts – and the striking success of Uganda's abstinence program – are clear. No other method has produced the success rates or saved as many lives as Uganda's ABC approach…In

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Culligan, Kerry: Uganda Shines Amidst Misery. University of Pretoria Center for the Study of AIDS, www.csa.za.org

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Uganda, 10 years of the abstinence-based approach have slowed the march of the disease.‖10 While most international health organizations are less fervent in their positive view of abstinence based programs, they do note that abstinence education has played a part in Uganda‘s approach. For example, Rebecca Wind of the Alan Guttmacher Institute points to the benefit of adopting varied tactics to combat the AIDS epidemic; she writes, ―Uganda‘s successful reduction of HIV prevalence rates during the 1990s resulted from progress on all three fronts of its behavior-change prevention strategy—delaying sexual initiation among young people, reducing the number of sexual partners and promoting condom use among people who are sexually active.‖11 In agreement with Wind, Tom Carter of the Washington Times writes, ―While condom distribution and so-called ‗safe sex‘ have been the core of failed U.S. and international efforts in Africa to inhibit HIV transmission for 20 years, ABC is winning important backers on the left and the right, as ‗abstinence, be faithful and condoms‘ campaigns in Senegal and Zambia, modeled on the one in Uganda, have begun to show similar positive results.‖12 Many medical organizations do not agree that abstinence education is key to Uganda‘s success; however, it is significant that Uganda is the only country in Africa with a declining HIV prevalence in its population, as well as the only country until now to include a focus on abstinence and fidelity within marriage in its anti-AIDS campaign.

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Delay, Tom: Address to the US House of Representatives. majorityleader.gov/news.asp Wind, Rebecca: Increased Abstinence, Fidelity, and Condom Use Drive HIV/AIDS Declines in Uganda. The Alan Guttmacher Institute, 2002, www.guttmacher.org 12 Carter, Tom: Uganda Leads by Example on AIDS. The Washington Times, March 13, 2003, www.washtimes.com

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There is an undeniable correlation between a culture that proclaims the dignity of human sexuality and successful containment of the virus. Programs that simply advocate “safe sex” through condom use do nothing to enhance the dignity of human interactions. True societal good follows upon the renewal of human culture according to the dignity of the person. This has proven to be the case in Uganda and is concurrent with the anthropology of John Paul II. He states, ―We know the significance that anthropology has for ethics, that is, for moral doctrine. It seems to be totally reasonable to look precisely in the ‗theology of the body‘ for the foundation of the truth of the norms that concern the fundamental problematic of man as ‗body‘.‖13 It is necessary to espouse an adequate anthropology of the human person, namely one that regards the body as an intrinsic good, in order to promote a proper sexual ethos. Throughout Africa, there must be a shift in the perception of the human person from an object for one‘s pleasure to an equal other with whom to enter into communion. Only such an ethos which will be successful, as in Uganda, in overcoming the AIDS epidemic on the African continent.

13

John Paul II: Theology of the Body, 7/18/84

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Below are two charts of data provided by the Ugandan Ministry of Health regarding the progress of the epidemic from 1989 to 1999.14
Table 1: HIV infection rates (%) at selected antenatal sentinel sites. Site 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999

Nsambya 24.5

25.0

27.8

29.5

26.6

21.8

16.8

15.4

14.6

13.4

12.3

Rubaga

-

-

27.4

29.4

24.4

16.5

20.2

15.1

14.8

14.2

10.5

Mbarara

21.8

23.8

24.3

30.2

18.1

17.3

16.6

15.0

14.5

10.9

11.3

Jinja

24.9

15.8

22.0

19.8

16.7

16.3

13.2

14.8

11.0

10.5

10.8

Tororo

-

4.1

12.8

13.2

11.3

10.2

12.5

8.2

9.5

10.5

4.5

Mbale

3.8

11.0

12.1

14.8

8.7

10.2

7.8

8.4

6.9

6.3

5.7

Kilembe

-

-

-

-

7.0

16.7

11.1

10.4

8.5

-

7.5

Pallisa

-

-

-

7.6

5.0

1.2

-

-

3.2

2.6

3.2

Soroti

-

-

-

-

9.1

-

8.7

7.7

5.3

7.7

5.0

Matany

-

-

-

-

2.8

7.6

-

2.0

1.6

1.3

0.9

Hoima

-

-

-

-

-

-

-

12.7

9.0

5.4

3.5

Kagadi

-

-

-

-

-

-

-

-

10.3

11.5

11.0

Mutolere -

4.1

5.8

-

4.2

-

3.6

2.6

-

2.5

2.3

Moyo

-

-

-

-

5.0

-

3.1

-

-

3.2

5.2

Arua

-

-

-

-

4.4

-

-

-

-

-

5.2

Source: St Mary’s hospital Lacor, Gulu sentinel site

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The Republic of Uganda Ministry of Health Online: www.health.go.ug

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Table 2:HIV Prevalence among ANC attendees at St. Mary’s Hospital Lacor, Gulu Age-class 15-19 20-24 25-29 30-34 35-49 Age missing overall

1993

HIV-1 prevalence (%)

21.5

31.8

28.9

25.7

15.2

40.9

27.1

No.of tested women

284

333

204

109

46

22

998

1994

HIV-1 prevalence(%)

17.2

24.5

25.5

20.9

15.7

20.0

21.9

No.of tested women

587

710

501

258

89

15

2160

1995

HIV-1 Prevalence (%)

8.7

17.8

20.4

10.2

10.0

0.0

14.7

No.of tested women

483

646

422

197

80

14

1842

1996

HIV-1 Prevalence (%)

9.6

15.9

14.4

20.4

11.9

12.5

14.3

No.of tested women

281

396

250

137

59

8

1131

1997

HIV-1 Prevalence (%)

11.5

17.6

20.2

19.2

11.1

14.3

16.3

No.of tested women

828

1000

682

308

144

42

3004

1998

HIV-1 Prevalence (%)

10.2

13.0

16.8

12.5

6.3

9.3

12.8

No.of tested women

1039

1414

955

432

191

54

4085

1999

HIV-1 Prevalence (%)

7.4

13.1

15.9

15.2

9.6

7.7

12.3

No.of tested women

1321

1704

1164

566

261

26

5042

Source: St Mary‘s hospital Lacor, Gulu sentinel site

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This graph, provided by the World Health Organization shows the marked decline of the virus among Ugandan teenagers between the years 1990 to 1997.15

HIV prevalence rate among 13-19 year olds in Masaka, Uganda

15

The World Health Organization: www.who.int

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Works Cited

Pope John Paul II. The Theology of the Body (1997, Pauline Books and Media, Boston, MA) The Republic of Uganda: Ministry of Health Online (www.health.go.ug) The World Health Organization: (www.who.int) Wasike, Anne Nasimiyu, LSOSF: The Scourge of Aids: African Women and Children in Kenya. (www.skk.uit.no/WW99/papers/nasimiyu_wasike-anne.pfd_) p. 3-5 Culligan, Kerry: Uganda Shines Amidst Misery. (University of Pretoria Center for the Study of AIDS, www.csa.za.org) Delay, Tom: Address to the US House of Representatives (majorityleader.gov/news.asp) Wind, Rebecca: Increased Abstinence, Fidelity, and Condom Use Drive HIV/AIDS Declines in Uganda. (The Alan Guttmacher Institute, 2002, www.guttmacher.org) Carter, Tom: Uganda Leads by Example on AIDS. (The Washington Times, March 13, 2003, www.washtimes.com

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