Pope Benedict XVI heads for Africa this week, where he is likely to face questions over the Catholic Church's stance on condoms on the continent hardest hit by HIV and AIDS.

His arrival in the West African nation of Benin Friday will mark the pontiff's second visit to Africa.

His first in 2009 to Cameroon and Angola caused a global outcry when he suggested condom distribution aggravated the AIDS problem.

The pope has since seemed to ease that stance, saying in a book published last year that condom use is acceptable "in certain cases," notably to reduce the risk of HIV infection.

Catholics in Africa have long been caught between the church's doctrine and the realities of a killer disease affecting millions of people. Sub-Saharan Africa is home to nearly 70 percent of the world's HIV cases.

"What the pope said is the ideal," said 28-year-old Benin journalist and Catholic faithful Lea Glago, referring to the 2009 comments.

"But to be honest with you, I do not respect it and I find it difficult to respect this. I do not know anyone around me that does."

Catholic charities provide much of the AIDS care in sub-Saharan Africa, where 22 million infected people live. Pragmatism sometimes takes precedence over parsing the meaning of Vatican pronouncements.

In the tiny southern African kingdom of Swaziland, the country with the world's worst HIV prevalence rate of about 26 percent of the adult population, some Catholic missionaries say they prefer to focus on saving lives.

"As a church man, a lot of what you are doing is not praying. It is crisis response," said Father Martin McCormick, a missionary and founder of Hope House, a hospice caring for AIDS patients and their families.

McCormick also oversees 60 Catholic schools where 8,000 pupils are AIDS orphans.

"If you have 8,000 hungry kids, you don't think back to the Vatican. You think 'human response' to what you see in front of you. I don't think policies or philosophies."

In the same country, Sister Diane Dalle Molle, a Catholic nun who has for the past eight years counselled and tested people for HIV, said "we can tell them what is available out there."

"We don't provide condoms, but they know where they can get them," she said.

Some, however, choose to stick to the dogma. Gift Mambipiri, leader of Zimbabwe's Catholic student movement, said: "The church is about life and saving life. The holistic approach is abstinence and total faithfulness."

In Nigeria, Africa's most populous nation, the head of the country's national anti-AIDS agency called the Catholic Church's position on condoms "unrealistic".

"Realistically, many people understand (condom use), but don't want to go against the doctrine -- people just want to play faith," said John Idoko, head of the Nigerian AIDS control agency.

He said a group of "fanatic" Catholics last year took his agency, the health ministry and a drugs control agency to court for promoting the use of condoms, alleging they were distributing condoms with holes and fuelling the spread of HIV.

The case was struck off the roll after the complainants failed to prove their allegations.

In South Africa, the country with the world's highest number of HIV cases, the Catholic Church and its clinics, hospices, home care programmes and orphanages has found itself at the forefront of the fight against AIDS.

At the office of the South African Catholic Bishops' Conference, Sister Victoria said its Education for Life Programme is based on the promotion of abstinence.

"We are not allowed to teach about condoms," she said. "Sex is for marriage. We are trying to encourage abstinence. We do face reality, but we need to tell the truth."