Our attention is now rightly focused on the new coronavirus pandemic. As the number of cases grows, other health issues and concerns seem to become minimized. However, the Covid-19 virus is not the only worrisome transmissible agent in the Philippines setting. For many years the human immunodeficiecy virus (HIV) has been causing mayhem, and deserves our focused attention. The statistics reveal the seriousness of the situation. In 2019 alone (even with underdiagnosis) there were over 12,000 new HIV cases, and approximately 750 AIDS related deaths. This equates monthly to over 1,200 newly diagnosed cases, with around 60 HIV-AIDS related deaths.
The HIV epidemic in most countries is levelling off or decreasing. But there are a handful of countries where the infection rates are actually increasing, and one of these is the Philippines. The infection rate here was initially termed “slow and growing,” but now is best described as “fast and furious.” From 1984 to 2006, the main mode of transmission was male to female sex. From 2007 onwards there was a shift, with the predominant mode of transmission becoming sexual contact among males who have sex with males (MSM). Of the approximately 42 new cases of HIV per day, 85% are in males having sex with other males. Around one third of these cases are youth, aged just 15 to 24 years old.
When it comes to pastoral concern for, and outreach to MSM it is important to avoid stigmatizing these individuals. As Pope Francis has noted, “we would like before all else to reaffirm that every person, regardless of sexual orientation, ought to be respected in his or her dignity and treated with consideration” (Amoris laetitia, n. 250). Such a view is compatible with the recognition that in all epidemics it is standard medical practice to give more attention to the most at-risk populations (known as MARPs). For example, we would not fear stigmatizing the elderly, by pointing out to them the age-specific dangers of the corona virus, asking them to exercise appropriate cautions, and to avoid infectious contacts. Rather than being stigmatizing it would rightly be understood as a loving, caring response, and to counsel otherwise would be considered both medically and morally negligent. Similarly, to offer the supportive guidance and counsel of sexual abstinence to MSM’s constitutes an authentically loving and caring (and non-stigmatizing) response, especially in the face of a serious health threat.
As an ethicist, during the last 10 years I have been interested in and worked with, and on behalf of, LGBTQ+ persons in the Philippines setting. As a medical doctor I have given advice to ease the suffering of HIV infected persons, and as a Catholic priest I have celebrated funeral masses for persons who died of AIDS-related illnesses. I recently was talking to 3 men, all gay, who shared to me their experiences. The first recounted how he had 100 sexual partners, the second 250 and the third over 750. Now they are seeking to live chastely. Their lives have become marked by a new order and peace. I am reminded of the concluding words of Donum vitae (1987): “the Congregation for the Doctrine of the Faith addresses an invitation with confidence and encouragement to theologians, and above all to moralists, that they study more deeply and make even more accessible to the faithful the contents of the teaching of the Church’s Magisterium in the light of a valid anthropology in the matter of sexuality.” The call to chastity raises various challenges and complexities, and young men who are gay have acknowledged to me that while they are in a “loving relationship” they sometimes develop an emotional dependency on the older male, whom they consider a father-like figure, since in their own life, they may have lacked any sense of fatherly love as they grew up. The pastoral approach to each person will vary depending on their context and unique history. It is one thing to address promiscuity, and wholly another to address emotional dependency. In my opinion, neither of these facets of same sex attraction are being addressed and accompanied well in the Philippines’ context. The group called “Courage” (a ministry within the Catholic church ministering to persons with same sex attraction) is doing a remarkable work of accompaniment, but we could say the harvest remains great, and the laborers few in this important line of pastoral outreach, especially when we consider that around 9% of young males here express same sex attraction, compared to only around 2% in the USA. Young people when they experience confusion about sexual morality and identity need authentic accompaniment, sound guidance, and a call to a higher and liberating standard.
The Canadian Bishops have perceptively noted how “avoidance of difficult questions or watering down the Church’s teaching is always a disservice. Such attitudes could lead young people into grave moral danger” (Episcopal Commission for Doctrine of the Canadian Conference of Catholic Bishops, Pastoral Ministry to Young People with Same-Sex Attraction, June 2011, n. 16.) One thing is for sure: we need to learn how to accompany the LGBT group more closely, and to understand their specific needs. What will help to reign in the HIV epidemic here is more frank discussion about the driving factors, especially in the MSM group. Messages about HIV-AIDS prevention are often so generic, that “we are all at risk,” which while largely correct, risks diluting the message in significant ways for those who most need to receive strong medicine.
It takes courage to warn of the dangers of promiscuity (both homosexual and heterosexual), and to share a clearer message about the beauty of chaste love. In the meantime, by tarrying ethically, the number of HIV cases only continues to grow. If we try to step around the issue of the HIV epidemic, and especially around the call to bring authentic ordering to sexual behaviors, we will remain involved and responsible for great harms in the lives of those we are called to support and aid. Thankfully in CTEWC there is space to share our views on these important topics, and it is to be hoped that we can be a group that freely expresses concerns about issues like these, without fear of recrimination or other politically-correct pressures being levied against those whose views might differ from our own.