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ADDRESS

By
C. Everett Koop, MD, ScD
SURGEON GENERAL
OF THE
U. S, PuBLic HEALTH SERVICE
AND
DEPUTY ASSISTANT SECRETARY OF HEALTH
U, S, DEPARTMENT OF HEALTH AND HUMAN SERVICES

EJ

PRESENTED TO THE UNIVERSITY OF PENNSYLVANIA CHAPTER
oF ALPHA OMEGA ALPHA |
PHILADELPHIA, PENNSYLVANIA
Aprit 7, 1987
(GREETINGS TO HOSTS, GUESTS, FRIENDS. ETC.)

IT’S MY PLEASURE TO BE HERE THIS AFTERNOON TO ADDRESS YOU
CONCERING OUR EFFORTS AT CONTROLLING THE SPREAD OF AIDS. ONE OF
THE DEADLIEST AND ALSO ONE OF THE MOST MYSTERIOUS DISEASES TO
STRIKE MANKIND IN MANY, MANY YEARS,

FIRST OF ALL, SINCE THERE’S BEEN SO MUCH INTERPRETATION AND
MISINTERPRETATION OF THE FACTS ABOUT AIDS, LET ME QUICKLY RUN

THROUGH THEM NOW. THIS IS HOW THINGS STAND...AND I SHOULD ADD, AS
OF NOON TODAY,

IT’S HARD TO BELIEVE, BUT IT HASN'T BEEN 6 YEARS SINCE THE
FIRST REPORTS OF THIS STRANGE DISEASE WERE RECEIVED BY OUR CENTERS
FOR DISEASE CONTROL IN ATLANTA, YET, IT SEEMS LIKE AN ETERNITY.

SINCE 1981 WE'VE SEEN THE OFFENDING VIRUS IN A MICROSCOPE AND
WE'VE NAMED AND RENAMED IT. 17'S CURRENT BIOMEDICAL NAME IS
"HUMAN IMMUNODEFICIENCY VIRUS.’ OR HIV,

A SCREENING TEST WAS ALSO DEVELOPED TO DETERMINE IF THE VIRUS
1S PRESENT IN SOMEONE’S BLOOD. BOTH WE AND THE FRENCH SHARE THE
CREDIT FOR THAT.
AND I SHOULD ADD THAT THE TEST IS VERY GOOD. PRIOR TO THIS
TEST, THE AIDS VIRUS WAS TURNING UP IN SOMETHING LIKE 4 UNITS OF
EVERY 10,000 UNITS OF BLOOD COLLECTED. TODAY, WE ESTIMATE THAT
THE AIDS VIRUS MIGHT BE PRESENT IN NOT MORE THAN 4 OR 5 UNITS OUT
OF EVERY ONE MILLION UNITS COLLECTED,

IS THAT GOOD OR BAD? WELL, I HAVE TO TELL YOU THAT I KNOW OF
VERY FEW PROCESSES IN THE PUBLIC HEALTH ARENA THAT COME ANYWHERE
NEAR THAT CLOSE TO PERFECTION. AS YOUR SURGEON GENERAL, I AM
SATISFIED THAT THE AMERICAN BLOOD SUPPLY, RELATIVE TO AIDS, IS THE
SAFEST IN THE WORLD. THAT GOES FOR AIDS...AND IT GOES FOR
EVERYTHING ELSE, TOO,

ALSO, IN THE PAST 6 YEARS WE'VE BEEN ABLE TO GALVANIZE A
LARGE, INTERNATIONAL ARMY OF BIOMEDICAL RESEARCHERS TO WORK ON
UNLOCKING THE SECRETS OF THIS DISEASE. HERE IN THE UNITED STATES,
THE FEDERAL GOVERNMENT ALONE IS SPENDING OVER $300 MILLION IN AIDS
RESEARCH THIS YEAR AND THE PRESIDENT HAS ASKED CONGRESS FOR MORE
THAN $400 MILLION FOR RESEARCH FOR 1988,
AND FINALLY, OVER THE PAST 6 YEARS WE'VE DEVELOPED A WAY OF
MONITORING THE SPREAD OF THE DISEASE THROUGH AN INTRICATE NATIONAL
AND INTERNATIONAL SYSTEM OF EPIDEMIOLOGICAL REPORTING,

THIS IS EXTREMELY IMPORTANT, BECAUSE IT PROVIDES US WITH OUR
ONLY BASIS FOR ESTIMATING WHAT THE IMPACT OF THIS DISEASE IS --
AND WILL BE -- UPON OUR HEALTH CARE SYSTEM AND UPON OUR SOCIAL
INSTITUTIONS THEMSELVES...NOW AND, I’M AFRAID, FOR YEARS TO
COME.

IT’S BECOMING QUITE CLEAR TO US THAT THE DISEASE OF AIDS --
AS 1T CONTINUES TO SPREAD THROUGHOUT OUR POPULATION -- WILL BE
DRAWING EVER MORE HEAVILY NOT ONLY UPON THIS COUNTRY’S MEDICAL AND
FINANCIAL CAPITAL, BUT ALSO UPON OUR SOCIAL AND POLITICAL CAPITAL,

JUST HOW SERIOUS IS THIS EPIDEMIC ANYWAY? ONE LOOK AT THE
NUMBERS SHOULD LEAVE YOU PROFOUNDLY IMPRESSED,

IT ALL BEGAN WITH ONLY 5 CASES OF PATIENTS IN LOS ANGELES,
THESE WERE REPORTED IN JUNE 1981, AS OF LAST WEEK. THE END OF
MARCH OF 1986, THE CUMULATIVE TOTAL OF AMERICANS WHO HAVE HAD AIDS
HAS PASSED THE 33,000 MARK.
OVER HALF OF THEM HAVE ALREADY DIED OF THE DISEASE. MOST OF
THE REST APPARENTLY WILL.

LAST YEAR MORE THAN 13,000 NEW CASES WERE ADDED TO THE
TOTAL. THIS YEAR WE EXPECT ANOTHER 23,000 CASES,

 

BY THE MIDDLE OF 1991 -- A DECADE AFTER THOSE FIRST 5 REPORTS
CAME IN FROM LOS ANGELES -- WE EXPECT THAT A QUARTER OF A MILLION
AMERICANS WILL HAVE CONTRACTED AIDS...A DISEASE THAT, SO FAR, HAS
A MORTALITY RATE OF 100 PERCENT.

THIS IS A TERRIBLE DISEASE, FOR WHICH WE DO NOT YET HAVE A
CURE, NOR DO WE HAVE A VACCINE...AND WE PROBABLY WON'T HAVE ONE
GENERALLY AVAILABLE BEFORE THE END OF THE CENTURY.

MAKE NO MISTAKE ABOUT IT. AIDS LS FATAL AND IT IS
SPREADING. AND THE ONLY THING WE HAVE THAT MAY WORK AGAINST IT IS
EDUCATION... EDUCATION... AND MORE EDUCATION.
ANOTHER THING WE KNOW WITH SOME CERTAINTY IS THAT THE AIDS
VIRUS IS TRANSMITTED FROM ONE PERSON TO ANOTHER EITHER IN BLOOD OR
IN SEMEN, NO OTHER BODILY FLUIDS -- TEARS, SALIVA, OR PERSPIRA-
TION, FOR EXAMPLE -- HAVE THE CONCENTRATION THAT THE VIRUS SEEMS
TO REQUIRE, CERVICAL SECRETIONS ALSO CONTAIN THE VIRUS, AND
STUDIES ON THAT MEANS OF TRANSMISSION ARE IN PROCESS.

BUT WE HAVE NOT ONE SUBSTANTIATED CASE OF THE VIRUS BEING
TRANSMITTED BY COUGHING OR SNEEZING...BY FOOD UTENSILS OR WATER
GLASSES...BY TOILET SEATS, AND SO ON,

THIS IS WHY THE U.S, PUBLIC HEALTH SERVICE HAS ADVISED THE
EDUCATIONAL COMMUNITY THAT THERE IS NO SCIENTIFIC, MEDICAL. OR
PUBLIC HEALTH REASON FOR BARRING OR ISOLATING A PERSON WITH THE
VIRUS FROM ANY ROUTINE SCHOOL ACTIVITY.

1 HAVE TO SAY, THEREFORE, THAT A DECISION TO BAR A CHILD FROM
SCHOOL BECAUSE HE OR SHE HAS TESTED POSITIVE FOR AIDS IS NOT A
PUBLIC HEALTH DECISION.
THE PECULIAR CHARACTERISTICS OF THE AIDS VIRUS ALSO EXPLAIN
WHY TWO-THIRDS OF ALL AIDS VICTIMS ARE HOMOSEXUALS OR BISEXUAL
MEN, SOME SEX PRACTICES AMONG THESE MEN NOT ONLY PRODUCE SEMEN,
BUT THEY CAN ALSO CAUSE BLEEDING. AS BLOOD AND SEMEN ARE
EXCHANGED BETWEEN PARTNERS, THE VIRUS MAY BE TRANSMITTED.

NOW, THERE’S A DISTINCTION HERE THAT NEEDS TO BE UNDERSTOOD
BY US ALL. I/VE SAID MANY TIMES -- AND I’LL REPEAT IT AGAIN HERE
-- THAT "WE'RE FIGHTING A DISEASE,..NOT PEOPLE.” WE’RE FIGHTING A
VIRUS THAT HAS NOVEL BIOPHYSICAL CHARACTERISTICS AND REQUIREMENTS
»»+WE ARE NOT AT WAR WITH A LIFESTYLE.

SOME MEMBERS OF THE PUBLIC GENUINELY MISTAKE A GIVEN LIFE-
STYLE AS BEING -- ITSELF -- THE CAUSE OF AIDS. BUT THERE’S NOT A
SHRED OF SCIENTIFIC TRUTH TO THAT.

NEITHER HOMOSEXUALITY NOR HETEROSEXUALITY PER SE IS THE
ISSUE.
IN FACT, AFTER SEVERAL YEARS OF INTENSIVE AIDS EDUCATION
DIRECTED TO HOMOSEXUALS AND BISEXUAL MEN, IT APPEARS THAT THEY
HAVE BECOME MORE CAUTIOUS IN THEIR SEXUAL PRACTICES AND. AS A
RESULT, THE TRANSMISSION OF OTHER DISEASES LIKE SYPHYLLIS.
GONORRHEA, AND HEPATITIS HAS, IN FACT, GONE DOWN. THEY HAVE A
SHORTER INCUBATION PERIOD THAN AIDS DOES AND. HENCE, WE CAN TRACK
THEM MORE EASILY FOR SHORT-TERM DATA,

WE CAN ONLY ASSUME -- AND I BELIEVE ASSUME CORRECTLY -- THAT
THE TRANSMISSION OF AIDS HAS PROBABLY GONE DOWN, ALSO.

OF COURSE, THESE MEN REMAIN HOMOSEXUAL OR BISEXUAL AND THEY
ARE STILL THE PERSONS MOST AT RISK OF CATCHING AIDS...AGAIN, NOT
BECAUSE OF THEIR PARTICULAR SEXUAL ORIENTATION. BUT BECAUSE OF THE
WAY THEY MAY PRACTICE WITHIN THAT ORIENTATION.

ODDLY ENOUGH, THAT’S EXACTLY THE SAME ISSUE IN REFERENCE 10
INTRAVENOUS DRUG ABUSERS, WHO CONSTITUTE THE SECOND LARGEST GROUP
OF AIDS VICTIMS.
THE ONES WHO USE THEIR OWN CLEAN NEEDLES FOR EACH “FIX” ARE
KILLING THEMSELVES BY ABUSING POTENT, ADDICTIVE, ILLEGAL DRUGS,
BUT THEY PROBABLY WON'T KILL THEMSELVES THROUGH AN AIDS-RELATED
DISEASE.

BUT I.V. DRUG ABUSERS TEND NOT TO BE THIS FASTIDIOUSLY
HYGIENIC, ON THE CONTRARY, ABOUT 90 PERCENT OF ALL HEROIN ADDICTS
BORROW USED, DIRTY NEEDLES AND OTHER CONTAMINATED DRUG
PARAPHERNALIA FROM OTHER ADDICTS.

IN OTHER WORDS, 9 OUT OF 10 DRUG ADDICTS ARE MAKING
ABSOLUTELY SURE THAT THEY DIE AS EARLY AND AS UNCOMFORTABLY AS
POSSIBLE.

NOW IT ALSO HAPPENS THAT A THIRD OF THESE DRUG ABUSERS ARE
ALSO HOMOSEXUALS...MEN WHO’VE VASTLY INCREASED THEIR RISK OF AN
EARLY DEATH,

HOMOSEXUALS, BISEXUAL MEN, AND INTRAVENOUS DRUG ABUSERS
COMPRISE THE VAST MAJORITY OF AIDS VICTIMS SO FAR...ABOUT 9 OUT OF
10, BUT, AS YOU MAY KNOW BY NOW. THIS IS NO LONGER AN EXCLUSIVE
CLUB,
ABOUT 4 PERCENT OF ALL REPORTED AIDS VICTIMS ARE HETERO-
SEXUALS...MEN AND WOMEN WHO ARE NEITHER HOMOSEXUAL NOR BISEXUAL
NOR I.V. DRUG ABUSERS. APPARENTLY THEIR ONLY HIGH-RISK ACTIVITY
WAS TO HAVE HAD SEXUAL RELATIONS WITH SOMEONE ELSE WHO HAD AIDS,

 

A COMMON EXAMPLE COULD BE THAT OF A HETEROSEXUAL MAN WHO HAS
SEX WITH AN AIDS-INFECTED PROSTITUTE, THEN GOES HOME AND HAS SEX
WITH HIS UNSUSPECTING WIFE OR WITH OTHER WOMEN, ALL OF WHOM COULD
RECEIVE THE VIRUS FROM HIM,

NOTHING VERY KINKY ABOUT IT...NOTHING VERY EXOTIC, BUT ALL
VERY TRAGIC,

THE TRAGEDY IS THEN COMPOUNDED WHEN ONE OF THESE WOMEN
BECOMES PREGNANT AND PASSES THE VIRUS ON TO HER NEW-BORN INFANT
EITHER IN UTERO OR IN THE BIRTH CANAL DURING DELIVERY,

IT'S TRUE THAT THE NUMBER OF CHILDREN BORN WITH AIDS IS STILL
QUITE SMALL, THEY CONSTITUTE JUST OVER 1 PERCENT OF THE TOTAL
NUMBER OF ALL AIDS VICTIMS,
10

A COUPLE OF YEARS AGO, HOWEVER, THERE WEREN'T ANY, NOW THERE
ARE 470, IN FACT, SOME HOSPITALS -- IN NEW YORK, NEW JERSEY, AND
WASHINGTON, D.C., FOR EXAMPLE, -- HAVE HAD TO SET ASIDE ISOLATION
WARDS TO TAKE CARE OF THE RISING NUMBER OF INFANTS INFECTED WITH
THE AIDS VIRUS AND USUALLY ABANDONED BY THEIR MOTHERS,

1 SHOULD ADD THAT, BECAUSE OF THE STIGMA OF AIDS, THERE ARE
FAR FEWER FOSTER HOMES OPEN TO THESE CHILDREN. AND, IN FACT, THE
STIGMA HAS BEEN AN INVISIBLE BUT VIRTUALLY IMPENETRABLE BARRIER
BETWEEN THEM AND A WHOLE VARIETY OF SOCIAL AND PUBLIC HEALTH
SERVICES,

THIS INTER-SEXUAL AND INTER-GENERATIONAL CHAIN OF INFECTION
TS NOT A NEW STORY, IT’S THE SAME STORY WE IN PUBLIC HEALTH HAVE
BEEN TELLING FOR YEARS IN REGARD TO THE TRANSMISSION OF HERPES,
SYPHYLIIS, GONORRHEA, CHLAMYDIA, AND OTHER SEXUALLY TRANSMITTED
DISEASES,

BUT AIDS HAS PUT A NEW TWIST ON THAT OLD STORY. THE AIDS
INFECTION DOESN’T END WITH A SHOT OF AN ANTIBIOTIC,

IT ENDS IN DEATH.
Il

ANOTHER FACT THAT IS EMERGING WITH MORE CLARITY IS THE
INCIDENCE OF THE DISEASE AMONG BLACKS AND HISPANICS, IN THE
POPULATION GENERALLY. 1 OF EVERY 8 AMERICANS IS BLACK... BUT AMONG
AMERICANS WITH AIDS, 1 OF EVERY 4 IS BLACK: 24 PERCENT OF THE
TOTAL CASES REPORTED SO FAR,

ONE OF EVERY 12 AMERICANS IS HISPANIC,..BUT 1 OF EVERY 7
AMERICANS WITH AIDS IS HISPANIC. ALSO, ABOUT A THIRD OF ALL BLACK
AND HISPANIC AIDS VICTIMS ARE 1.V. DRUG ABUSERS, WHICH IS ALSO
DISPROPORTIONATE,

AND ONE FURTHER NOTE OF TRAGEDY, MORE THAN HALF THE NUMBER
OF INFANTS WITH AIDS ARE BLACK AND ANOTHER 24 PERCENT ARE
HISPANIC. AGAIN. THESE ARE HIGHLY DISPROPORTIONATE FIGURES.

NINE OUT OF 10 OF THOSE BLACK AND HISPANIC CHILDREN WITH AIDS
GOT THE VIRUS FROM THEIR INFECTED MOTHERS EITHER IN UTERO OR
DURING DELIVERY.

AND JUST TO INCREASE OUR SENSE OF HORROR AT THIS CATASTROPHE
OCCURRING IN THE BLACK AND HISPANIC COMMUNITIES, WE SUSPECT THAT
THESE CASES ARE VASTLY UNDER-REPORTED,
12

WHAT DO ALL THESE PIECES OF INFORMATION SUGGEST? I THINK
THEY MEAN THAT THE DEMOGRAPHY OF THE DISEASE OF AIDS IS CHANGING
». AND DRAMATICALLY.

AT ONE TIME WE WERE CONCERNED PRIMARILY -- ALMOST EXCLUSIVELY
-- WITH THE POPULATIONS AT RISK IN SAN FRANCISCO, LOS ANGELES, AND
IN NEW YORK CITY, AND THESE CITIES STILL HAVE THE HIGHEST NUMBERS
OF AIDS CASES, TO BE SURE,

BUT THEY’RE NO LONGER ALONE. OTHER CITIES AND STATES ARE
SHOWING A RISE IN CASES, TOO. HERE ARE SOME EXAMPLES OF THE
SPREAD:

HOUSTON HAD 77 CASES IN 1983, BUT IT REPORTED 428 LAST YEAR.

DALLAS HAD ONLY 26 AIDS CASES IN 1983: IT HAD 284 LAST YEAR.

ATLANTA HAD 25 THEN AND 221 LAST YEAR.

BOSTON, 38...AND 187 LAST YEAR,
13

IN ALL, 17 CITIES HAVE EACH REPORTED MORE THAN 300 CASES OF
AIDS SINCE THE COUNTING BEGAN IN 198],

AS OF TODAY. AT LEAST 1 OR MORE CASES HAVE BEEN REPORTED IN
ALL 50 STATES, GUAM, THE TRUST TERRITORY, THE VIRGIN ISLANDS, AND
THE DISTRICT OF COLUMBIA,

COLORADO, FOR EXAMPLE, HAD 176 NEW CASES DURING THE PAST 12
MONTHS, MARCH ’86 TO MARCH ‘87,

HIO HAD 179 DURING THE SAME PERIOD,

ARKANSAS... 32,

MISSISSIPPI...28, AND SO ON,
14

THE UNRELENTING SPREAD OF THIS DISEASE OVER FOR THE PAST 6
YEARS HAS CARRIED IT FURTHER AND DEEPER INTO OUR SOCIETY AND WE
SIMPLY AREN’T YET ABLE TO SLOW IT DOWN, MUCH LESS STOP IT
ALTOGETHER.

IT IS ESSENTIAL, THEREFORE, THAT THE AMERICAN PEOPLE HAVE A
CLEAR UNDERSTANDING OF THE THREAT POSED TO THEM BY THIS DISEASE
AND ARE, THEMSELVES, READY TO FIGHT BACK,

IT WAS, BY THE WAY, FOR THAT VERY PURPOSE -- THAT IS, TO
INCREASE PUBLIC UNDERSTANDING -- THAT PRESIDENT REAGAN ASKED ME,
BACK IN FEBRUARY 1986, TO PULL TOGETHER EVERYTHING WE KNEW ABOUT
AIDS AND PUT IT ALL DOWN IN A PLAIN-ENGLISH REPORT TO THE AMERICAN
PEOPLE.

FOR 8 MONTHS -- FEBRUARY THROUGH SEPTEMBER OF LAST YEAR -- I
MET QUIETLY AND PRIVATELY WITH INDIVIDUALS AND GROUPS FROM ACROSS
THE SPECTRUM OF SOCIETY...
15

GROUPS LIKE THE NATIONAL EDUCATION ASSOCIATION, THE P.T.A..
AND THE STATE BOARDS OF EDUCATION...

I MET WITH THE CHRISTIAN LIFE COMMISSION OF THE SOUTHERN
BAPTIST CONVENTION AND THE SYNAGOGUE COUNCIL OF AMERICA...

I MET WITH THE NATIONAL COALITION OF BLACK AND LESBIAN GAYS
AND THE WASHINGTON BUSINESS GROUP ON HEALTH,

I MET WITH 26 GROUPS IN ALL.

THEY WERE ALL EXTRAORDINARILY HELPFUL. EACH ONE PLEDGED 10
DO WHATEVER WAS NECESSARY TO DISTRIBUTE MY REPORT ACROSS THE
LENGTH AND BREADTH OF AMERICA. AND MANY OF THEM ALREADY HAVE.
16

AFTER 8 MONTHS OF LISTENING AND WRITING, I DELIVERED MY
REPORT TO THE WHITE HOUSE LATE LAST SEPTEMBER. THE DOMESTIC

POLICY COUNCIL ACCEPTED IT...AND, OF COURSE. THE PRESIDENT
ACCEPTED IT,

SO FAR THAT REPORT HAS ACCOMPLISHED TWO THINGS:

FIRST. IT HAS IMPRESSED THE COUNTRY GENERALLY THAT AIDS IS
INDEED EVERYBODY’S PROBLEM. SOME PEOPLE DID NOT WANT TO BELIEVE
THAT.

NOW THEY MUST,
17

SECOND, THE REPORT MAKES CLEAR THAT, IN ORDER TO END THE
CHAIN OF TRANSMISSION OF THIS DISEASE ONCE AND FOR ALL. WE NEED TO
TEACH OUR YOUNG PEOPLE THE FACTS ABOUT AIDS AND ABOUT THEIR OWN
SEXUALITY. THE OBJECTIVE IS TO MAKE THEM A LOT MORE RESPONSIBLE
IN THEIR RELATIONSHIPS THAN THEIR ELDERS HAVE BEEN,

WHAT MIGHT SUCH AN EDUCATION PROGRAM SAY? WHO SHOULD SAY
IT? WHO SHOULD HEAR IT? AND WHEN SHOULD THEY HEAR IT?

EDUCATION IN THIS COUNTRY HAS BEEN AND MUST CONTINUE TO BE A
CONCERN AND RESPONSIBILITY OF STATES AND COMMUNITIES. THE FEDERAL
ROLE, HOWEVER, IS IMPORTANT AS FAR AS GETTING FACTUAL. SCIENTIF-
ICALLY ACCURATE INFORMATION INTO THE HANDS OF THE TEACHING STAFF.
13

FROM A PUBLIC HEALTH POINT OF VIEW, THE BEST DEFENSE AGAINST
AIDS IS TOTAL ABSTINENCE. AND THAT IS CERTAINLY THE MESSAGE WE
SHOULD GET ACROSS TO OUR CHILDREN.

BUT MOST CHILDREN WON'T REMAIN ABSTINENT AFTER THEY BECOME
ADULTS, SO WE MUST INTRODUCE THEM TO THE NOTION OF THE VALUE OF --
AND 1 WOULD ALSO SAY THE BEAUTY OF -- A FAITHFUL. MONOGAMOUS
RELATIONSHIP... THE KIND OF RELATIONSHIP IN WHICH YOU HAVE ONLY ONE
CONTINUING SEXUAL PARTNER...AND THAT PERSON IS AS FAITHFUL AS YOU
ARE,

TQ PARAPHRASE MR. LEE IACOCCA, I SAY...

IF YOU HAVE A MONOGAMOUS RELATIONSHIP...KEEP IT.

IF YOU DON’T HAVE ONE, GET IT,
19

FOR INDIVIDUALS WHO WON’T ABSTAIN, YET DO NOT HAVE A
MONOGAMOUS RELATIONSHIP EITHER, I STRONGLY ADVISE THAT THEY TAKE
EVERY PRECAUTION TO PROTECT THEMSELVES AND THEIR PARTNERS FROM THE
RISK OF GETTING AIDS.

THEY NEED TO KNOW WITH ABSOLUTE CERTAINTY THAT NEITHER THEY
NOR ANY OF THEIR SEXUAL PARTNERS ARE CARRYING THE AIDS VIRUS, IF
THEY ARE NOT ABSOLUTELY CERTAIN, THEN THEY MUST TAKE PRECAUTIONS.
FOR EXAMPLE...

* DON’T HAVE SEX WITH SOMEONE WHO ALREADY HAS AIDS OR WHO
INDULGES IN HIGH-RISK BEHAVIOR. SUCH A PERSON MIGHT BE A
PROSTITUTE OR AN 1.V. DRUG USER WHO BORROWS USED NEEDLES, IT
WOULD ALSO INCLUDE ANY SEXUALLY PROMISCUOUS PERSON -- WHETHER
HOMOSEXUAL OR HETEROSEXUAL,
20

* AND IF YOU DO DECIDE TO HAVE SEX WITH SUCH AN INDI-
VIDUAL -- A PROFOUNDLY SERIOUS HEALTH DECISION -- THEN, IF
YOU’RE A MAN, USE A CONDOM FROM START TO FINISH, IF YOU’RE A
WOMAN, MAKE SURE YOUR MALE PARTNER USES A CONDOM,

A CONDOM WON'T PROVIDE 100 PERCENT PROTECTION -- FEW THINGS IN
LIFE DO. BUT CONDOMS SEEM TO OFFER THE BEST BARRIER TO THE
TRANSMISSION OF AIDS, SHORT OF MONOGAMY AND ABSTINENCE,

THIS IS THE KIND OF INFORMATION WE NEED TO GET ACROSS TO OUR
CHILDREN, IF WE ARE TRULY CONCERNED ABOUT THEIR LIVES AND THE
FUTURE LIFE OF OUR SOCIETY,
21

I HAVE ALWAYS FELT THAT THIS WAS PRIMARILY A JOB FOR
PARENTS, THEY'RE THE ONES WHO SHOULD BE THE PRIMARY TEACHERS OF
SEXUALITY AND HUMAN RELATIONS TO THE CHILDREN OF THIS COUNTRY,

BUT I KNOW THAT MOST PARENTS EITHER CAN’T OR WON’T. HENCE,
OUR SCHOOLS, CHURCHES. SYNAGOGUES, AND OTHER COMMUNITY INSTITU-
TIONS MUST STEP IN TO DO WHAT’S NEEDED...AND WHAT'S RIGHT,

IT’S A DIFFICULT CHALLENGE.

BUT I BELIEVE THAT WE AMERICANS ARE A GOOD AND STRONG
PEOPLE. THROUGH TWO CENTURIES OF CHALLENGES OF MANY KINDS, WE'VE
CLUNG TO OUR FUNDAMENTAL VALUES OF PERSONAL FREEDOM. MUTUAL
ASSISTANCE, AND NATIONAL UNITY.
22

THOSE VALUES HAVE WITHSTOOD EVERY TEST OF THE PAST. AND THEY
ARE BEING TESTED AGAIN...RIGHT NOW,..BY THE INFILTRATION OF THIS
LETHAL DISEASE OF AIDS.

BUT I FIRMLY BELIEVE THAT OUR ENDURING AMERICAN VALUES WILL
ONCE MORE BE OUR GUIDES FOR COLLECTIVE ACTION AND ONCE MORE WE
SHALL SURVIVE A GRAVE THREAT TO OUR NATIONAL HEALTH AND WELL-
BEING,

THANK YOU,

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