each woman having on average three children, is one of the chief reasons for its poverty, and that many there disagree with Catholic teaching on contraception. He replied that the key is "responsible parenthood": Some people think that—excuse my expression here—that in order to be good Catholics we have to be like rabbits. No. Responsible parenthood. This is clear and that is why in the Church there are marriage groups, there are experts in this matter, there are pastors, one can search; and I know so many ways that are licit and that have helped this. He also said that Pope Paul VI's teaching was prophetic, in view of the drop of the birth rate in some countries to little more than one child per woman. Medical use The Church does not consider at all illicit the use of those therapeutic means necessary to cure bodily diseases, even if a foreseeable impediment to procreation should result therefrom, so long as the contraceptive effect is not directly intended for any motive whatsoever. For example, the use of female steroid hormones as treatment for endometriosis rather than with contraceptive intent is not considered to conflict in any way with Catholic teaching. Moral theologians call this the principle of double effect. The use of condoms to prevent disease is a more controversial and more complex issue, with theologians arguing both sides. Unlike drugs and surgical procedures, the Church's position was that using condoms during sex, for any purpose, is morally contraceptive and thus a sin. Issues surrounding the Catholic Church and AIDS became highly controversial since 1990, primarily because many prominent Catholic leaders publicly declared their opposition to the use of condoms as a disease preventative. Other issues involve religious participation in global health care services and collaboration with secular organizations such as UNAIDS and the World Health Organization. In November 2010 Pope Benedict said that it was a responsible act, though still not a truly moral solution, to use condoms in some very special cases as a device for the prevention of disease. He gave male prostitutes as an example, where the purpose is to "reduce the risk of infection" from HIV. While still believing that contraceptive devices interfere with the creation of life, the Pope stated that in that particular case, it can be a responsible act to raise awareness of the nature of such an act, and as a benefit,