So when news broke in Italy last year that Pope Benedict XVI might reconsider the church’s stand in the case of married couples where one partner is infected, a momentous change seemed to be in the offing. Some commentators, noting this pope’s background as John Paul II’s theological enforcer, made analogies with “Nixon in China.” Only someone with Benedict’s reputation for conservative orthodoxy, they suggested, could change church practice on this issue while reconciling it with doctrine that’s been firmly established since the 1968 papal ban on all contraception. But nothing like that has happened.

As with so many issues considered at the Vatican, where cardinals in past centuries were accused of debating how many angels could dance on the head of a pin, the condom issue is fraught with such complexities that even Benedict might have trouble sorting them out.

“This is one of those cases where it’s really anybody’s call at this point,” Father Thomas D. Williams, dean of theology at Regina Apostolorum University in Rome told me at the time. “Bishops, moral theologians -- everybody who’s seriously involved in this is really divided. I don’t know that the pope will find either side sufficiently convincing.”

The flurry of speculation began when the Pontifical Council for Pastoral Assistance to Health Care Workers, headed by Cardinal Javier Lozano Barragán, decided to consider the issue as part of a broad look at several questions of bio-ethics. "My department is carefully studying it, along with scientists and theologians entrusted with drawing up a document about the subject," Barragán told the Italian paper La Repubblica.

In Africa, where the Catholic Church and its affiliated charities often play a vital role delivering health care to the poor and solace to the dying, the issue of how best to address the raging epidemic of AIDS is especially critical. The church preaches abstinence as the best prevention. Many within church organizations contend that condoms give a false sense of security while encouraging dangerous promiscuity. But non-Catholic health workers often regard that position as unconscionable, and see the debate as one in which the theoretical possibility of preventing life with condoms has to be weighed against the statistical probability of losing millions of lives without them.

According the United Nations program on HIV/AIDS prevention (UNAIDS), “Condoms are the only devices currently available that protect against the sexual transmission of HIV, and they are a mainstay of HIV prevention programs. The male latex condom is the single most efficient technology available to reduce the sexual transmission of HIV and other sexually transmitted infections.” Indeed, one of the great problems for those fighting the spread of AIDS is, precisely, finding ways to protect wives from being infected by their husbands. According to UN statistics, “only 4.9 percent of married women of reproductive age use condoms. Many women find it hard or impossible to negotiate with their partners to use condoms.”

Yet, as Williams explained, church doctrine has held that use of condoms within marriage is a particular “moral evil” equivalent to oral sex, anal sex, mutual masturbation or any other act in which sperm is released without the possibility of procreation. “One fundamental question is whether this is something that is always wrong or not -- what in church lingo we would describe as ‘intrinsically’ evil,” said Williams. “It’s almost counterintuitive, because the church sees no ‘added’ evil with the use of condoms in cases of prostitution, or casual relationships with multiple partners or homosexual relationships. Even though the church would never say this in principle, on a pastoral level anybody would say if you are going to a prostitute, it’s already a moral evil, but use a condom.”

It’s precisely because what the church calls “the marital act” is supposed to be “open to life” that the use of a condom is seen as a sin among couples who otherwise have followed church teachings about the sanctity of marriage and fidelity. “I know, you say that’s where you want to give people a break,” said Williams, an American moral theologian. “But that’s the way it is – because of the sacredness of the sexual act as something to be defended and protected in its integrity, and it is only to be protected that way within marriage.”

Thus at the Vatican a major part of the debate is about whether the condom changes the nature of marital sex so fundamentally that it is considered evil. “What makes the sexual act what it is, is the man depositing his sperm in the woman’s body,” said Williams. “When you are using a condom the man is depositing his sperm within a latex sack.” Some theologians contend this is “overly focused on the physicality of what is happening,” he adds, but if the church holds that sex with a condom is not a “marital act,” then like other forms of sex “it would be morally out of bounds for all Catholics.”

Many in the church are aware that such arguments seem “arcane,” said Williams. “Ninety percent of people, even Catholics, don’t have a clue about theses things.” Yet about one thing there is no question: these are matters of life and death.