There can be few literate members of Western society who are unfamiliar with the acronym AIDS, or its French equivalent SIDA, for both terms have rapidly found a place in everyday speech. AIDS stands for the Acquired Immune Deficiency Syndrome. It is acquired because it is not hereditary, although an immune deficiency of similar mechanism but unrelated causation may be hereditary. It is an immune deficiency because it produces failure of the defence system of the body to protect it against infection. Finally it is called a syndrome because it is recognized as a collection of symptoms which may occur together, but is not regarded as being a disease in its own right. AIDS is, in fact, the final stage of the infection of the human body by the AIDS virus, now generally known as the human immunodeficiency virus or HIV for short.

The emergence of AIDS

AIDS was first reported in June 1981 as occurring amongst promiscuous male homosexuals in the large urban cities on the east and west seaboards of the United States. Its cause was at first unknown although its behaviour resembled that of an infection. Two years later the virus was identified in the Pasteur Institute in Paris. Since its first recognition, the syndrome has been reported from most regions of the world, notably from Africa where there is some evidence that the infection may have originated in Zaire.

Medical experience of AIDS

We have only known about AIDS for eight years and are ignorant of its long-term features. We do not know, for example, if everyone who is infected with HIV will eventually and inevitably progress to the fatal end-stage of AIDS, or whether there are factors which will operate to prevent this progression. This means that we should be careful in our usage of the term AIDS. All AIDS is HIV infection, but not all HIV infection is AIDS. When the syndrome first appeared the mass media seized on the term AIDS and used it exclusively. They gave the impression that all HIV infection was AIDS and so contributed to the initial panic which swept the United States. As medical experience of the infection increases we shall be able to see our present problems in a better perspective than we can now.

Christian interest in AIDS

The five books which form the subject of this review article are all from Christian publishers. Four of them were launched together at a joint news conference in London in November 1987. This must indicate a Christian interest which is unusual especially when the topic they are concerned with is a medical one. Several reasons suggest themselves in explanation of this Christian interest. These may be personal, social, ethical and theological. Christians must be concerned with the threat to human life and happiness which HIV presents in most areas of the world, and do what they can to minimize this threat. They must emphasize the relevance ofChristian ethical behaviour to the transmission of HIV infection, and they must wrestle with the moral and theological issues which arise from the sudden appearance of such a condition so intimately bound up as it is with human behaviour.

These five books then are an expression of the current Christian interest in HIV infection and AIDS. Their authors represent a wide theological spectrum and four of them are doctors. Inevitably, the medical authors cover much common ground. For this reason it might have been better if they had combined in the joint production of one book rather than in the joint launching of four books at the same news conference. Let us now look at these books and try to assess their value to the readers of Themelios who may be involved now or in the future in the pastoral care of HIV-infected persons.

The 20th Century Plague

Dr Caroline Collier was a general practitioner in Stourbridge until she was appointed the AIDS Lecturer and Resource Officer of the Christian Medical Fellowship in April 1987. Her book is the shortest and the cheapest of the five under review and she manages to pack a great deal of information into its ninety-five pages. However, because of its brevity the book tends to give a more dogmatic tone to its statements than do the other books. This was illustrated by the reception the book received from the Press who accused Dr Collier and the Christian Medical Fellowship of drawing up a plan for the control of AIDS and HIV-infected persons based on compulsory testing of the population for HIV infection and segregation of those found to be positive in separate towns or cities. In fact, such a plan was only mentioned as an option in the book and was not put forward as the official view of the author or the Christian Medical Fellowship.

The Truth about AIDS

This book is the longest of the five books and is the most comprehensive in its coverage of the subject. Its author, Dr Patrick Dixon, is in terminal care practice in London and he has read and travelled widely in the preparation of his book. It contains by far the greatest number of references (mostly medical), but still manages to be very readable and very practical. If you can afford only one book on AIDS, then this is the one to buy.

Sexual Integrity: The Answer to AIDS

The author of this book is Dr Jack Dominian who is a well-known consultant psychiatrist with a special interest in the ethical and social problems of sex and marriage. Dominian is a practising Roman Catholic who does not always find himself in agreement with the teaching of his Church, as this book illustrates. He regards the arrival of AIDS as a fundamental challenge to contemporary sexual morality and urges a total rethinking of modern sexual behaviour. His own contribution to this he summarizes in the phrase sexual integrity which he prefers to the word chastity because of the unfortunate repressive associations which that word has acquired. His book needs careful reading for he uses psychological terms which are not always as precise as students of ethics and theology would prefer. Thus he appears to be able to find room in his phrase sexual integrity for the acceptance of homosexual relationships and even premarital heterosexual intercourse provided these are based on loving personal relationships. Some of the author’s arguments could result in the justification of AIDS-promoting behaviour rather than forming the answer to the problems raised by AIDS.

AIDS: Sharing the Pain

This is the only book by a non-medical author amongst the five being reviewed. Bill Kirkpatrick, the author, is an Anglican minister who runs a counselling centre in central London and has written his book to provide pastoral guidelines for those involved in caring for persons with HIV infection. It gives the impression that it originated as a commonplace book compiled out of the author’s experience and reading in the course of his ministry to HIV-infected persons. He provides useful checklists concerning matters to be covered in HIV counselling. The last forty pages of the book form a helpful repository of information on facts, literature and agencies related to AIDS and its problems. The book reflects the high Anglican tradition of its author, but will also be found valuable by those who do not belong to this tradition.

AIDS and the Positive Alternatives

Dr Margaret White is a general practitioner in Croydon and an elected member of the General Medical Council. She has written previously on the Christian position on abortion. Her book on AIDS is popularly written, well-researched and contains some apt quotations. The ‘positive alternatives’ mentioned in the title of the book are chastity before marriage and fidelity after marriage, the twin pillars of Christian sexual ethics.

The prevention of HIV infection

The World AIDS Summit held in London in January 1988 concluded that the single most important means for the prevention of AIDS was the dissemination of information to the people at risk about how HIV infection was spread. The information contained in these books is therefore to be welcomed, especially as it is provided in a Christian context and with reference to Christian values. However, information is not enough. Man needs also motivation. It is just not true that if he knows the right thing to do, he will automatically do it. He needs to be motivated to do it. It is just here that the Christian church can make a vital contribution with its message that human, nature and human conduct can be changed. This is the message of the gospel and this is the answer to AIDS. If a man, or woman, knows that the body of the Christian is the temple of the Holy Spirit (1 Cor. 3:16) then the risk of HIV infection is removed. It is the church’s responsibility that the education of those at risk of HIV infection is not confined to biology, but firmly set in the context of Christian values and Christian ethics. Inthis way the church will be practising true preventive health care.

The care of persons with HIV infection

At present there is no cure for AIDS, only drugs which may delay its progression. The treatment of AIDS is therefore palliative and needs to cover all aspects of the life of those affected by the syndrome. These will include personal, domestic, social and spiritual aspects. They demand the total care of the whole person. This again is where the Christian community can make an important contribution. There is much useful guidance about ways in which this might be done in these five books, notably those by Dixon and Kirkpatrick.

The challenge of the future

It is widely believed that the world is still only in the early phase of a global and fatal epidemic. This situation presents a challenge to Christian members of the caring professions and to the Christian community as a whole. There are signs that the church is beginning to respond by the appointment of specialist workers and the planning of AIDS hospices, but much more will be needed in the years to come. Let us hope and pray that the church will be able to take an effective part in combatting this twentieth-century plague, and not be found wanting in the hour of human need.

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