By Stephen W. Hiemstra
The radio silence today on discussions of morality is killing people.
In my annual physical this year, my doctor indicated that Baby Boomers are now considered at risk for hepatitis C and require routine screening. The key justification for this recommendation was:
“There is increasing HCV [hepatitis C virus]-associated morbidity and mortality, as annual HCV-associated mortality in the US increased more than 50% from 1999 to 2007 [currently 3.5 million cases]. People born 1945-1965 with hepatitis C face increasing hepatitis C-associated morbidity and mortality.” (CDC 2019b)
What stuns the heart is how hepatitis is usually contracted. The Center for Disease Control and Prevention (CDC) reports:
“Although transmission via injection drug use remains the most common mode of HCV acquisition in the United States, sexual transmission is an important mode of acquisition among HIV-infected MSM [men having sex with men] with risk factors, including those who participate in unprotected anal intercourse, use sex toys, and use non-injection drugs.” (CDC 2019a)
While one might contract hepatitis in a third-world country through exposure to unprotected water, in the United States one generally needs to engage in high-risk behavior to contract the disease. In this context, thoughtful teaching about the morality of avoiding high-risk behavior can save lives and reduce much suffering.
Public Health Crises
High-risk behavior has become a public health hazard in the United States . Given our recent experience with Acquired Immuno-Deficiency Syndrome (AIDS), this conclusion should come as no surprise.
Roughly 675,000 people have died in the United States from AIDS according to the CDC (2016). In addition, there were 1.1 million people in the United States infected with AIDS in 2015. Two-thirds of them were gay men. Most of the rest have been intravenous drug users, although spouses of victims can also contract the disease. The average lifetime treatment cost in 2010 dollars was: $379,668, which implies a drug market of roughly half a trillion dollars, one of the nation’s largest (CDC 2017, 2018a).
On top of HCV and human immunodeficiency virus (HIV) infection, the number of sexually transmitted diseases (STDs—chlamydia, gonorrhea, syphilis, and chancroid) have growing rapidly over the past decade, especially among millennials and the elderly. A thirty-one percent increase between 2012 and 2017 (2.3 million cases) reported STDs cases reversed a downward decline in reported cases that began in the 1940s (CDC. 2018b). Today’s sexual liberality bears much of the blame for these outcomes.
You may be thinking, why do I care? Isn’t using a condom sufficient caution and isn’t there a pill for every one of these diseases? The answer today is a qualified yes. Yes—if you are diagnosed early, then these diseases are treatable and there may even soon be a cure for AIDS.
The trouble is that not everyone has a health plan and gets a prompt diagnosis—sex has an addictive quality that often leads to taking more risks. More troubling is the observation that diseases often mutate into new, more viral strains—twenty years ago no one had heard of HCV and before 1980 no one had heard of HIV.
For those that want to limit this conversation to the realm of personal freedom and conversations with their doctors, the opioid crisis raises the specter of conflicting incentives in the health care system.1 Treating AIDS is expensive and it may also be more profitable than treating other illnesses. What happens if drug companies and other health care providers become complicit in promoting alternative lifestyles motivated by their economic interest rather than concern for those afflicted?2
Who exactly can you trust when a lot of money is changing hands?
Toward a Christian Perspective
An ounce of prevention is worth a pound of cure.
Before any conversation about moral behavior, know that God loves you because he created you and sent his son, Jesus Christ, to die for you. God’s love is extended unconditionally, irrespective of your health care status. But God’s love is a gift that must be accepted. The consequences of rejecting God’s love (or holding it lightly) can be severe.
The teaching of the church on the question of human sexuality has been clear since biblical times (Fortson and Grams 2016). Sex is reserved for married couples in a lifelong relationship between one man and one woman. All other sexual activity is sin, something that Christians are advised to avoid (Gagnon 2001).
The focus of a disciplined life is ideally on God. Extramarital sex leads to other priorities and denigrates the image of God that we should normally look for in other people.3 One pastor I know makes the point that he always knows when kids start having sex because they soon drop out of church.
Knowing that the health care consequences of sexual immorality in this world can be severe, the critical question for those wavering on their response: if by your words you lead someone else into risky behavior, are you okay with the pain and other consequences? Are you okay, for example, with the problem that rising health care costs mean that more young mothers cannot afford care for their kids?
One of the most tortured women that I ever met was an HIV-positive prostitute who lost custody of her kids back in 2011. At one point she considered herself a consenting adult. Now, her kids have lost their mother. We cannot anticipate all the consequences of our decisions—the best we can do is to rely on God’s help to make better decisions.
If it is too late to worry about the above question, remember that we worship a God of second chances. Turn to him and find forgiveness, remembering Jesus’ words to the woman caught in adultery.4
Campbell, W. P. 2010. Turning Controversy into Church Ministry: A Christlike Response to Homosexuality. Grand Rapids: Zondervan. (review)
Center for Disease Control (CDC). 2016. “Today’s HIV/AIDS Epidemic.” CDC Factsheet. Online: https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/todaysepidemic-508.pdf. Accessed: 8 January 2019.
Center for Disease Control (CDC). 2017. HIV Cost-effectiveness. Online: https://www.cdc.gov/hiv/programresources/guidance/costeffectiveness/index.html. Accessed: 8 January 2019.
Center for Disease Control (CDC). 2018a. Basic Statistics [on AIDS]. Online: https://www.cdc.gov/hiv/basics/statistics.html. Accessed: 8 January 2019.
Center for Behavioral Health Statistics and Quality (CBHSQ). 2015. Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (Health and Human Services (HHS) Publication No. SMA 15-4927, NSDUH Series H-50). Retrieved from http://www.samhsa.gov/data. (Cited: 18 October 2018).
Center for Disease Control (CDC). 2018b. Sexually Transmitted Disease Surveillance 2017. Online: https://www.cdc.gov/std/stats17/2017-STD-Surveillance-Report_CDC-clearance-9.10.18.pdf. Cited: 24 September 2019.
Center for Disease Control and Prevention (CDC). 2019a. Epidemiology and Prevention of HIV and Viral Hepatitis Co-infections. Online: https://www.cdc.gov/hepatitis/populations/hiv.htm. Cited: 24 September 2019.
Center for Disease Control and Prevention (CDC). 2019b. CDC Recommendation: Adults Born from 1945-1965 (Baby Boomers) get Tested for Hepatitis C. Online: https://www.cdc.gov/hepatitis/populations/1945-1965.htm. Cited: 24 September 2019.
Fortson, S. Donald and Rollin G. Grams. 2016. Unchanging Witness: The Consistent Christian Teaching on Homosexuality in Scripture and Tradition. Nashville: B&H Academic.(review)
Gagnon, Robert A. J. 2001. The Bible and Homosexual Practice: Texts and Hermeneutics. Nashville: Abingdon Press. (review)
Pope Paul VI. 2014. On Human Life (Humanae Vitae). San Francisco: Ignatius Press. (review)
Washington Post (WP) 2019. “Follow The Post’s investigation of the opioid epidemic.” Online: https://www.washingtonpost.com/national/2019/07/20/opioid-files/?arc404=true. Cited: 24 September 2019.
Wener-Fligner, Zach. 2015. “Every US company arguing for the Supreme Court to legalize same-sex marriage.” March 10. Online: https://qz.com/359424/every-us-company-arguing-for-the-supreme-court-to-legalize-same-sex-marriage. Cited 24 September 2019.
1 More than 200,000 Americans have died from opioid overdoses. Many of these addictions began with prescription painkillers known to be addictive and very profitable for the companies producing them.. (e.g. WP 2019)
2 Among the 379 companies filling an amicus brief before the Supreme Court on Obergefell v. Hodges were some of the largest drug companies in the United States. (Wener-Fligner. 2015)
3 Mary Eberstadt cites four prophecies made in the Pope encyclical that appear to have taken place: “a general lowering of moral standards throughout society; a rise in infidelity; a lessening of respect for women by men; and the coercive use of reproductive technologies by governments.” (Pope Paul VI 2014, 11)
4 See John 8. A good book on ministering to homosexuals has been written by Campbell (2010)
Other ways to engage online: