THE REDUCTION OF LAW-RELATED HARM: A BIBLICAL AFFIRMATION OF HIV PREVENTION

Transcription

1 THE REDUCTION OF LAW-RELATED HARM: A BIBLICAL AFFIRMATION OF HIV PREVENTION 'Care for people who are infected and affected by HIV' is a topic that is growing in importance for many Christian organizations which are not yet themselves experiencing the impact of an HIV epidemic. However, public discussions among Christians about HIV lack clear affirmations regarding preventing the spread of HIV. Most public comments by Christians on HIV involve ambiguous qualifications, and lack a decisive commitment to preventing infection. These qualifications mostly arise because early in most HIV epidemics, most HIV infection occurs during activities such as multi-partner sexual activity and injecting drug use, each of which is inconsistent with Christian aspirations. Popular approaches to preventing HIV infection in such situations appear to conflict with prevailing Christian attempts to encourage faithful monogamy, celibacy, and abstinence. Contemporary wisdom regarding HIV prevention and care, rallies around notions such as 'value-free' and 'non-judgemental' approaches as well as supporting the mobilization of groups which are most at risk of HIV infection. In contrast to this, Christian interests very often revolve around things such as the discernment and removal of sin, and the mobilization of Christian groups. Preventing an HIV epidemic, or even individual infections, involves negotiating unfamiliar and difficult terrain. Never the less, there is a genuine reason for Christians to struggle to come to terms with HIV prevention. The absence of public affirmations by Christian organisations of HIV prevention initiatives, raises a number of questions. Is there no foundation in Christianity for preventing the spread of HIV? Is there no forum for examining the topic in detail? Is there no interest in the topic until our own families and communities are affected? I believe that there is a Biblical foundation for preventing the spread of HIV. It needs to be debated and developed. This is best done before our own families and communities are affected, though there are many Christian communities which no longer have this luxury. The Biblical foundation that I will put forward does not address HIV itself. Instead, it involves understanding the Bible's relevance to a context in which HIV spreads. In this paper, I will comment on the spread of HIV among injecting drug users. It is quite likely that this argument will not be relevant to other situations of HIV

2 spread, such as mobile labour forces, sexual slavery and exploitation, homosexual activity, mother-to-child transmission, or the infection of a faithful, monogomous spouse (to name just a few). The processes affecting each type of transmission need to be understood. Once the processes of transmission are identified, it is possible to examine the Biblical foundations for prevention. I will make three affirmations that I think belong in Christian discussions about HIV prevention among injecting drug users. They are part of a recurring Biblical theme that I have called 'The reduction of law-related harm'. My intention is to urge you to consider whether there actually exists a theme, tradition or theology, which might be called 'the reduction of law-related harm', and if there exists such a theme, its application to the spread of HIV. 1. We must affirm a commitment to life over a commitment to law This affirmation is necessary because sometimes, attempts to be faithful to law have harmful consequences. When I refer to 'law' here, I'm referring to Biblical law, international and state law, moral law or 'norms', and even the unwritten law we have in our homes. The principles I am suggesting are relevant to all of these laws, whether they are good laws or bad laws, God's laws or our laws. Take, for example, the policing of international drug trafficking. In order to avoid detection and siezure, drug traffickers will try to stay ahead of the police. When one route is monitored or disrupted, they go somewhere else. By international law enforcement agencies disrupting drug trafficking routes, more people are exposed to injecting drug use and its associated risks of infection. African countries, for example, which hadn't experineced large scale injecting drug use, are some of the latest countries to identify the emergence of injecting drug use, as drugs are trafficked through Africa to avoid detection and siezure elsewhere. The same principle can be seen at the level of individual drug users. If someone is caught with a needle the State law might lead to their imprisonment, whilst the moral law might see them bashed up, or kicked out of their home. To avoid all this, many drug users decide to not keep their own needle with them. They go somewhere, where there will be a needle and use that one. This can be a very efficient way of spreading HIV. The idea of the reduction of law-related harm is an acknowledgement of such situations, and reconsiders the meaning behind the law in the light of the priorities of the law-makers. The teaching of Moses gives an example how to deal with the potentially harmful consequences of law and affirm life over law. The law permitted revenge killing.

3 But, if someone killed someone else by accident, there was a designated city of refuge for them (Numbers 35). They would be safe in the city of refuge while they were there, but outside the city of refuge, they were at risk of being killed by the avenger of blood who was entitled to take their life. Jesus' life also illustrates a commitment to life over law. For example, he healed a man on the Sabbath (Mark 2:23-3:6). This was a situation in which Jesus' own actions were considered by the Pharisees to be outside of the law and punishable by death. In defense of his actions, Jesus asked the observers if it was lawful to save life, or to kill? Whilst HIV prevention is intended to save life, it invariably coincides with judgements about people's behaviour and identities. Jesus' teaching also affirms a commitment to life over law. For example in the parable of the Good Samaritan (Luke 10:25-37) the injured man's identity under the law may have saved him or caused him to be left for dead. Was he a 'dead' man or not? Was he a Jew or a Samaritan? Was he a relative or not? The Law could have been used to justify the Priest's and the Levite's neglect of the half dead man on the road. Their choices appear to have been between wanting to be 'lawful', right, good, etc or actually loving. The life of a man who had been violated by people (who themselves defied the law), rested on his potential rescuer s choice between 'lawfulness' and love. Just as the Prophets of the Old Testament and the Gospels contain numerous stories of Jesus speaking about these situations, the current prospect of HIV epidemics has stimulated contemporary thinking on this as well to enable us to find practical ways of living in the tension between our ideals and reality. For example, organizations in Calcutta are working closely with the police to minimize the imprisonment of drug users. This is an important step in reducing HIV transmission, since the risk of HIV infection for a drug user is much higher in prison than outside of prison. Similarly, an early response to the possibility of HIV epidemic among injecting drug users in Australia, was that users could carry their used needles and syringes in a plastic bottle which has the lid on, and not be liable under the law. This made it possible for people to access needle exchanges or at least carry their own needle with them without such a great fear of arrest. The Apostle Paul, in Romans 7, also saw the potential of the law to lead to death, even for those who were trying to be faithful to the law. One of the things he was saying is that law increases an awareness of wrong-doing, but it doesn't increase your ability or opportunity to change. This leads to the second affirmation

4 2. We must increase the opportunity for people to change and affirm small signs of change. Many Christians feel comfortable with advocating that people change. However, it is usually qualified by saying something like, as long as the change involves a change from using drugs to not using drugs. This change from drug use to abstinence cannot be the only option given to drug users if we are to prevent the spread of HIV. HIV can spread very fast. Some places, such as Manipur in North-East India, have seen over 50% of the injecting drug users infected within 12 months of the virus being identified in their company. Since HIV prevention programmes which depend solely upon rehabilitation and abstinence from risky sexual activity and drug use are necessarily long term in nature, the speed at which HIV can spread, can compromise the effectiveness of such programmes. In addition to this, there aren't enough treatment places (for detoxification and rehabilitation) for everyone who wants to choose this option? For example, in Delhi, India, there are less than 500 'beds' available for drug treatment at any one time. These beds are available to people who use alcohol and marijuana as well as harder drugs like heroin and other opiates. Current estimates place the number of heroin and other opiate users in Delhi at between 30,000 and 150,000 people. Even if the drug treatment system was completely devoted to assisting injecting drug users leave injecting and those users wished to leave using, the current facilities available could not assist all drug users to stop using before a large portion of the population becomes infected with HIV. Instead of this narrow definition of change, 'change' needs to be recognised as 'any behaviour change that protects life'. There are many life-affirming changes that can be made on the spectrum between injecting more hygienically and abstinence from drug use. Jesus was quick to affirm small signs of life. A woman told him the truth. A man just wanted to get a look at him. A woman just wanted to touch him. People just wanted better health. Jesus rewarded very small signs of life with an opportunity for more life. We too must increase people's opportunity to change for 'life' and affirm any changes for 'life' which they make. 3. We must fulfill the law By and large, Christian organisations and individuals don't want to be seen to be condoning bad behaviour, or illegal behaviour. The following quote from a Christian magazine is a response to an article raising awareness about HIV and AIDS. It articulates a popular sentiment

5 Why have you taken the standard wet liberal line about being nonjudgemental about AIDS? You talk about 'Christian care at the grassroots level, without blame or prejudice', but fail to deal with the problem at a biblical level. The overwhelming number of AIDS victims throughout the world contract it because of adultery, fornication, homosexuality and drug abuse. Sin is sin, and needs to be condemned as such. We need to declare the boundaries, have compassion when people suffer from crossing those boundaries and then insist that they must live within them. This quote is similar to another common response to the proposition of affirming law over life is, But we need laws, we can't just throw them away. I am not advocating the destruction of law. Instead, I am trying to echo Jesus' sentiment of Do not think that I came to destroy the Law and the Prophets. I did not come to destroy but to fulfill. (Matt 5:17) Law, often, isn't very detailed. The book of Hebrews describes it as a shadow of good things, not the very image (Heb 10:1). Jesus was often interpreting the Law, and giving it more detail. An interesting example of this is when Jesus was asked to interpret the law on paying taxes to Caesar (Matt 22:17). The Law of Moses was revealed during a period of self-government, but Jesus was interpreting it during a period of foreign occupation. The fact that laws don't usually comment on things that haven't yet happened complicated the question posed to Jesus by the Pharisees. This is also the case with HIV and drug use in India. The last major amendment to India's drug control laws was made in However, an HIV epidemic among injecting drug users wasn't identified in India until Drug control laws that pre-date India's HIV epidemic cannot be expected to protect society from HIV. Fulfilling the law involves acknowledging the current law, just as Jesus would say, You have heard that it was said (Matt 5:21, 27, 38). It then, however, involves giving more detail, which should fulfill the purpose for which the law was made. It is submitted that the purpose of God's law is the promotion of life. Jesus' fulfillment of the law generally placed more responsibility on those who felt safe with the existing laws, rather than on those who were already under judgement according to those laws.

6 Conclusion Developing a Biblical foundation for preventing the spread of HIV demands much more than identifying risk behaviours and demanding that people at risk of infection abstain from 'immoral' behaviour. It demands an understanding of the greater context of infection as well. The Bible can inform our response to this context as well as to individuals. The rapid spread of HIV among injecting drug users in the world over the past two decades, raises the question of how we can apply the biblical theme on 'the reduction of law-related harm' to the prevention of HIV. This may involve much debate. I have described some specific contexts of injecting drug use and the associated vulnerability to HIV infection. Having identified the contexts within which HIV is likely to spread, I have put forward three affirmations, which I suggest are contemporary reflections of the Gospel. We can affirm a commitment to life over a commitment to law. We can affirm all change that is life-giving. We can fulfill the law. If it is possible to develop Biblical affirmations for the prevention of HIV among injecting drug users, then it should also be possible to develop affirmations for other types of HIV prevention activities.