During the last three days of January, after an 18-month exploration of the topic, The Kansas City Star published a series of articles on cases of AIDS among Catholic priests. Propelled by the assertion that "priests are dying of AIDS at a rate at least four times that of the general U.S. population," the story was picked up by news outlets across the country and around the world. In response to criticism of the authors’ methods for comparing death rates in the general population and those of priests, The Star subsequently modified its story. The amended version indicated that the rate was "about double the death rate of the adult male population," although this detail was apparently not included in the original, nationally circulated story.
First, what about the numbers? In my experience with religious orders of men, it is not uncommon to observe H.I.V. infection rates of 0.25 percent to 1 percent, comparable to the United Nations AIDS Program’s estimate of 0.5 percent for the rate of H.I.V. infection among adults in the United States. So yes, The Star’s numbers are plausible. But even though the proportion of priests and religious who are homosexual appears to be higher than in the general population (with variation probably occurring by geographic region and in different historical periods), the data for priests do not compare with highly sexually active gay populations, in which rates as high as 50 percent have been documented.
But beyond concern about accuracy of the numbers, my initial reaction was to ask: "Why is this story getting so much attention now?" Is it that people are surprised priests have developed AIDS, or that some are homosexual? The data are certainly not new. The fact that priests have been stricken with H.I.V.-AIDS has been noted in local and national newspapers and magazines, in The National Catholic Reporter and Origins, in books written by priests living with AIDS and in AIDS quilts made for the Names Project. Many have been quite open about their diagnoses while remaining actively engaged in ministry.
Nevertheless, these articles have brought the issue to a markedly wider audience and provide the opportunity to highlight a series of related developments. These include my impression that the number of new infections among clergy and religious has actually trended downward over time, that the church’s response to infected clergy has become more enlightened and compassionate and, most important, that there has been a significant evolution in how sexuality and psychosexual development are understood and incorporated into formation programs.
My association with this topic has involved caring for priests and religious living with H.I.V.-AIDS since the 1980’s. But it has also included efforts (with the National Catholic AIDS Network and the National Federation of Priests Councils) to inform superiors, vocation directors and bishops who have struggled to deal with cases of infected individuals and who have also sought to understand how to diminish the risk that other members could become H.I.V.-infected.
Central to many workshops on AIDS for religious and diocesan leaders have been panels of priests and religious living with H.I.V. infection. During the first such conference (organized by Damien Ministries in 1988), participating priests felt so stigmatized and fearful of negative repercussions that they wore paper bags over their heads as they shared their experiences.
Over the years panelists have spoken of never being able to talk about their sexuality, and of living in fear that they would be rejected or ostracized if their homosexuality were discovered. They have reported internal or extrinsic pressure to appear or "pass" as heterosexual, and have felt inhibited from discussing the challenges of being faithful to their vows as they have moved through different stages of adulthood. They have spoken of living in fear that they might have acquired H.I.V., of how difficult it was to come to terms with the reality of their infection once diagnosed and of how denial and shame sometimes delayed their seeking medical attention. They have spoken of being afraid and ashamed to disclose their infected status to superiors and peers, and of worrying that they might cause scandal. They have feared that they might be withdrawn from ministry and relocated geographically, or that they might be dismissed and cut off from personal and financial support. They have described their desires to remain active in ministry and to be open about their H.I.V. status with the communities they serve. And they have shared the difficulties of living with complicated medical regimens, and how they have approachedsometimes with feartheir own process of dying.
These workshops and conferences have addressed caring for infected members, as well as the ethical, clinical and juridical complexities in developing policies on the testing of candidates for H.I.V. infection. But they have also drawn attention to what conference participants frequently pointed out were fundamental issues underlying the stories they had heard: how human sexuality has been inadequately considered and incorporated into formation programs.
If there is a silver lining to the tragedy of priests and religious dying of AIDS, it is in the vastly increased attention given to the area of psychosexual development in the training of clergy and religious. For example, not 20 years ago I was chastised by a major superior for being involved with efforts to promote dialogue between heterosexual and homosexual members of a religious order. I was told that such conversations were inappropriate because "we have put sexuality behind us and we don’t need to deal with those questions." This attitude has unfortunately led to an atmosphere in which sexual issues were simply not talked about, and where shame and stigmatization prevented an open discussion of the challenges that all vowed religious and priests face as they grow into mature expression of their vows.
Experience has taught that authentic psychosexual development simply cannot occur when sexuality in general, and sexual orientation in particular, are treated as subterranean topics. Whether or not it is permissible to speak about one’s sexuality and orientation in seminaries or religious life, sooner or later individuals will come to terms with who they are, whether at age 25, 35 or 65.
It is true that one should never presume that H.I.V. infections among clergy and religious are the result of sexual activity in violation of the vows; cases have occurred from transfused blood, from administration of clotting factors and from H.I.V. infections acquired before entering the seminary or religious order. However, in my estimation, many instances of AIDS among religious and priests in the United States are at least partly related to a history of inattention to psychosexual development in formation programs and to the strongly negative attitude of the church toward homosexuality. This has made it difficult, if not impossible, for many gay persons to feel confident and healthy about who they are, and even to accept the fact that they are homosexual. As J. A. Loftus, S.J., former director of the Southdown treatment center in Canada has described, some gay persons are so homophobic and afraid of being stigmatized that they are unable to acknowledge themselves as gay even though they may be engaging in frankly homosexual behavior (Clergy and Religious Exposed to AIDS, Emmanuel Convalescent Foundation, 1989). In addition to making it impossible for them to hear preventive messages directed toward the gay community, this is evidence of a pathological disconnection between self-identity and evident sexual orientation.
In many circumstances in which vowed religious have become infected with H.I.V., this has been the result of finally dealing with sexual feelings that have erupted after years or decades of being submerged. Where there has been silence on these issues, instead of a proactive, systematic treatment of integrating sexuality with celibacy, an adolescent-like exploration of relationships may occur. If one’s orientation has been treated as unacceptable and one has never learned to develop authentic and appropriate intimate friendships, this exploration may include furtive sexual contacts that can place individuals at high risk for acquiring H.I.V. infection.
Partly as a result of the church’s experience with H.I.V.-infected clergy and religious, I believe that a sea change is occurring in this area (albeit more often in religious orders than in the training of diocesan clergy). We are recognizing the absolute necessity of dealing openly, realistically and respectfully with the fact that orders and dioceses are made up of human beings who share the same spectrum of sexual orientations as the population at large. Religious orders in particular have recognized that, if they are to form individuals who can minister effectively in contemporary society, their members cannot be "asexual" but must be possessed of a consolidated understanding of their sexuality. They must be able consciously to attend to the challenges of living celibacy that will continue to evolve as they advance through the stages of adult development.
As superiors have learned to care for infected clergy and religious, they have also learned to listen attentively to the lived experience of gay priests and religious. This has led to a more widespread acknowledgment that diocesan presbyterates and religious communities include gay members, and to the realization that the strength of such an organization and the union of its members depend upon mutual trust, understanding and respect. It has revealed that the central issue is not one’s sexual orientation, but that one be fully integrated, authentic, faithful to the vows and capable of working and living with persons of other sexual orientations as one exercises the priestly ministry or lives the order’s charism. It has spawned formation programs that develop individuals with interior freedom, integrity, self-knowledge and self-confidence because they believe that along with their vocations, their sexual orientations, whether heterosexual or homosexual, are also gifts from God.
It gives one hope to observe developments in religious formation over the last 20 years, but the process of moving forward in our understanding of human sexuality through reflection on experience needs also to occur in the church at large. Even a cursory review of comments that readers have posted on The Star’s Web site (http://www.kcstar.com/projects/priests) indicates a wide spectrum of perspectives and feelings on this topic, ranging from relief that the issue is finally being aired, to rage at the very concept of homosexual priests, to compassionate awareness that clergy are so human that they, too, can make mistakes.
In every instance I know in which a priest has revealed his H.I.V.-AIDS status to the parish or school he serves, the response has not been judgment or ostracism but an outpouring of concern and support. Parish members providing 24-hour care to their priest as he approaches death is a revelation of the loving energy of reconciliation radiating from the heart of the church, an energy that I hope can empower our continued efforts to engage in dialogue on the complexity and mystery of God’s gifts of sexuality and human dignity.
Jon Fuller, S.J., M.D., was the founding president of the National Catholic AIDS Network and is assistant director of the Adult AIDS Program at Boston Medical Center. He teaches at Boston University School of Medicine, Weston Jesuit School of Theology and Harvard Divinity School.