We are in the midst of an epidemic. On both sides of the Atlantic, infections caught through sexual activity (STIs) are spreading rapidly, causing fear and destruction, and overwhelming health services. My grandfather was a specialist in STI treatment in the English Mid­lands from 1930-70. During the early part of his working life he saw only three types of STI: syphilis, gonorrhoea and 'non-specific urethritis' (probably unrecognized chlamydia). With the arrival of antibiotics after the Second World War, the battle against STIs was considered all but won. However, with the increased acceptance of sex outside marriage from the 1950s onwards, there has been a steady rise in occurrence. The range of infections has also increased with the appearance of over 20 new infections, including AIDS, many of which are not curable with antibiotics. Historically confined to prostitutes and their users, these infections are now widespread, with 10 per cent of 18-24 year olds having experienced an infection.

How does the medical profession view the epidemic? It has taken its attitude from an increasingly secular society, whose immorality has been the cause of the problem. Doctors have tried to remove any moral dimension from their clinical practices (this approach is also reflected in their general acceptance of abortion and willingness to consider the introduction of euthanasia). Such infections are then labelled an unfor­tunate consequence of a 'lifestyle choice'. Patients choose the way they want to live, and doctors come to their help with a powerful array of treatments. A doctor could expect professional censure if he expressed a view that STIs were the price to be paid for sexual immorality or were a sign of God's judgment. He would be seen as abusing his expected moral neutrality and as returning to mediaeval judgmentalism. Sadly, many Christian doctors have also yielded to pressure from society by attempt­ing to leave all moral considerations outside their consulting rooms.

The epidemic poses a challenge to the faithfulness and wisdom of Christian doctors and of ministers who face its clinical and pastoral implications. As in all areas of life, God warns us not to be 'conformed to this world' but rather to be 'transformed by the renewing of our minds', so that we are able to test his 'good and acceptable and per­fect will'. Right thinking will lead to right words and actions. Faithful application of biblical principles to such an epidemic will have many God-honouring benefits. It will strengthen our witness to the truth of God's laws and designs in the area of sex and marriage, will inform our pastoral response to those suffering from such infections, and will limit the spread of these diseases. Blindness to the spiritual implications of the epidemic has prevented our society from removing the scourge from its midst. Only when society is able to turn to God's people for God's wisdom will this begin to change.

The Relationship between Sexual Sin and Disease⤒🔗

The roots of all sickness can be traced to man's sinfulness since the Fall, but not all disease is caused directly by a specific sin. Job's friends made this error in their assessment of his suffering. Jesus made it clear that the 'man born blind' was not suffering from the direct consequence of his or his parents' sin (John 9:1-3). However, there are many examples from the Bible where diseases are a direct consequence of a specific sin. The Lord punished the Egyptians' hardness of heart by sending a plague of boils (Exod. 9:8-12). Paul warned the Corinthians that many were weak, sick or had even died because they had been guilty of taking the Lord's Supper in an unworthy manner (1 Cor. 11:2, 7-30).

Sometimes sickness is consequent upon a specific sexual sin. After David's adultery with Bathsheba, his son became ill and died (2, Sam. 12:15-18), and David cried out to the Lord for relief from 'the bones you have broken', though this may denote his psychological torment rather than a physical sickness (Psa. 51:8). The plagues of Revelation 9 afflict mankind steeped in sins that include sexual immorality (verse 21).

In Romans 1 Paul explained that the offence of idolatry leads God to 'give up' (verses 2, 4, 26) individuals to sexual immorality. The words 'giving up' signify that both heterosexual and homosexual immorality are in themselves a mark of God's judgment – a result of God's lifting his graciously restraining hand which we experience in the moral checks of the Bible, our consciences, our taboos, and the laws of the state. As men and women reject God's authority over their lives, God releases them from these beneficial controls so that they do 'what is against nature' (verse 26), using their bodies in shameful ways (verse 27), for which they were not designed.

Whilst the practice of sexual activity outside marriage is a judgment in itself, Paul makes it clear that the consequences are not limited only to the unnaturalness of the activity. He goes on to warn them that they will receive in themselves the penalty of their error which was due (verse 27b).

This clause refers immediately to male homosexual activity (verse 27a), but it also applies to female homosexual activity of the preceding verse (verse 26) as well as to acts of both a homosexual and heterosexu­al nature as described in verses 24 and 29 (NKJV: 'sexual immorality').

From this clause we can surmise four things about the penalty:

1. There is a causal relationship between the error and the pen­alty.
2. The words 'in themselves' imply that the penalty affects the sexually immoral personally.
3. It is unwelcome and unpleasant.
4. It expresses God's justice in his judicial punishment for the sin. We can accordingly expect 'the punishment to fit the crime'.

It is not clear what, if any, specific penalty Paul had in mind. He may be emphasizing the fact that disobedience to God's law inevitably causes grievous dysfunction and suffering. The commentator Matthew Henry states this general principle thus: 'The whole of creation is at war with those in arms against God' (on Numbers 21:4-9). Sexual activity was designed by our Creator to involve the giving of our inmost selves in the most intimate of all emotional, physical and spiritual expressions amid the security and abandonment of unconditional marital love. When abused, the deepest things will cause the deepest damage. In this way, 'Evil shall slay the wicked' (Psa. 34:21).

Candidates for the 'Penalty'←⤒🔗

It is surely possible to be more specific about some forms that this pen­alty for sexual immorality has taken in recent times. Here are some examples:

Degradation of Character and Sexuality←↰⤒🔗

As John Stott puts it, 'Illicit sex degrades people's humanness; sex in marriage, as God intended, ennobles'. Such degradation can be seen in the decline of feminine charm and masculine chivalry amidst heterosexu­al promiscuity, and the distortion of sexuality in the macho woman and effeminate man of homosexual activity.

Loss of Fertility←↰⤒🔗

Removing the act of procreation from the God-designed context of mar­ried family life has led to the barrenness of infertility. Such manifestations of God's judgment were experienced by Israel in the wake of idolatry and sexual immorality: 'As for Ephraim, their glory shall fly away like a bird – no birth, no pregnancy, no conception! Though they bring up their children, yet I will bereave them to the last man.' (Hos. 9:11-12.). All over Europe contraception with the 'safety net' of abortion has brought dramatic population shrinkage. STIs themselves can cause infertility. Homosexual activity is also necessarily barren (hence the significance of the issue of homosexual adoption).

Acquisition of an STI←↰⤒🔗

We will now examine how STIs fulfil the characteristics of such a 'pen­alty'.

The 'Penalty' of STIs←⤒🔗

STIs are specifically passed through Sexual Immorality←↰⤒🔗

One of my colleagues from India described work amongst a tribal group with a strong taboo regarding sexual intimacy outside marriage. He never came across STIs in his clinical work. Similarly, STIs would largely disappear in a few years if our society began to obey God's laws again.

Families can suffer from the penalty of their immoral members. An innocent wife of an adulterer can find herself infected, and sometimes the sins of a parent are 'visited on the next generation' when an infant catches an STI through the birth canal. All over Africa children are bereft of their parents as 'AIDS orphans'. However, because the spread of these infections is limited to genital contact, individuals in families who have chosen to live according to God's commands need not be afraid of 'the pestilence that walks in darkness' (Ps. 91:6). There is a correlation between the extent of departure from God's design and the frequency and severity of STIs. Homosexual activity, which is a distor­tion of both context (i.e. outside marriage) and design, is marked by more frequent and generally more serious infections.

God Removes the Joy of Sexual Intimacy←↰⤒🔗

God-ordained sexual intimacy strengthens the marriage bond and also brings new life. In contrast, sexual contact with an infected person can bring sickness and death. For this reason the event may be surrounded by fear and distrust rather than affirmation and joy.

Fear is made worse by the uncertainty; many STIs are asymptomatic. Asymptomatic individuals can unknowingly both spread infections and suffer the lasting effects of infertility or cancer. Human Papilloma Virus, the agent of genital warts, causes the vast majority of cases of cervical cancer, which can appear some twenty or more years after a sexual encounter. Some health clinics suggest that a person take a potential partner's sexual history as a precaution before intimacy occurs. With­out God's good commands for living, what a dark cloud of distrust enshrouds a relationship!

God May Remove the Gift of Sexual Intimacy←↰⤒🔗

God's judgment fell on haughty and faithless Israelite women whose much-flaunted beauty (Isa. 3:18-23) turned to disfigurement and shame (verses 17 and 24). Sexual intimacy may be rendered impossible by impotence and a loss of desire caused by fear and disfigurement (one partner may reject the other because of disfigurement).

God May Remove the Fruitfulness of Sexual Intimacy←↰⤒🔗

The procreative ability of those with STIs can be threatened. Infertility can arise from an inflammatory reaction to Chlamydia and Gonorrhoea which over some years may scar the tubes connecting the womb to the ovaries.

Discerning God's Purpose in STIs←⤒🔗

The phenomenon of STIs is not simply an epidemiological curiosity, a clinical challenge or an embarrassing inconvenience. It is palpable evidence of God's judgment on individuals and on a society for violat­ing the sanctity of sexual intimacy. The hallmarks of his justice can be seen from the facts above. If we choose to abuse his good gift of sexual intimacy then he will take away its blessing. He may also remove its fruitfulness and remove further sexual opportunity through incapacity, disease or death.

The purposes of God's judgments are often mysterious, but we can discern some beneficial effects. As his judicial response to the breaking of his moral law, he uses STIs to restrain, convict and direct people. They act as his road signs of 'Danger ahead', 'Take a U-turn', and 'Take this route'.

As an expression of God's common grace, the existence of God's judgments will encourage some to refrain from sexual immorality through fear of infection. Some teachers and doctors may conclude cor­rectly that promoting chastity rather than the condom is the only way to prevent their spread (this will be addressed in another article).

But STIs also speak directly to us of God's existence, power and righteousness:

Of his existence because he is declared in his wondrous works which include those of judgment (Ps. 78:32).

Of his power because we learn that no-one can hide from his holy gaze and escape his sovereign judgments for sin (Rom. 9:22-23).

Of his righteousness as he expresses his anger towards sin (Ps. 83:13-18), the same anger that led Jesus to suffer punishment for our sins on the cross. We also see his righteousness in the perfection of his commands. How sharp is the divide between the blessings of sexual in­timacy in marriage and the curses of sexual immorality! The pain of sin speaks of the reality of sin, which in turn proves the existence of moral laws that our society so determinedly seeks to deny.

Some will experience the turning of wrath to mercy as they come under conviction of sin and turn to God for salvation (Ps. 83:16). His judgments also warn the unrepentant of worse to come in the eternal ag­ony of hell which will eclipse the symptoms of even the worst of STIs.

Practical Application←⤒🔗

Too often the subjects of sin and judgment are avoided from the pulpit. Yet we need to face the tragedy of the situation. His people need to know that our society is experiencing a taste of the awfulness of God's judgment for rejecting his laws. How can his people 'rejoice with trem­bling' (Ps. 2:11) if we remain ignorant of his judgments?

At an individual level, should pastors or doctors ever consider explaining the spiritual facts to those they meet with such infections? We surely live in times when 'they hate the one who rebukes in the gate, and they abhor the one who speaks uprightly' (Amos 5:10). In his day Amos observed, 'Therefore the prudent keep silent at that time, for it is an evil time' (Amos 5:13).

Yet there are other occasions when in the midst of great opposition the Lord asks his people to warn the wicked of the peril of their ways (for example, Ezek. 3:18). Our response requires great spiritual discern­ment. We need to examine the motives of our own hearts. We need to be sure that any reluctance to speak these truths does not arise through fear of man's rejection or of damaged reputation. We need to pray for fearless but humble hearts that are willing to speak the truth in love when God so requires.