If you ride New York City’s subways, you will see public service advertisements blazoned above you. Some come from “NYC Condom,” a service of the New York City Health Department, some from other groups (like the BACCHUS Initiatives of the National Association of Student Personnel Administrators). The messages come in snappy phrases and acronyms: “Take Pride. Take Care.” “Be Sexy. Be Safe.” Or the three “B’s” and three “S’s”: “B Smart. B Sexy. B Safe.”
This is America’s moral conscience at work: Have sex as you want, and wear a condom. It isn’t only the “safe” part, don’t get or give a disease, that constitutes the moral lesson. There’s also the “sexy” part: to “be you,” and to be “proud” of being you, do the sexy thing. They go together.
The very shallowness of the message is part of its destructiveness. Not only is the “safe” part not really true—condoms only kind of help, and they do nothing to fend off the emotional danger. To believe that “safe sex” is a mode of self-fulfillment is to embrace a lie about human personhood that harms the body and soul together. Still, it’s the prevailing message in America today, paid for by the nurturing parent of municipal care that hovers over the millions of young and old who travel the rattling subways on their way to and from the world’s financial center.
On the other side of the globe, the Christian Church offers another message. At a soccer match in Makamba, Burundi, two teams of teenagers go at it. One represents an Anglican school, the other another high school. The match is sponsored by the local Anglican church, and the announcer in the stands carries on over the loudspeaker as the game is played, vigorously describing the moves, failed shots, injuries, and tussles of the players while the crowd of several hundred young people watch, clap, moan, and cheer.
In the course of the game, though, the announcer interjects other comments. “Play well here, but don’t forget that your health depends on sexual abstinence until you’re married!” “Love the game, and love your friends. But love them enough to wait for marriage.” “The best athlete waits!”
At halftime, the bishop talks about the Christian understanding of sex and marriage, and God’s purposes for human flourishing. Then he thanks the group that helped make the game possible: UCE, which stands for Universal Chastity Education. UCE is a private Christian organization whose goal is to help reduce HIV/AIDS through sharing the Christian message of human fulfillment through grace-filled abstinence and the monogamous love of married life. Their work with Catholic, Anglican, and Lutheran churches in East Africa has inspired thousands of young people and changed their lives. The game continues.
The Christian Church has a distinct voice on the matter of human flourishing. In the wake of political changes in the West, that voice is now unique. When it comes to HIV/AIDS, there is nothing like it. As the AIDS crisis enveloped Africa, Western nations generously pressed the snappy acronym “ABC”—Abstinence, Be faithful, use a Condom—as a strategy for education and public health. It wasn’t the only message being disseminated, of course: Merely suggesting abstinence as a public health measure was viewed by some as an irresponsible intrusion of religious fundamentalism into politics. But even the letters of “ABC” didn’t add up. Churches realized that the last letter—condom use as a message—ended up derailing the first two letters, and the advice disintegrated. The message of human flourishing that the Gospel presents was richer and deeper, demanding more perseverant engagement than any acronym could offer. Physical and spiritual health needed to be joined. Working in Uganda and elsewhere, churches resisted “ABC” and pressed in another direction. The results were astonishing.
When Pope Benedict visited Cameroon in March 2009, he stated at one point that condom usage could not be the answer to the African AIDS pandemic, but might actually “make the problem worse.” Only abstinence outside of marriage and faithfulness within it could properly control the disease. News outlets quickly picked up these comments, and the pope was lambasted for ignorance and malfeasance both. Melinda Gates had earlier summed up the common view: “In the fight against AIDS, condoms save lives. If you oppose the distribution of condoms, something is more important to you than saving lives.”
It took a maverick academic to set the record straight: The Christian Church may be correct on the health front. In “Condoms, HIV-AIDS and Africa—The Pope Was Right,” a Washington Post op-ed (March 29, 2009), Edward C. Green pointed out what the research clearly demonstrated. Condoms could reduce HIV infection in carefully controlled commercial sex contexts (e.g., the Thai prostitution industry), but condom distribution and education haven’t worked in settings of relational breakdown, like East Africa, where it is common to have multiple sexual partners.
What does work? Green’s answer was straightforward: “Strategies that break up these multiple and concurrent sexual networks—or, in plain language, faithful mutual monogamy.” Green, a respected medical anthropologist, had labored extensively in researching this field. His 2003 book, Rethinking AIDS Prevention, showed how abstinence and faithfulness, for the most part in its religiously ordered form, had contributed more to Uganda’s striking reduction of its HIV infection rate in the late 1980s and early ’90s than “safe sex” could hope to. (A comparison with Botswana’s failed condom-oriented approach is heartrending.) The evidence supports the pope’s negative conclusion: Increased condom distribution was actually correlated to increased infection (an empirical observation the reasons for which remain debated). Green’s volume didn’t earn him embraces from many official agencies, but subsequent research by others has backed his conclusions.
Green is not a Christian. But he recognizes that the Church’s claims about health are spot-on. That these claims are bound up with the actual character of human life as God has framed it, furthermore, is a strikingly transformative message for those who grasp it. This is something that Uganda, at least for a while, experienced, and that other countries are learning as well. In these places and on this score, the Church is doing what she is supposed to do: providing a unique ministry of life-saving and soul-forming, through Christian witness. It is the kind of ministry that triumphantly presses against the life-draining messages of the urban subway underground. From Pentecostal communities like Deliverance Church in Kenya to international programs like Youth Alive, the reality of human beings as whole persons created by God forms the bedrock for transfigured practical existence.
Christian groups like Universal Chastity Education are the Church’s lifeblood in this kind of ministry, and are cause for celebration and support. UCE’s straightforward ministry reveals how Christian life may be spread within the desiccated channels of human culture. The group was started, almost serendipitously, by two American medical doctors, Kim and Ken Dernovsek (a dermatologist and endocrinologist), in conjunction with young Ugandan Christians. The Dernovseks were both Anglicans at the time (they have since joined the Catholic Church) and were visiting Uganda in 2003 on a medical exchange.
Kim’s work in dermatology made her the first professional to see local teenagers with sexually transmitted diseases (STDs) like herpes, chlamydia, and gonorrhea. She was already sensitized to problems arising from multiple sexual partnerships among young Americans. In Uganda, she applied her clinical experience, and a visit with the Uganda Christian Medical Fellowship led to a lecture at Makerere University. Two hundred people, many of them students, came to listen, and afterwards a small group approached her to solicit her help. She asked what she could do, and they showed her cards on which it was written “True Love Waits.” The cards were part of a LifeWay abstinence pledge program begun in the early 1990s. “We need more of these for the youth of Uganda,” they said. “It’s what we present to our spouses on our wedding day.”
Challenged by the encounter, the Dernovseks learned more about the work of young Christians in Uganda, and decided to join their medical expertise to the effort. With support from Anglican and then Roman Catholic bishops in the area, and initially relying on their own funds, they helped to organize Ugandan students who would take the message of abstinence and Christian devotion to secondary schools in the countryside. Within a few years, UCE programs spread to Burundi and to Tanzania. At least forty Catholic, Anglican, and Lutheran bishops officially endorsed their work, including Cardinal Emmanuel Wamala of Uganda. In every case, however, it was African Christians themselves who approached the organization, thirsting for a way to ease the suffering of their millions of compatriots with AIDS and to reorder the culture of undisciplined sexual encounters that lay behind much of the health crisis.
The realities of HIV/AIDS in sub-Saharan Africa remain staggering. The scourge of Ebola, with its close to 10,000 fatalities in 2014, pales in comparison with the 1.2 million who died of HIV/AIDS worldwide during the same year, of whom close to 800,000 were in Africa.
Westerners, however, seem to have lost interest. In Uganda, 80,000 to 100,000 people died of AIDS each year into the late 1990s. There are 3,700 new cases of HIV infection a day in sub-Saharan Africa, almost 90 percent of which are among those fifteen years and older. The numbers have improved, but remain grave. No one is inured to what is at stake. Every new generation, every new class in a secondary school, is faced with a challenge of life and death. The crisis touches on the intimacies of human relationship, and through that, the meaning of human existence itself.
HIV is not the only sexually transmitted disease, however. There are close to 20 million new cases of STD infection each year in the U.S. alone, half of which are among young people fifteen to twenty-four years of age. In Africa, that number is closer to 100 million each year. Many of these diseases, although curable in theory, lead to severe health complications, some of them mortal. While HIV/AIDS has been pushed into the shadows of North American experience, the larger challenges to sexual health unite young people in Africa and the West, which is not surprising given that sex and intimacy are common human realities.
The young Africans who do the work of UCE all understand this well. They are mostly university students or recent graduates who know firsthand the concrete stakes of personal sexual order. Some have had close relatives die of AIDS. They’ve witnessed the loss of friends and neighbors. More than that, though, each has had to navigate the overwhelming pressures of growing up in broken or impoverished societies where sex becomes one of the stepping stones to success and comfort, even if more often than not a standard stumbling block of horrendous proportions.
Pregnant teens routinely drop out of school—or are expelled. At the same time, girls are pressured by relatives, teachers, and administrators to exchange sexual favors for school tuition and good grades. For boys, a culture of poverty and scarcity offers evanescent self-esteem through sexual triumph. Traditional generational structures of authority have collapsed under multiple economic and political burdens in every region. Self-construction on the basis of sexual self-assertion is often seen as a necessity.
In this context, the antidote isn’t simply sexual discipline. Young people need more than that. What is required is a sense of being grasped by the absolute ordering love and power of God. When they experience this in the Church, they sense what it means to be a divinely wrought creature, with wonderful possibilities and promised gifts. The young volunteers and leaders of UCE in places like Uganda or Tanzania are not purveyors of sober sexual control. They offer, within a sphere their young peers can understand, a vision of life in God. And such life can shape a just society.
UCE’s workers are healing wounded communities. In Tanzania, Isaac Lema travels hundreds of miles by bus each month, between his university studies and his UCE work in the southeastern part of the country. He is a devout Lutheran who works with an energetic Catholic priest in the city of Iringa, a university center and truck-crossroads that has one of the highest HIV infection rates in the country. The concrete parish church has signs in Swahili plastered over the building asking for cell phones to be turned off during Mass. (No running water, but cell phones! It is one of the strange evolutions of contemporary global existence.) But as Isaac drives around the countryside, he takes a call on his mobile phone from a young student who wants to know how to deal with an uncle who demands sex for school fees. On another call, a young man trying to resist his peer group’s foray into rural assault on young women seeks advice. When not on his phone, Isaac organizes clubs that gather and discuss what it means to be a “whole” person before God, in body and spirit.
Jude Walubo is Isaac’s counterpart in Uganda. He is a young Catholic graduate in education who evolved from a quiet and gentle helper on UCE outreaches to an organizer of other volunteers, Anglican and Catholic, as they fan out in the Kasese diocese of northwestern Uganda. Speaking at schools to hundreds of students at a time, the UCE teams that Jude oversees share testimonies of personal faith and renewed self-respect; they answer questions; they sing and they pray. They ask students if they wish to pledge themselves to sexual abstinence until marriage and sexual fidelity within it. Where possible, students organize in the school for ongoing encouragement and support. Sometimes they gather in the open air to listen and participate as microphones and loudspeakers are set up, occasionally attached to car batteries. Sometimes they meet in classrooms, where individual students themselves rise and share their worries and testimonies.
UCE’s work is driven by the passions of young people like Jude and Isaac. In Burundi, Anglican Bishop Martin Nyaboho has organized a team from his diocese, Makamba, at the southeastern edge of the country. They work with schools, run seminars for young married couples, meet with the large community of sex workers in the border town of Nyanza Lac, broadcast a weekly radio program, and use the natural contexts of young people—like soccer matches—to share the message of creaturely self-respect and divine love. The popular singer Gérard Musumari joins the team at a high school as students cheer. Musumari’s immediate family was hit by AIDS, and he shares songs of hope, sexual self-restraint, and Christian strength.
Hope requires knowledge. Isaac has studied psychology and penned small books in Swahili that help teenagers understand their purpose and health. Sexual education is almost nonexistent in most parts of this region. The older traditional rites of passage are either disappearing or are unable to deal with digital pornography, urban anonymity, and the driving anxieties of an uncertain future. The UCE Manual on Sexuality from an African Christian Perspective has collated hundreds of anonymous student questions from secondary school events and given them a question-answer format. Can a girl get pregnant when she is dancing with a boy who has a secret ejaculation? Can mosquito bites spread HIV? The manual also addresses dangerous myths: if a boy wears a tight belt while having sex, can this prevent pregnancy? If one condom can’t guarantee 100 percent protection (at best 85 percent), are two condoms better protection than one? The book, now being distributed in English to hundreds of schools in Uganda and Tanzania, awaits further translation.
The manual also addresses questions about the Christian faith. Running through its responses is a message about the nature of human flourishing within the rich context of the Christian community. The politicization of the AIDS pandemic is one of the more degrading elements of the cultural battles that the West exported around the world. In the course of these struggles, unhealthy alliances and antagonisms of religious and political groups—Uganda being a prime example—have obscured the actual realities at stake. As Green found, it is barely possible for otherwise serious Western researchers to provide grudging approbation for the public health benefits of traditional Christian witness. Meanwhile, some Christian organizations undermine their witness because of their links to corrupt local political forces. Behind all this, however, are the realities of human transformation. This makes the Christian voice regarding human flourishing unique. Sexual discipline itself is not the fundamental issue; it is a sign of a more comprehensive life with God, among God’s people.
Nevaless Masika, a young Ugandan woman, heard several UCE presentations. It took time to think things through, but she finally accepted the Christian message. Before, she writes, “I had had a boyfriend who was married. I thought that I needed him to support me financially. After signing the commitment card, I left that man completely. I started a new journey of abstinence and the whole of me changed. I changed in terms of prayer. My behavior changed. My life changed, and I took opportunities to join church activities.” Nevaless joined a lay church group—the Legion of Mary—and became active in a range of ministries, including UCE itself. She tells young people that abstinence provides a context in which important goals can be pursued in the right order: health, schooling, and of course, the building up of one’s faith. “Remember [that God] forgives us, and even if we did not know of His way, we can change. He can purify us. God will call us home to live a blessed life with Him.”
For people like Masika, social and religious claims merge. UCE counts about 300,000 signed chastity pledges over the past decade. It is the kind of claim many secular critics mock. Yet schools where UCE has been regularly active have reported, over the course of three to four years, drastic drops in the rate of pregnancy among female students (from forty-nine one year to three at one school). More needs to be done to measure concrete results. But there is more going on than numbers. The American “ABC” health message is intrinsically limited by the poverty of its view of the meaning of our shared humanity. What is distinct about the Church’s voice amid the competing claims regarding human flourishing is the most obvious fact about the Church’s existence in the first place: the divine life in Christ.
The God who creates, purposes, forgives, empowers, and transforms inevitably makes discussion of sexual health a matter of “evangel,” or “good news.” By reorienting human life toward the practice of faithful generative love, God reveals himself within a realm of engraced existence that changes common life. In the small rural community of Gasaka, Burundi, not so distant in time from a long civil war, UCE club members from the local secondary school recently invited parents and the adult community to a set of presentations. They performed plays, skits, poems, and songs that endorsed chastity, within and outside of marriage, as a specifically Christian vision.
Some of the parents, illiterate subsistence farmers, stood up and expressed their astonishment at the wonderful things these young people had learned. Their own children, one parent said, had brought them a message of “a new way of living.” The adults asked to sign chastity commitment cards, pledging to be faithful in marriage and to God. Many of the parents could not read, write, or even “make their mark” on the commitment card. The students took the hands of their parents and helped them to sign. An entire community of generations was reconstituted within the created sphere of God’s love.
Being smart, safe, and sexy is not about a “new way of living.” It is about damage control within ways of living that are already out of control. When America’s civic culture promulgates its acronymic exhortations, it announces its own impotence as a formative culture. Something different happens when Muslim students in Tanzania listen to messages of “waiting” and “faithfulness” (the nation requires that groups like UCE address all faiths in their schools). This isn’t the expected Western assault on their culture. They hear, in fact, an invitation to a place of flourishing that is otherwise receding for young people around the world. Instead of encountering the scandal the West so often exports, they learn trust. This is the future.
There are around 1.2 million Americans who are infected with HIV today. Of the 50,000 new infections each year, about one-fourth are among young people, aged thirteen to twenty-four. These represent but a fraction of the 20 million new cases of STDs the U.S. sees each year, among young and old both. Meanwhile, every day, over 5.5 million riders on New York City’s subways stare at messages whose content represents defeat in the face of a voracious civilization of despair. Perhaps they look away and burrow back into their books or close their eyes amid the sealed chambers of their earphones. Here, everybody is urged to be proud in the solitude of their goalless desires.
The message of the Gospel stands above ground, in the light. It can be seen and heard by African and American alike. The last few years of cultural turmoil in the West and around the globe have begun to pull the veil from this reality, and inaugurated a new era of clarity. With it come ministries of clarity. Despite opposition from the devolved cultures of the West, they witness with a new freedom.
Ephraim Radner is professor of historical theology at Wycliffe College.