The Report of
The Committee to Formulate a Biblical Response
To the Epidemic of AIDS
The formation of this committee came as a result of the concern of members of the 105th Annual Conference to educate the members of our particular churches about the epidemic of AIDS. This epidemic is one of growing proportions and of great seriousness to the general well being of our nation. The church will not be able to side step this issue or ignore it. AIDS is a fact that we must not disregard. Billy Melvin of the National Association of Evangelicals writes, "If current projections hold true, every local church in our country will be impacted by the AIDS epidemic in the next five years."
The committee clarified its purposes as educational and of providing resources for the particular churches to help them respond biblically in their unique setting. Therefore, along with some basic content on AIDS, we are providing materials that we trust will give guidance in formulating policy at a local level.
I. Medical Considerations
The first indications that a new disease had developed began in 1979, when the center for Disease Control (CDC) in Atlanta, Georgia began to receive reports of a rare cancer called Kaposi's Sarcoma in the "wrong" patients. Kaposi's Sarcoma is a tumor of blood-vessel tissue in the skin or internal organs that had been known mainly among older Italian and Jewish men and in Africa. However, a more aggressive form of the same cancer began to appear among white middle-class males with a history of homosexuality. Secondly, the CDC noted a dramatic increase in pneumonia caused by a Pneumocystic carinii (a widespread but usually harmless protozoan) in this same group of men. Further investigation indicated that these men had a severe immunodeficiency. It seemed clear that an infectious form of immune deficiency was increasing and the name Acquired Immunodeficiency Disease Syndrome or AIDS was coined.
Since 1979, the number of cases of AIDS has increased dramatically each year. Understanding of the disease has increased; however, medical science is not close to finding a cure or even a good treatment for the disease.
AIDS is caused by a virus called the Human Immunodeficiency Virus or HIV. The HIV infects one of the body's white blood cells called the Helper T cell. The Helper T cell's function is to help other cells do their various jobs such as fighting foreign organisms, making antibody, and killing cancer and virus infected cells. The Helper T cells are essential for the other cells to perform their functions.
Once the HIV has infected the Helper T cell, it will incorporate its genetic material into the T cell's genetic material. The virus will remain latent or dormant, until it is activated to make more viruses. When it is activated, the virus reproduces itself rapidly, killing the Helper T cell in which it has been residing. The new viruses go on to infect more of the patient's Helper T cells. The HIV infected Helper T cells are not able to perform their normal functions and die as a result of virus reproduction. This results in a profound immunodeficiency in the patient.
The transmission of the HIV is accomplished in three ways. First, through sexual contact. In this way the virus enters the body through a damaged area of the mucosal membrane. The virus is transmitted more easily in homosexual relationships (male to male) for anatomical and behavioral reasons than heterosexual relationships. It is transmitted both male to female and female to male. However, it has not been observed to be transmitted by female homosexuals. Secondly, the virus is transmitted by contact with blood. The virus must enter the blood stream via a needle stick or a cut on the skin. Thirdly, there is congenital transmission where the virus can pass to the infant through the placenta or at birth when there may be a mixing of the infant's and mother's blood.
The virus has been isolated from a variety of body fluids, but given the fragile nature of HIV, the only infectious body fluids are blood and blood products, semen, vaginal secretions, and breast milk. The virus dies very quickly outside the body.
The Center for Disease Control and the National Institute of Health has defined four clinical groups or categories for people with AIDS. The first is Antibody Positive or HIV+. This is the largest group and it has been shown that they possess antibody to the HIV virus which indicates that they have been exposed to the virus. It is believed to take from 2 to 12 weeks and perhaps as long as 6 months for a person to become HIV+. These people are carriers who show no symptoms of the disease but they carry the virus and are able to spread it to others.
The second category is called the lymphadenopathy group. These patients are HIV+ and are able to spread the disease to others. In addition, they are experiencing some of the initial symptoms of AIDS. These symptoms include swollen lymph nodes and an enlarged spleen. The lymph nodes may increase and then decrease in size at different times during this stage. Other symptoms include fevers of unknown origin and weight loss.
AIDS - related complex (ARC) is the third clinical group. In addition to displaying the above characteristics, ARC patients experience general fatigue, a feeling of just not being well, diarrhea persisting as long as 8 weeks, and night sweats. Kaposi's Sarcoma and various lymphomas along with herpes simplex virus infections are seen. The patient may recover and go through a very healthy period before the symptoms reappear, and this pattern may occur several times a year.
The last group is those with fully developed AIDS. At this point in the disease the patient will have many opportunistic infections. Opportunistic infections are those caused by normally harmless organisms and they are indicative of some underlying disorder such as immunodeficiency, cancer, diabetes, etc. The patients usually die due to the opportunistic infection. In very late stages of AIDS, the HIV virus attacks the central nervous system directly causing dementia. Once patients enter this stage, death usually results within a year.
There is a fifth group which can be distinguished. This is pediatric AIDS. These children have acquired AIDS congenitally, Approximately 50% of babies will develop AIDS if their mothers had AIDS. Pediatric AIDS is similar to adults with the exception that there are no sarcomas. The first symptoms are usually a failure to thrive, that is, no weight gain, and an enlarged spleen, followed by recurrent infections.
It is estimated that it takes approximately 4 to 5 years to progress from the HIV+ stage to fully developed AIDS. Over the eight to nine years of experience with AIDS, it is estimated that 40 to 50% of those infected with HIV will develop AIDS. However, most "experts" in the field believe that give enough time, of those infected with HIV, 100% will develop AIDS.
Medically speaking there is no cure for AIDS nor is any likely in the near future. At present, there is only the hope of extending life with experimental drugs such as AZT. These drugs have adverse side effects and some AIDS patients are not able to tolerate them. What can be done is to try to combat the opportunistic infections which are the most common direct cause of death.
II. Theological Considerations
As we prepare to minister in our particular churches to people with AIDS we must be ready to deal with the issue that has been raised in the Christian community as to whether AIDS is a judgment of God, and especially upon the homosexual community specifically.
The answer to this question is "Yes" and "No." In fact, a better answer might be "in some cases yes, in some cases no.
What is the judgment of God? It is the action that results when God's holy nature has been violated. Judgment upon sin in the believer's life could be termed as discipline. This is a corrective measure that God uses to bring a wayward child back to himself when he has been resisting God.
Judgment on the unbeliever is different. It includes vengeance because dishonor has been done to the person of God and His holy nature has been violated. It is also punishment upon the offender. This vindicating punishment is clearly taught in Scripture. We see this in Romans 12:19:
Do not take revenge...but leave room for God's wrath, for it is written: "It is mine to avenge I will repay," says the Lord.
This is a quote from Deuteronomy 32:35. It is instructive to read the passage in its context:
Have I not kept this in reserve and sealed it in my vaults? It is mine to avenge; I will repay. In due time their foot will slip; their day of disaster is near and their doom rushes upon them.
In this context the vengeance or judgment of God is directed against the enemies of God who will reap what they have sown. In this text, we see first of all God's reaction towards sin by the word "avenge." Sin is something which He must judge. There is also implied the need for punishment when He says, "I will repay."
This judgment ultimately includes eternal separation from God. However, in the present life it includes retribution over and above the natural course of events.
When we look at the AIDS epidemic, we must ask if this is a penalty which is a definite imposition over and above the natural course of events. We take the natural course of events to mean the normal exigencies of life--the normal ups and downs of life. Divine retribution is above and beyond that. The divine judgment is more than the usual tragedies of life.
Is AIDS more than the usual tragedies of life, the usual sickness and diseases that come to us? The answer to that question is very important when we come to discuss AIDS and judgment. That is a difficult question to answer simply by observation because there are horrible and painful diseases. If we affirm that AIDS is a judgment from God what will stop us from saying that cancer is not?
Romans 1:27 may shed some light on this for us where it states:
"...Men committed indecent acts with other men, and received in themselves the due penalty for their perversion. (NIV)
In Ezekiel 7:3, in a context of judgment, God says, "I shall judge you according to your ways, and I shall bring all your abominations upon you."
This is reiterated in verses 4, 8, and 9 as well.
From these verses it seems clear that one of God's judgments is not terrible disaster per se, but it is simply allowing the natural and logical consequences of sin to pile up, awful as they are, to punish the sinner.
Thus, we might say that those who engage in immoral behavior and contract AIDS are experiencing the judgment of God as the natural and logical consequence of their sinful lifestyle.
That brings us to the next question. Is everyone who has contracted AIDS under the judgment of God? Here we believe that we are safe to say, "no."
Why? The answer to that question is in the nature of sin itself. Sin is rarely, if ever, static. It has a dynamic all of its own that often reaches out beyond those who are directly involved. For example, the sin of the alcoholic who drinks away his paycheck affects his whole family when they go ill-clothed and unfed. The alcoholic receives the judgment of God in his body because of the sin of drunkenness, but the innocent children who have never touched a drop of liquor suffer from that sin as well. The immoral person may receive AIDS as a divine judgment upon his licentious lifestyle and pass it to an innocent person. However, we would not call AIDS a judgment of God upon innocent persons. They are the unfortunate victims of the effects of sin.
One more thing regarding judgment must be addressed. That is the issue of why some contract AIDS as a result of their immoral lifestyle and some who are just as immoral do not. There is not always a predictable cause-effect relationship between behavior and punishment. For example, a tornado kills and destroys the property of both the righteous and the unrighteous. Biblically, Jesus warned against this direct association of disease and disaster with personal (John 9;1-2) or group sin (Luke 13;1-9). Ultimately, the answer to this question lies in the mystery of the nature of God. In the end He will judge all sinners.
Why some seem to get away with it while others do not is a question beyond our ability to understand and in reality takes us into the realm of God's prerogatives. We must tread very lightly and not stand in judgment of Him. The answer lies in the words of God himself, "I will have mercy on whom I have mercy, and I will have compassion on whom I have compassion." (Romans 9:15).
We now turn to the question of ministry. Should we minister to those with AIDS? As we saw in the previous section, homosexuals, heterosexuals, and IV drug users who contract AIDS are experiencing the judgment of God as a result of the logical consequences of their immoral lifestyle. Some might raise the question, "Is it wrong to try to help those under judgment?" The answer is an emphatic, "No!"
In an ultimate sense, all suffering in the world is a result of sin. Paul writes, "...sin entered the world through one man, and death through sin." (Romans 5:12). On that basis we could argue that we should never fight against death or seek to postpone it because it comes as God's righteous judgment against all men for their sins. Obviously, such a conclusion would be ridiculous and wrong. It flies in the face of God as He has revealed Himself in the Gospel.
Our guideline should be the simple question, "What would Jesus do?" Would he reach out to the AIDS sufferer as He reached out to the leper? Jesus was known as a friend of sinners. Can His Church be known as anything less? The life and work of the Church is to be redemptive, a ministering to the world of the complete redemption wrought by the Lord Jesus Christ. We are called to follow in His steps showing God's love as well as His holiness to our world.
Thus we show His love in our ministry to those who have AIDS. We care for them with the goal of sharing the Good News. But we also show to them His holiness in that we do not excuse or condone an ungodly or immoral lifestyle. Instead we show them how to become partakers of His holiness.
The disease of AIDS cannot be ignored by the individual Christian or the Church as a whole. We who know the Lord Jesus Christ cannot pretend that we are exempt from addressing this issue no matter how much we wish that it would go away. We must respond in a compassionate and godly way if we are truly going to be the "salt of the earth."
Jesus had compassion for the sick. He was deeply concerned for those who were afflicted with various diseases. Because we are followers of our Lord, we must also have this same compassion and minister the love of our Lord in the lives of others.
Galatians 6:2 says, "Carry each other's burdens, and in this way you will fulfill the law of Christ." This carrying of burdens is particularly pressing in the case of people with AIDS. Christians with AIDS need the body of Christ to minister Christ's love to them. These people need Christians to help shoulder the burden, not shun them.
Some may say, "That verse applies to Christians, so I do not need to be compassionate towards unbelievers with AIDS." This is a wrong attitude. Galatians 6:10 says, "let us do good to all people, especially to those who belong to the family of believers." The context here demands us to respond to the hurts and pain of others whether they are believers or not.
I Corinthians 13 causes us to reflect on our own lack of love and compassion for people with the dreaded disease of AIDS. We cannot ignore this passage of Scripture because we think that the AIDS epidemic is a "special case" nor exempt ourselves because we feel that this is a "rare" disease.
Galatians 5:22 tells us that "the fruit of the Spirit is LOVE." How this works itself out in reality is seen in our attitude concerning the person with AIDS. To lack love and not express it to the person with AIDS is a denial of saving faith. This is a serious thing. We need to be careful that we are not denying our Lord by not having and showing love and compassion for the person with AIDS and those around him or her.
The above is only a brief summary of what the Bible says about Christians showing compassion for people. Even if we only had one verse of Scripture, that would be enough to move us to compassion for the person with AIDS. One man with AIDS says, "How can anyone who calls himself a Christian not have compassion for the person with AIDS?"
Compassion is not an option, and to respond to people with AIDS in any other manner is an indication that there is a deep spiritual need in one's life. The Apostle John writes, "Whoever claims to live in him must walk as Jesus walked" (I John 2:6). In reality, we do not have to argue the point that Christians must reflect the compassion of Jesus when it comes to people with AIDS. The real need is to train and inform the person to behave as Jesus would. We need to discipline ourselves not to over-react. We must show the love of Christ to those who are sick with this disease.
III. Practical Considerations
A. Preparation for Ministry
1. The First Step
How do we minister to people with AIDS? Where do we start? We believe that we must start by educating our people as to the nature of AIDS prior to an actual occurrence of AIDS in our churches. We need to help them understand the disease better and what threats it does or does not hold for the healthy person.
Secondly, we must help the people of our churches to deal with AIDS emotionally. It is completely normal for one to have a strong emotional reaction to the whole issue of AIDS. There is a natural fear we all experience when we realize that the HIV virus is deadly. Coping with the normal fears associated with AIDS is not an easy process. Education will help, as well as sharing one's concern with others. Thirdly, taking the problem to the Lord will be of great help in dealing with the anxiety associated with AIDS (See Psalm 55:22).
2. The Second Step
Another aspect of coping with the emotional reaction to AIDS is the prejudice that is associated with the primary groups afflicted with AIDS. These primarily are the homosexuals and intravenous drug users. We find ourselves repulsed by homosexual lifestyle and may have little sympathy for drug abuse. However, if we are to minister to these two groups, we must deal with our prejudices. We must see them through the eyes of God. We must carefully evaluate our thoughts and replace them with thoughts that reflect the way God sees each person. As we begin to see these people from God's perspective we are moving toward the ability of ministering to them compassionately.
How do we overcome our prejudices? Again, as mentioned above, we should know the facts concerning the disease. This will alleviate the fear of having contact with those who have this disease. After we have established in our minds that contact with people with AIDS is not a dangerous step, we are then free to minister to them with the love of Christ. We must first deal with fear--our own, the infected person's fears, his family's fears, his friends' fears, and, of course, the fears of the people in the church.
Secondly, we need to overcome the tendency to judge and categorize people according to our own standards. We need to ask ourselves the very hard question, "How would my Lord Jesus treat this person?"
Thirdly, we must try to place ourselves in that person's position. How would you like to be treated if you had the disease? In speaking to a person with AIDS, he tells us what an individual with the disease expects from the Christian community.
a. They desire to be treated with love and respect. They are made to feel less than human by almost everyone else; thus the Christian must restore them by expressing the love of Christ. This is done by acceptance and love, and by touching them. To be physically touched is something that a person with AIDS longs for.
b. They desire that they not be held up as "freaks" to be whispered about and pointed to. This is devastating to the human spirit. Christians should never be a part of destroying another human being's spirit.
Prejudice in any area of life is sin. We overcome sin by naming it and asking our Lord for forgiveness. The place to begin our search for a policy on AIDS is on our knees before God asking Him to reveal our prejudices and be healed ourselves by the forgiveness of our Lord Jesus Christ - the one who came to hear the sick.
3. The Third Step
The third step in preparing for ministry is the development of a church policy on ministry to people with AIDS. This is absolutely essential and ideally should be done before someone in the church contracts AIDS. This will accomplish at least two things. One, each church will know how it is going to respond to the situation before it happens. This will save the church from making weighty decisions under pressure and in a short period of time.
Secondly, it will go a long way towards defusing the emotion which could be present when someone comes to church with AIDS. Developing a policy before there is a face attached makes it easier to develop a more objective stance. We have enclosed two suggested policy statements in the appendix.
B. Participation in Ministry
How do we actually minister to people with AIDS? First, we must show our love and acceptance of the person with AIDS and the family by expressing our care and concern in practical ways. The family of the AIDS patient is under extreme stress. The family not only needs to deal with the heartache of watching one they love die a painful death, but also with the prejudices of the state, medical community, society, and often, worst of all, the Christian community. This can be very demoralizing to all involved. We need to be a support, help, and encouragement to the families of people with AIDS, as well as those who have the disease.
Secondly, we must make ourselves available for anything the family needs. From the most "menial" task, to the most emotionally taxing effort, the believer ought to be there at any time, in spite of the inconveniences. In this way we show practically the love of Christ. Lon Solomon writes:
...when it comes to AIDS, God has given us the opportunity to step ahead of society because, frankly, society doesn't want much to do with this problem, not on the level we are talking about. They want to funnel money into informational programs and research. However, when it comes to hugging AIDS patients, going to their homes, feeding them when they're too weak to eat, helping them get their clothes on--there are very few people standing in line for that.
Thirdly, as a church we must encourage the person with AIDS to make the remainder of his life count. If he is a believer and has been reconciled to God we should allow him the privilege of ministering to others. One way to look at it is that the person testing positive for HIV has the sentence of death upon himself. He does not have time to argue about whether we may hinder him in his God-given responsibility to use his spiritual gifts. Consideration must be given regarding the condition of the patient and the spiritual climate of the particular church. These limitations should be spelled out in the church policy.
There are many ways that a particular church can minister. The following is a list of ministries that God has led various churches across the United States to develop:
1. Providing a twenty-four hour AIDS hotline - Run by a Sunday School class.
2. Visiting hospital wards on weekends with teams of volunteers.
3. Establishing AIDS crisis counseling centers.
4. Opening church doors once a month so that Families devastated by the tragedy of AIDS can meet in support groups.
5. Establishing day care centers for people with AIDS and their families.
6. Conducting Bible studies in homosexual communities.
7. Distributing literature door to doo in homosexual communities.
8. Raising monies for the cost of medication.
9. Following up on people with AIDS who are discharged from hospitals.
10. Providing part-time job referrals for people with AIDS.
11. Providing transportation for the many trips to and from hospitals.
12. Developing food banks for families of people with AIDS.
13. Operating halfway houses and hospices for those impoverished by AIDS.
Each of these ministries has grown out of the unique circumstances and situations of the sponsoring churches, but they share a commitment of putting action to their words and work to their faith. Each of them is committed to sharing the Gospel in an uncompromising manner.
In addition to all of that, they are each committed to fleshing out the Bible in tangible acts of goodness and mercy. They know it is only as the naked are clothed, the hungry fed, and the powerless are cared for, that true healing will come to our land. (Isaiah 58:6-8).
Sharing the Word of God and sharing the works of love through the meeting of needs is still not enough. There is something else that people with AIDS need. They need prayer. This is something that each person can do which will minister in a crucial way.
C. Pastoral and Ethical Considerations
A significant part of ministry to people with AIDS is the counseling ministry. This most likely will be done by a member of the pastoral staff. There are a number of issues that come up when one begins to counsel a person with AIDS. At all times it must be done with the utmost compassion and sensitivity. The following are suggestions that a pastoral counselor may consider when counseling the HIV infected person.
1. Marital Counseling
If a person is already married, counsel must be given in regard to the sexual relationship and to the bearing of children.
In regards to the sexual relationship certain ethical questions arise. If a spouse has sexual intercourse with his or her HIV+ spouse, are they committing suicide? If the HIV+ spouse has intercourse with his or her spouse, is he or she committing murder?
We counsel that if it is discovered that one of the marriage partners is HIV+, the couple refrain from sexual intercourse as it would be wrong to pass on a deadly virus to his or her spouse.
We recommend that counselors give the advice to refrain from sexual intercourse because of the devastating results of transmission of the disease or in a pregnancy that could produce a child with AIDS. The reason for this is that medical science is not convinced of the 100% effectiveness of the use of the condom. If this is so, to have sexual relations even with the condom is akin to playing Russian Roulette. Once a person is infected with the virus, there is no cure, and death is certain. The medical opinion is that AIDS is a deadly disease and must be avoided at all costs. Sexual fulfillment between husband and wife can be met in other ways. We feel the risk of contracting the virus is too great a risk to advise otherwise.
Secondly, if a woman is HIV+ she should not have children. This is difficult advice both to give and receive but it is the only alternative. If she is pregnant there is a one-in-two probability that the HIV virus will be passed on to the child. However, if she is pregnant she should be counseled not to abort.
2. Premarital Counseling
In premarital counseling we have a whole other set of issues. Should we as counselors require an HIV test? If the test is positive, do we counsel that the couple not marry? Or do we consent to marry them and counsel them not to participate in sexual intercourse? The question might be put to the HIV+ person, "Can you marry someone knowing that you might infect him or her with a deadly disease?"
This question should also be asked by the Pastor, "Can I marry someone to someone else knowing that they will be infected with a deadly disease? This and the other questions are ones that need much prayer and careful thought before a course of action is decided upon.
The following are possible avenues of approach in premarital counseling in regards to the problem of AIDS.
We encourage that those who counsel people for marriage should recommend testing for the HIV virus, from both individuals considering marriage. The reason for this is that the HIV virus is a deadly disease for which there is presently no cure, other than the grace of God in Divine Healing.
If one of the partners tests positive, the alternatives must be laid out before the couple.
Alternative One: Get married but do not have intercourse. The reasons for this are spelled out above.
Alternative Two: Decide to remain unmarried, and stop the spread of the virus by abstaining from all sexual activity.
Most people with AIDS recognize the horrible death they carry in their bodies and want to act responsibly. We in the Christian community must do our part in stopping the spread of this disease by giving these alternatives.
What are ministers to do when faced with the dilemma of counseling a couple where one or both have been infected with the virus? We, as a committee, feel a responsibility to the church and the world at large, and recommend that ministers do not consent to marry individuals with the virus. If they choose to marry elsewhere, we have done our duty to stop the spread of the virus.
As always, and especially in this case, part of compassionate counseling is confidentiality. Here is a subtle thing: we hurt so badly for the person with AIDS and the family that we want to share the burden with others so they can pray and be concerned as well. However, the compassionate thing to do is to wait for them to disclose the information themselves or wait until they give permission to share the situation. Being a vehicle of information that the family or person is not yet ready to reveal is not being compassionate.
How should we handle the information that a person has the virus?
First of all, we should not share information with anyone unless we have first received permission from the individual. The exception is when the person is acting in a irresponsible way. Then, as always discretion must be used.
Secondly, we must seek to create a climate in the church in which the information that there is a person with AIDS in the fellowship stirs a deep love and compassion, rather than judgment and hostility. That is what the committee is seeking to initiate. If we can make enough people aware of the facts, and their responsibility to act or react biblically, then we have accomplished our objective. We need to create a climate in Bible Fellowship churches of warmth and love and acceptance of the person who is different, and in particular, the person with AIDS.
The disease of AIDS is a terrible scourge upon mankind that is directly and indirectly taking its toll upon innumerable lives. The opportunity it gives the Church of Jesus Christ to show to the world the grace of God is one that does not come too often. It is one that the Bible Fellowship Church cannot afford to miss.
Therefore, the committee urges each particular church to look ahead and prepare itself for the time when they will have the privilege of ministering to a person with AIDS with the compassion of Jesus by adopting an AIDS policy for their church. We further encourage each particular church to educate its people about the disease of AIDS and the avenues of ministry to people with AIDS.
Committee to Formulate a Biblical Response to the Epidemic of AIDS: Philip E. Morrison, Pastor and Chairman, Carl J. Fischer, Jr., Pastor, Richard D. Harris, Pastor, Charles McConnel, Pastor, Lisa McKernan, Ph.D, Donald Reed, M.D., David J. Smock, Ph.D.