In a seismic shift on one of the most profound — and profoundly contentious — Roman Catholic teachings, the Vatican said that condoms are the lesser of two evils when used to curb the spread of AIDS, even if their use prevents a pregnancy.
The position was an acknowledgment that the church's long-held anti-birth control stance against condoms doesn't justify putting lives at risk.
"This is a game-changer," declared the Rev. James Martin, a prominent Jesuit writer and editor.
The new stance was staked out as the Vatican explained Pope Benedict XVI's comments on condoms and HIV in a book that came out Tuesday based on his interview with a German journalist.
The Vatican still holds that condom use is immoral and that church doctrine forbidding artificial birth control remains unchanged. Still, the reassessment on condom use to help prevent disease carries profound significance, particularly in Africa where AIDS is rampant.
"By acknowledging that condoms help prevent the spread of HIV between people in sexual relationships, the pope has completely changed the Catholic discussion on condoms," Martin said.
The change came on a day when U.N. AIDS officials announced that the number of new HIV cases has fallen significantly — thanks to condom use — and a U.S. medical journal published a study showing that a daily pill could help prevent spread of the virus among gay men.
"This is a great day in the fight against AIDS ... a major milestone," said Mitchell Warren, head of the AIDS Vaccine Advocacy Coalition.
Theologians have debated for years whether it could be morally acceptable for HIV-infected people to use condoms to avoid infecting their partners. The Vatican years ago was reportedly preparing a document on the subject, but it never came out.
The groundbreaking shift, coming as it does from the deeply conservative pontiff, would appear likely to restrain any public criticism from Catholic conservatives, who on Tuesday insisted the pope was merely reaffirming the church's moral teaching..
Conservatives have feared that a comment like this would give support to Catholics who want to challenge the church's ban on artificial contraception in an environment where they feel they are under siege from a secular, anti-Catholic culture.
George Weigel, a conservative Catholic writer, said the Vatican was by no means endorsing condom use as a method of contraception or a means of AIDS prevention.
"This is admittedly a difficult distinction to grasp," he told The Associated Press in an e-mail. What the pontiff is saying is "that someone determined to do something wrong may be showing a glimmer of moral common sense by not doing that wrong thing in the worst possible way — which is not an endorsement of anything."
Benedict's comments come at a time when bishops in the United States are intensely focused on upholding the strictest views of Catholic orthodoxy, emphasizing traditional marriage, natural family planning based on a woman's menstrual cycle and making abortion the most important issue.
In the book, "Light of the World: The Pope, the Church and the Signs of the Times," Benedict was quoted as saying that condom use by people such as male prostitutes was a lesser evil since it indicated they were moving toward a more moral and responsible sexuality by aiming to protect their partner from a deadly infection.
His comments implied that he was referring primarily to homosexual sex, when condoms aren't being used as a form of contraception.
However, questions arose immediately about the pope's intent because the Italian translation of the book used the feminine for prostitute, whereas the original German used the masculine.
The Vatican spokesman, the Rev. Federico Lombardi, told reporters Tuesday that he asked the pope whether he intended his comments to apply only to men. Benedict replied that it really didn't matter, the important thing was that the person took into consideration the life of another, Lombardi said.
"I personally asked the pope if there was a serious, important problem in the choice of the masculine over the feminine," Lombardi said. "He told me no. The problem is this: ... It's the first step of taking responsibility, of taking into consideration the risk of the life of another with whom you have a relationship."
"This is if you're a man, a woman, or a transsexual. ... The point is it's a first step of taking responsibility, of avoiding passing a grave risk onto another," Lombardi said.
Those comments concluded the press conference, and Lombardi took no further questions about how broadly this interpretation could be applied.
The clarification is significant.
UNAIDS estimates that 22.4 million people in Africa are infected with HIV, and that 54 percent — or 12.1 million — are women. Heterosexual transmission of HIV and multiple, heterosexual partners are believed to be the major cause of the high infection rates.
Benedict drew harsh criticism when, en route to Africa in 2009, he told reporters that the AIDS problem couldn't be resolved by distributing condoms. "On the contrary, it increases the problem," he said then.
In Africa on Tuesday, AIDS activists, clerics and ordinary Africans alike applauded the pope's revised comments.
"I say, hurrah for Pope Benedict," exclaimed Linda-Gail Bekker, chief executive of South Africa's Desmond Tutu HIV Foundation. She said the pope's statement may prompt many people to "adopt a simple lifestyle strategy to protect themselves."
In Sierra Leone, the director of the National AIDS Secretariat predicted condom use would now increase, lowering the number of new infections.
"Once the pope has made a pronouncement, his priests will be in the forefront in advocating for their perceived use of condoms," said the official, Dr. Brima Kargbo.
Lombardi said Benedict knew full well that his comments would provoke intense debate. Conservative Catholics have been trying to minimize the scope of what Benedict said since excerpts were published this weekend in the Vatican newspaper.
Lombardi praised Benedict for his "courage" in confronting the problem.
"He did it because he believed that it was a serious, important question in the world of today," Lombardi said, adding that the pope wanted to give his perspective on the need for greater humanized, responsible sexuality.
Luigi Accatoli, a veteran Vatican journalist who was on the Vatican panel that launched the book, put it this way:
"He spoke with caution and courage of a pragmatic way through which missionaries and other ecclesial workers can help to defeat the pandemic of AIDS without approving, but also without excluding — in particular cases — the use of a condom," Accatoli said.
The launch of the book, which includes wide-ranging comments on subjects from the sex abuse crisis to Benedict's belief that popes should resign if physically unable to carry out their mission, drew a packed audience to the Vatican press room. Making a rare appearance, Benedict's secretary, Monsignor Georg Ganswein, sat in the front row — an indication of event's significance.
In the book, the pope reaffirms Vatican opposition to homosexual acts and artificial contraception, as well as the inviolability of marriage between man and woman.
But by broadening the condom comments to also apply to women, the pope was saying that condom use is a lesser evil than passing HIV onto a partner, even when pregnancy is possible.
"We're not just talking about an encounter between two men, which has little to do with procreation. We're now introducing relationships that could lead to childbirth," Martin said.
Individual bishops and theologians have applied the lesser evil theory to the condom-HIV issue, but it had previously been rejected at the highest levels of the Vatican, Martin said.
Monsignor Jacques Suaudeau, an expert on the Vatican's bioethics advisory board, said the pope was articulating the theological idea that there are degrees of evil.
"Contraception is not the worst evil. The church does not see it as good, but the church does not see it as the worst," he told The Associated Press. "Abortion is far worse. Passing on HIV is criminal. That is absolute irresponsibility."
He said the pope broached the topic because questions about condoms and AIDS persisted, and the church's teaching hadn't been clear. There is no official Vatican policy about condoms and HIV, and Vatican officials in the past have insisted that condoms not only don't help fight HIV transmission but make it worse because it gives users a false sense of security.
The late Cardinal Alfonso Lopez Trujillo famously said in 2003 that the HIV virus could "easily pass through" a condom — setting off furious criticism by AIDS activists.
"This pope gave this interview. He was not foolish. It was intentional," Suaudeau said. "He thought that this was a way of bringing up many questions. Why? Because it's true that the church sometimes has not been too clear."
Lombardi said the pope didn't use the technical terminology of "lesser evil" in his comments because he wanted his words to be understood by the general public. Vatican officials, however, said that was what he meant.
"The contribution the pope wanted to give is not a technical discussion with scientific language on moral problems," Lombardi said. "This is not the job of a book of this type."
Associated Press reporters Rachel Zoll in New York, Jason Straziuso in Nairobi and AP Medical Writer Marilynn Marchione contributed to this report.