AIDS, often in silence
By JUDY L. THOMAS - The Kansas City Star
Date: 01/29/00 22:15
Hundreds of Roman Catholic priests across the United States have died of AIDS-related illnesses, and hundreds more are living with HIV, the virus that causes the disease.
The actual number of AIDS deaths is difficult to determine. But it appears priests are dying of AIDS at a rate at least four times that of the general U.S. population, according to estimates from medical experts and priests and an analysis of health statistics by The Kansas City Star.
In Missouri and Kansas alone, at least 16 priests and two religious-order brothers have died of AIDS since early 1987.
The deaths are of such concern to the church that most dioceses and religious orders now require applicants for the priesthood to take an HIV-antibody test before their ordination.
For the nation's 60 million Catholics, served by 46,000 priests, the AIDS issue goes straight to the heart of church doctrine -- a doctrine that teaches compassion and forgiveness but also considers homosexual relations a sin and opposes the modern practice of "safe sex."
In a nationwide confidential survey of 3,000 priests by The Star, two-thirds of the more than 800 responding lauded the church for being caring and compassionate to priests with AIDS. Often, the church covers medical costs, gives them a place to live and cares for them until they die.
Most priests, however, said the church failed to offer an early and effective sexual education that might have prevented infection in the first place. Two-thirds said sexuality either was not addressed at all or was not discussed adequately in the seminary. Three of four said the church needed to offer more education about sexual issues.
"Sexuality still needs to be talked about and dealt with," said the Rev. Dennis Rausch, a priest with AIDS who runs an AIDS ministry program for Catholic Charities in the Archdiocese of Miami.
"I've been trying to get into the seminary here for the last several years to do an awareness course for the guys, so when they come out, they at least have some knowledge."
Many priests and behavioral experts argue that the church's adherence to 12th-century doctrine about the virtues of celibacy and its teachings on homosexuality have contributed to the spread of AIDS within the clergy. Unwittingly, the church has kept fledgling priests -- some of whom were as young as 14 when they entered seminary in the '60s and '70s -- uneducated about the reality of a sexual world and its temptations.
Moreover, by treating homosexual acts as an abomination and the breaking of celibacy vows as shameful, the church has scared priests into silence, some say.
"I think this speaks to a failure on the part of the church," said Auxiliary Bishop Thomas Gumbleton of the Archdiocese of Detroit. "Gay priests and heterosexual priests didn't know how to handle their sexuality, their sexual drive. And so they would handle it in ways that were not healthy.
"How to be celibate and to be gay at the same time, and how to be celibate and heterosexual at the same time, that's what we were never really taught how to do. And that was a major failing."
Roman Catholic cardinals in the United States and high-ranking church officials in Rome declined requests to discuss the issue. The Vatican referred questions to local bishops.
In a statement released Saturday, the Rev. Patrick J. Rush, vicar general of the Catholic Diocese of Kansas City-St. Joseph, said: "The numbers of HIV-AIDS deaths of ordained clergy pale in comparison to the tidal wave in our country and throughout the world. Through their ministries, all of our priests offer their lives to serve others."
Rush said the Catholic Church has responded with compassion to those who suffer from AIDS.
"Faith reminds us that the afflicted are our brothers and sisters, men and women in God's image. They deserve our care, respect and support."
In an earlier interview, Bishop Raymond J. Boland of the Diocese of Kansas City-St. Joseph said the AIDS deaths show that priests are human.
"Much as we would regret it, it shows that human nature is human nature," Boland said. "And all of us are heirs to all of the misfortunes that can be foisted upon the human race."
Boland thinks church leaders now are doing a better job.
"I do feel today that a lot of our men get many opportunities -- the standard of spiritual direction, the standard of formation is much higher," Boland said. "And in all of the seminaries, we have people who are trained counselors."
Through the years, the issue of AIDS deaths among priests has been so sensitive that many of those who later died kept their illnesses a secret. Some death certificates listed AIDS-related conditions such as pneumocystis pneumonia but never mentioned the disease itself. Other certificates were falsified.
But within the church, many have been touched by the disease. To the surprise of researchers and some church officials, 801 priests responded to The Star's survey on AIDS and the priesthood -- a response rate of 27 percent. Nearly 60 percent said they personally knew at least one priest who had died of AIDS. And one in three said they knew priests who were living with HIV or AIDS.
The survey had a margin of error of 3.5 percentage points.
The Rev. Tom Casey, an Augustinian priest from the Boston area, cared for a priest who died of AIDS in 1991. Casey said the church bears some of the blame for his death.
"They have created a tremendous amount of homophobia," Casey said. "They're schizophrenic in the sense that they're wonderful when it comes to caring for people, but on the other hand, most churches don't generally have a healthy understanding of sexuality."
Casey said his friend, a deeply spiritual man, contracted AIDS through sexual relations.
"Part of it was repression, denial, and an acting out, which he realized was inappropriate," Casey said. "But because of that one part of his life that he had not addressed openly, it turned out, unfortunately, to be deadly."
The Catholic Church clearly is not alone. Clergy in other denominations also struggle with sexuality and have died of AIDS. But the Catholic Church's condemnation of homosexual acts, its requirement that priests be male and its unique demand of celibacy make the issue all the more vexing for its followers.
"There are some very strong social implications behind this," said Robert Goss, a former Jesuit priest who is now chairman of the Department of Religious Studies at Webster University in St. Louis.
Gays are in the priesthood, and not all of them are celibate, he said.
"Both of those issues are explosive issues that superiors and bishops don't want to deal with publicly."
Goss himself left the priesthood after 11 years when he fell in love with a seminarian who was just shy of ordination. The two became longtime partners. The former seminarian died of AIDS in 1992.
Several church leaders respond that the church is dealing with the issue forthrightly. Any criticism, they say, must be tempered by the realization that many priests wish to keep their medical condition private, as do many AIDS sufferers outside the church.
Seminary education on sexuality has been slow to evolve, but so has the acceptance of homosexuality and the understanding of AIDS in the general population. Many of today's priests, whose average age is about 60, entered the seminary in the 1960s, the age of "free love" and sexual experimentation -- not HIV awareness.
The church hasn't abandoned its priests who have HIV or AIDS, some say, and often celebrates their accomplishments.
"There are priests who are gay, there are priests with AIDS, there are priests who are different that are doing wonderful ministry," said the Rev. Jim Nickel, director of pastoral care for Damien Ministries in Washington, D.C.
"No matter what their frailties, no matter what their history, no matter what
their differences, there are people out there who are making a difference."
Hiding the truth
Exactly how many priests have died of AIDS or are infected with HIV is unknown, in part because many suffer in solitude.
When priests do tell their superiors, the cases generally are handled quietly, either at the priests' requests or because church officials are reluctant to discuss them.
In 1995, Bishop Emerson J. Moore left the Archdiocese of New York and went to Minnesota, where he died in a hospice of an AIDS-related illness. His death certificate attributed his death to "unknown natural causes" and listed his occupation as "laborer" in the manufacturing industry.
After a Minnesota AIDS activist filed a complaint, officials changed the cause of death to "HIV-related illness." The occupation, however, has not been corrected.
"I think there's still a lot of shame and dysfunction there," said Sue Ledbetter, who helped form an AIDS support group in Wichita in the early 1980s. "In the early days, they wouldn't even recognize AIDS on death certificates. They would put things like `died of pneumonia, hepatitis.' And the priests probably did have those things. But they got those things because of complications from HIV and AIDS."
Farley Cleghorn, an epidemiologist with the Institute of Human Virology in Baltimore, said it was common practice with early cases not to disclose AIDS as a cause of death.
"The first priest that I saw with AIDS -- this was back in 1982 -- we did not put AIDS on the death certificate, because they wanted us not to," Cleghorn said.
"The law says that you have to be truthful in that it's a legal document, and if you lie on a legal document, you could incur penalties. But there is no auditing procedure for a death certificate. And without lying, you could say that the terminal event was the stopping of the heart and the cessation of respiration."
Cleghorn said he has treated about 20 priests and religious-order brothers with AIDS, all of whom had kept it a secret.
"The church and religious orders need to acknowledge that there is a problem -- that priests have sex and they are susceptible to all sexually transmitted diseases, including AIDS," Cleghorn said.
"I think the most important message is that, just like every other part of the population, priests need sex education and sexual disease prevention."
In the early 1990s, experts who counseled and treated priests with AIDS estimated that about 200 in the United States either had died of AIDS or had contracted the disease. Now, those who work with infected priests say the numbers are higher.
"You're talking several hundred," said the Rev. Jon Fuller, a Jesuit priest and physician who serves as assistant director of Boston Medical Center's Clinical AIDS Program.
The Star alone -- through death certificates and interviews with fellow priests and family members -- found information on about 100 priests who have died of AIDS nationwide since the mid-1980s.
And many priests and medical experts now agree that at least 300 priests have died. That translates into an annualized AIDS-related death rate of about 4 per 10,000 -- four times that of the general population's rate of roughly 1 per 10,000 and about double the death rate of the adult male population.
Other statistics and experts suggest that those estimates are too conservative.
For example, the annualized death rate of priests confirmed by The Star to have died of AIDS in Kansas and Missouri from 1987 to 1999 is 7 per 10,000, or seven times that of the general population.
That death rate is consistent with the rate calculated by The Star after reviewing death certificates of priests who died in California, Missouri and Massachusetts in 1995. The finding: six priests -- or 7.3 per 10,000 -- died of AIDS in those states that year. The AIDS death rate of the general population in those three states in 1995 was 1.8 per 10,000.
A.W. Richard Sipe, a former priest who has spent more than 30 years studying sexuality issues in the church, thinks that about 750 priests nationwide have died of such illnesses. That would translate into an AIDS-related death rate eight times that of the general population.
Joseph Barone, a New Jersey psychiatrist and AIDS expert, puts the number of U.S. priests who have died at 1,000 -- nearly 11 times the rate of the general population.
Barone directed an AIDS ministry from 1983 to 1993 for students at North American College in Rome. While there, he set up an underground AIDS testing program. Over seven years, he tested dozens of seminarians. Barone gave them false names, drove them to their tests in an unmarked car and paid for the tests himself.
"I didn't know who they were; they didn't know who I was," Barone said.
Of those he worked with, he said, 1 in 12 tested HIV-positive.
By the time Barone left Rome, he had treated about 80 priests with AIDS. Most of them were gay, he said, and contracted the disease through sexual activity.
"The tragedy is many of them have been so duplicitous and so closeted," said Barone, a member of the National Catholic AIDS Network.
"They didn't realize what they were doing, not only to themselves, but to other individuals, because of the exponential transmission rate."
Another researcher who has extensively studied the issue of AIDS within the church is the Rev. Thomas Crangle, a Franciscan priest in the Capuchin order in Passaic, N.J. In 1990, Crangle conducted a mail survey of hundreds of priests selected at random.
Crangle said that of the 500 surveys he sent, 398 were returned. About 45 percent of those responding volunteered that they were gay, and 92 -- nearly one-fourth -- said they had AIDS.
"I was surprised," Crangle said. "I felt there was a problem, but I didn't think
it was of that magnitude."
`It's never fair to presume'
Many Catholics say it is irrelevant how the priests contracted AIDS. Some caution that it would be wrong to assume that all priests with HIV became infected by engaging in homosexual activity.
"I would never ask a priest how he got it, just like nobody asked me two years ago how I got cancer of the colon," Boland said. "But I would provide for him. I would not write him off and say, `Because you've got AIDS and because there are doubts about how one can acquire it, therefore you're not a good priest.' "
HIV is spread most commonly by sexual contact with an infected partner. In the early years of the pandemic, most of those with AIDS in the United States were white men who contracted HIV through homosexual relations.
The disease also is transmitted through heterosexual contact, blood transfusions (although the risk is extremely small today), dirty needles during intravenous drug use, or from infected mothers to their babies during pregnancy or birth.
Experts say the incidence of AIDS among priests stems primarily from sexual contact.
As long ago as the early 1980s, the Rev. John Keenan discovered that Catholic priests were contracting AIDS at an alarming rate.
"We looked at what was taking place in the gay Catholic population, and there was a lot of concern about the epidemic proportions of HIV," said Keenan, a Blessed Sacrament priest and clinical psychologist who runs Trinity House in Chicago, an outpatient clinic for priests.
Keenan and his staff developed an anonymous AIDS testing program, then notified priests, bishops and superiors of religious communities.
The response surprised him.
"Originally, it was just for people in our region," Keenan said. "And then we started getting people from all over."
Keenan now runs weekly support sessions for infected priests. He believes most priests with AIDS contracted the disease through same-sex relations. He said he treated one priest who had infected eight other priests.
Charlie Isola, a New York City social worker and psychotherapist, said all the priests with AIDS that he has treated are gay men in their 40s to early 60s who became infected through same-sex relations.
"Some of them had sexual contact in the seminary which continued after ordination, and some of the men had their first sexual contact with other priests or with laymen after they were ordained," Isola said.
Other means of transmission, however, can't be ruled out, since many priests have served as missionaries in countries that have poor medical practices.
The Rev. Luis Olivares, 59, pastor of Our Lady Queen of Angels Church and an activist who ministered to poor immigrants in Los Angeles, died of AIDS in March 1993. Doctors thought Olivares contracted HIV from contaminated needles while being treated for an injury during a visit to Central America.
"I think it's important for people to remember that it's never fair to presume how somebody got it," said Fuller, the Jesuit priest and doctor. "It isn't really relevant."
More important, Fuller said, is the question of when a person contracted AIDS. Because the virus has a long incubation period, a priest may have become infected before taking his vows, Fuller said.
Others argue that failing to address how the priests were infected shows that the church is in denial about the issue.
"The thing about this is it's a public manifestation of the fact that this guy is sexually active," said Maureen Fiedler, director of Catholics Speak Out, a national group based in Hyattsville, Md., that is critical of some of the church's positions.
"And the church just doesn't want to admit it."
A teachable moment
Like some others with AIDS, many priests keep their illnesses hidden for as long as they can. Yet when priests finally do open up, their bishops or superiors generally treat them with compassion.
One of the first priests with AIDS to attract national attention was the Rev. Michael R. Peterson. Peterson was a priest of the Archdiocese of Washington and founder of St. Luke Institute, a psychiatric hospital in Maryland for Catholic priests and religious-order men and women. He died in 1987 at age 44.
The month before Peterson died, he and Washington's Archbishop James Hickey sent a letter to the priests of his diocese and to every Catholic bishop and religious superior in the country.
"I hope that in my own struggle with this disease, in finally acknowledging that I have this lethal syndrome, there might come some measure of compassion, understanding and healing for me and for others with it -- especially those who face this disease alone and in fear," Peterson wrote.
Hickey -- now a cardinal -- added, "Father Peterson's illness reminds us in a personal way of the terrible human tragedy of AIDS in our midst. His suffering challenges us to reach out with renewed conviction and compassion to those with AIDS and their families and friends."
Boland was working in Washington at the time and was friends with Peterson. When Peterson died, Hickey sent Boland to the hospital to identify the body.
"We had his funeral in the cathedral, and the archbishop talked about it," Boland recalled. "You talk about a teachable moment. First of all there was a shock, but when that wore off, they said, `Gee, this maybe is the model of how we should deal with people in this situation. Even a priest.' "
Peterson's openness and the church's acknowledgment that he had AIDS have been
the exception, not the norm. Though more than 12 years have passed, many priests
with AIDS continue to suffer in silence.
Missed opportunity?
The Rev. Harry Morrison entered the seminary in 1969 after graduating from college. Though older than many fellow seminarians, he wasn't any wiser when it came to sex.
Several years in the seminary didn't help.
"When young men go into seminary, they don't even know what celibacy is," said Morrison, a California priest who has AIDS. "A lot of this technical language, these Latin phrases, all you know is there's something to be afraid of. You don't even know exactly what it means."
Morrison said one phrase seminarians learned was adverte oculos.
"That's an old, old, old admonition," he said. "It means turn away your eyes. Eye contact is dangerous. And that's all a seminary faculty member would have to say. They would walk past you and they would just simply say, `Custody of the eyes."'
Another warning was about "particular friendships."
"That was the main issue," Morrison said. "In a seminary, you're not supposed to have particular friendships, because they can lead to perdition."
Lack of education and inadequate preparation on sexual issues continues to be a problem in the seminaries, many priests and behavioral experts said.
"In my experience, the great majority of the priests who take that vow are really not developed enough psychosexually," said Isola, the New York therapist.
"During seminary, the questions about sex or homosexuality or sexual feelings were usually dealt with by the novicemaster or the head of training saying, `If you say the Mass every day and say the rosary every day, the rest of it will take care of itself,' which for many of them just doesn't work."
Several priests, responding confidentially to The Star's survey, offered similar comments.
"I don't think the real problem is HIV/AIDS but rather the basic dishonesty of the church with regard to all sexuality," wrote one gay priest. "Priests and others have to disguise and hide their sexuality in all sorts of ways and of course this leads to unhealthy sexual expression."
Some priests say the church was warned nearly 30 years ago that such problems could develop but failed to take steps to prevent them.
In 1967, the U.S. Catholic bishops voted to conduct an extensive study of the life and ministry of the American priest. The U.S. Catholic Conference published the findings in a 1972 book called The Catholic Priest in the United States: Psychological Investigations.
Most significant among the findings was that a large proportion of priests were psychologically underdeveloped and had failed to achieve a healthy sexual identity.
"For whatever reasons, these priests have not resolved the problems which are ordinarily worked through during the time of adolescence," the report said. "Sexual feelings are a source of conflict and difficulty and much energy goes into suppressing them or the effort to distract themselves from them.
"Most report that their education about sexual development was negative or non-existent; many report no normal developmental social experience."
Gumbleton said the church missed an opportunity in the '70s when the bishops received the report.
"They made it very clear that we had major problems because of underdevelopment of two-thirds of the priests of this country," he said. "It brought out the facts and would have been the basis for developing programs within the seminary to help people to grow into healthy adults with integrated sexuality.
"The report was given to the bishops, and they just said `Thank you.'...It was a disaster. That study was one of the best things we ever did. I was totally frustrated at the time, and I still remain frustrated. I've always thought that was a huge failure on the part of the conference of bishops."
In 1983, the National Conference of Catholic Bishops' Committee on Priestly Life and Ministry followed up with a 59-page booklet called "Human Sexuality and the Ordained Priesthood."
The booklet's purpose was to provide "a structured, objective basis for priests and bishops to reflect personally and talk about some important realities -- realities which otherwise might not get looked at or dealt with helpfully."
Topics included celibacy, loneliness and relationships. Three pages dealt with homosexuality.
It was, said a priest responding to The Star's survey, "one of the most neglected documents in recent years."
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