Religion and sexuality make strange bedfellows. No society has ever existed without them, but when it comes to HIV and AIDS, the two social constructs coexist uncomfortably.

Religion often acts as a barrier to HIV prevention work, AIDS activists, public health experts and sociologists attending the XVII International AIDS Conference said.

In the absence of a vaccine or cure for AIDS, it is education, awareness and the consistent use of condoms that will stop HIV from spreading.

Homosexuality, premarital and extramarital sex are a reality of our lives, activists said. When religions make condemnations against sex outside of marriage, same-sex behaviour, or the use of condoms or other forms of contraception, it severely hinders efforts to prevent new infections of HIV, a virus that is largely sexually transmitted.

According to a 2005 study conducted among young people in Mexico, 75 per cent said that religion did not influence their sexuality. More than 50 per cent said they used condoms.

'Probably religion has abdicated its central place in people's lives,' said Gabriella Rodriguez, assistant professor of infectious disease at Mount Sinai Medical Centre, who discussed the study.

Given the predominantly Roman Catholic society in Mexico, the church has had a 2,000-year history of prohibiting contraception and homosexuality. 'However, the country has now approved legal union of homosexuals, and women have access to abortion services,' Rodriguez said.

Religion, culture and tradition are all critical issues for successful HIV prevention programmes. While some religious organizations have been very active in providing care and support for people with HIV/AIDS, some have blocked measures that are regarded as best practices in prevention and have helped to perpetuate judgements of sexual behaviours and identities that make reaching vulnerable populations more difficult.

'Sexuality and religion are not such different concepts. Both are ideas and practises constructed by societies that are direct expressions of the culture, ... symbols that play an essential role in social relations,' Rodriguez said.

'Societies can exist without science, without art or philosophy. But no society has existed without sexuality and religion.'

While sexuality controls the body, religion regulates the sacred. But somewhere along the way, sexuality got linked to the sacred and became controlled by religion.

Ashok Row Kavi, India's most prominent gay-rights activist, said that sexuality was integral to Hinduism.

'Fulfillment of sexual desire and pleasure have been given high importance in a culture which has allowed space for alternate sexuality,' he said.

'We did not have homophobia. The culture of sexual openness was repressed during the Mughal period and the (British) colonization that followed.'

Most homosexuals say that religious orders have stigmatized them, leading to unbearably high degrees of stigma and shame. Cipriano Martinez, an Australian gay man living with HIV, said: 'I demand that the pope apologize to gay men for promoting homophobia.'

'Faith-based institutions must treat HIV as a health issue and not a moral issue. The association of HIV with 'sin' inhibits prevention,' Martinez said.

For other gay men, religion and spirituality have ironically helped them come to terms with their own sexuality. Kavi, a former monk with the Ramakrishna Order in India, said that when he told a fellow monk about his homosexuality, the monk responded, 'Why does that bother you? We're not supposed to be having sex anyway.'

When Kavi responded that 'the world doesn't like us,' the monk said that 'all fingers are not equal, the mother has also made the homosexual.'

Given the central role that religion plays in many people's lives, various initiatives have reached out to religious leaders to garner their support against the AIDS epidemic.

Church leaders in northeastern India now support needle exchange programmes for drug users. In places such as Ukhrul in the remote north-eastern Indian state of Manipur, which has a highly concentrated epidemic with 4 per cent of the population infected, the church says that the impact of AIDS is so visible, they have no choice but to respond.

'In order to get the support of religious leaders, it is important for a programme to prove its good intentions and do good work that benefits the community,' said Aparajita Ramakrishnan of the Bill and Melinda Gates Foundation in India, referring to the power of the church in Indian states like Manipur and Nagaland.

Last month, UNAIDS, the joint United Nations programme on HIV/AIDS, brought together more than 70 Hindu leaders in the southern Indian city of Bangalore.

'It was a path-breaking effort. The leaders said the (AIDS) issue cannot be brushed aside, especially since it concerns young people,' said JVR Prasada Rao, director of the UNAIDS support team for Asia and the Pacific.

It is critical to address adolescent sexuality, because young people form an important part of the target group for HIV prevention services. According to UNAIDS, young people account for 45 per cent of all new HIV infections. Yet many still lack complete information on how to avoid exposure to the virus.

Given that the average age of marriage is increasing the world over, as is premarital sex, religious norms would likely need to evolve accordingly.

'We cannot expect religious leaders to be upfront about premarital sex and condom use, but they do agree for the need to promote responsible sexual behaviour,' Rao said.