AIDS: WHAT WE ALL NEED TO KNOW

BY
C, EVERETT KOOP, M.D., SC.D,
SURGEON GENERAL
OF THE
U, S, PUBLIC HEALTH SERVICE
U. S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

AIDS INTERFAITH COUNCIL
HOUSTON, TEXAS
MAY 27, 1988
1
AIDS IS POSING SOME VERY SERIOUS PROBLEMS FOR US ...
EDUCATIONAL, MORAL, ETHICAL, AND POLITICAL PROBLEMS. MOST OF YOU
WILL BE FACING THEM, AS LEADERS BOTH IN RELIGIOUS AND CIVIC
AFFAIRS. BUT I WOULDN’T BE SURPRISED IF A FAIR NUMBER OF YOU ARE
ALREADY STANDING FACE-TO-FACE WITH MANY OF THE DIFFICULT
QUESTIONS RAISED BY THIS EPIDEMIC,

AND We‘VE GOT TO TAKE THEM VERY SERIOUSLY BECAUSE I BELIEVE
AIDS IS POTENTIALLY ONE OF THE WORST INFECTIOUS DISEASES EVER TO
HIT THE HUMAN RACE,
2
YES, I SAID “POTENTIALLY” BECAUSE I HOPE THAT WE'LL SOMEHOW

ESCAPE THE FULL FORCE OF THE EPIDEMIC, THANKS TO SCIENCE AND
MEDICINE ... AND THANKS ALSO TO THE NATIVE COMMON SENSE OF MOST
PEOPLE. INCLUDING -- AND ESPECIALLY -- THE AMERICAN PEOPLE,

I'M BANKING ON THE IDEA THAT AMERICANS -- AND INDEED PEOPLE
EVERYWHERE ON THIS PLANET -- WILL HAVE THE GOOD SENSE TO LEARN
THE FACTS ABOUT AIDS AND WILL, THEREFORE, BEHAVE THEMSELVES IN
WAYS THAT PREVENT THE SPREAD OF AIDS.

BUT JUST WHAT ARE THE FACTS AT THIS TIME? WHAT DOES ONE
HAVE TO KNOW ABOUT THIS DISEASE IN ORDER TO PROTECT YOURSELF ...
YOUR FAMILY .... YOUR LOVED ONES .,. YOUR SCHOOL-...AND YOUR
CHURCH,
2
7

THE FIRST THING TO KNOW -- AND I SAY THIS, DESPITE MY
OPTIMISM OF A MOMENT AGO -- IS THAT THE AIDS VIRUS IS SPREADING.
WE KNOW THIS FROM THE REPORTS COMING IN TO THE U.S. PUBLIC
"HEALTH SERVICE EVERY WEEK FRON EVERY STATE AND TERRITORIAL HEALTH

DEPARTMENT .

FOR EXAMPLE, FROM MARCH 1986 TO MARCH OF ‘87, WE LOGGED IN
15,024 NEW CASES OF AIDS. BUT OVER THE MOST RECENT 12-MONTH
PERIOD -- FROM MARCH ‘87 TO MARCH 788 -- WE LOGGED IN ALMOST
24,000 NEW CASES.
4
YOU MAY REMEMBER THAT OUR FIRST CLUE ABOUT THIS DISEASE
APPEARED BACK IN JUNE 1981, WITH A REPORT OF 5 CASES OF A RARE
TYPE OF PNEUMONIA FOUND AMONG “OTHERWISE HEALTHY HOMOSEXUAL
MALES” IN LOS ANGELES, CALIFORNIA,

SINCE THOSE FIRST 5 CASES WERE RECORDED, LOS ANGELES HAS
REPORTED ANOTHER 4,600 CASES ... AND THE COUNTRY AS A WHOLE HAS
TURNED UP MORE THAN 52,740 CASES OF AIDS,

FROM 5 CASES TO 52.740 CASES IN LESS THAN 7 YEARS .., YOU
MUST TAKE SERIOUSLY ANY DISEASE THAT EXPLODES UPON A NATION WITH
SUCH SPEED AND SUCH SEVERITY.
5
BUT THE AIDS EPIDEMIC IS MORE THAN JUST AN EXERCISE IN
NUMBERS. THE FIRST REPORTS MAY HAVE COME FROM LOS ANGELES, BUT
TODAY EVERY STATE AND TERRITORY HAS BEEN TOUCHED BY THIS
_ EPIDEMIC.

I GRANT YOU THAT HALF OF ALL CASES REPORTED SO FAR HAVE BEEN
IN EITHER NEW YORK OR CALIFORNIA. BUT THE REST OF US CAN’T BE
SMUG ABOUT THAT INFORMATION.

INDIANA, OUT IN THE HEARTLAND OF AMERICA, HAS HAD 295 CASES
SO FAR ... KANSAS HAS HAD 133 ... MAINE, 70 CASES ... NORTH
DAKOTA, 6 ... AND EVEN GUAM HAS HAD 4 CASES SO FAR.
6
AND 20 CITIES IN 14 STATES HAVE EACH REPORTED OVER 500 CASES
OF AIDS SINCE 1981. AS OF MAY 6, 1988, HOUSTON HAS REPORTED
2,014 CASES WITH 1,252 DEATHS,

SO THIS EPIDEMIC IS GROWING NUMERICALLY AND SPREADING
GEOGRAPHICALLY,

HOWEVER, THE EXPANSION OF THE AIDS EPIDEMIC IS ONLY PART OF
THE STORY, ANOTHER PART IS EVEN MORE GRIM,

AIDS IS VIRTUALLY 100 PERCENT FATAL. OF THOSE 63,000
PERSONS WHO WERE REPORTED AS HAVING AIDS SO FAR, 32,000 HAVE

DIED, THAT’S AN OVERALL MORTALITY RATE OF 56 PERCENT.
—

/
BUT WAIT A MINUTE. OF THE PEOPLE WHO HAD AIDS IN 1981, SOME

92 PERCENT HAVE ALREADY DIED.
OF THOSE IN 1982, CLOSE TO 90 PERCENT HAVE DIED.

AND ALMOST A THIRD OF THE PEOPLE WHO WERE REPORTED WITH AIDS
JUST LAST YEAR HAVE ALREADY DIED.

WE DO NOT KNOW EVERYTHING ABOUT THIS DISEASE. BUT ONE THING
WE CAN SAY WITH SOME ASSURANCE:

IF YOU HAVE AIDS, YOUR CHANCES OF SURVIVING THE NEXT TWO OR
THREE YEARS ARE NOT VERY GOOD. BUT YOUR CHANCES OF
SURVIVING ANY LONGER THAN THAT ARE ALMOST NIL.
9

OF COURSE, WE HAVE A DRUG CALLED A.Z.T. WHICH SEEMS ABLE TO
PROLONG THE LIVES OF MANY PERSONS WITH AIDS. AND SEVERAL OTHER
DRUGS WITH THE SAME KIND OF PROMISE ARE IN THE DEVELOPMENTAL
PIPELINE. AND WE HAVE AN AEROSOL THAT IS PROPHYLACTIC AGAINST
PNEMOCYSTIS PNEUMONIA,

BUT -- IF AND WHEN THEY WORK -- THESE DRUGS WILL ONLY
PROLONG A PERSON’S LIFE FOR A FEW MONTHS .,, MAYBE A YEAR OR
SO. THEY DO NOT CURE YOU OF AIDS ,.. NOR OF ANY CONDITION

BROUGHT ON BY AIDS,

THE HARD TRUTH IS THAT WE HAVE NO DRUG .,. NO VACCINE ... NO
"MAGIC BULLET” OF ANY KIND THAT PREVENTS AIDS OR STOPS IT IN ITS
TRACKS,
9
NO DOUBT YOU’VE READ NEWS REPORTS ABOUT SOME VACCINE TESTING
THAT'S JUST GETTING UNDERWAY, IT’S TRUE ... WE HAVE ALLOWED SOME
VACCINE TESTING TO BEGIN,

BUT THESE ARE ONLY THE VERY FIRST STEPS IN VACCINE
DEVELOPMENT. THE REMAINDER OF THE PROCESS WILL BE VERY LONG --
STRETCHING TO THE END OF THIS CENTURY AT THE LEAST. AND THAT’S
PUTTING THE BEST FACE ON IT,

FOR THOSE WHO MINIMIZE THE SITUATION WE’RE IN, EXPECTING A
CURE TO BE DISCOVERED ANY DAY NOW... THEY .., ARE SADLY
MISTAKEN.
iG
"ANY DAY" COULD BE 12 TO 15 YEARS AWAY,

WHAT ELSE DO YOU NEED TO KNOW ABOUT AIDS?

HOW THE VIRUS REALLY OPERATES, FOR ONE THING. AT LEAST, AS
FAR AS We UNDERSTAND IT, REMEMBER, THE AIDS VIRUS IS STILL A
MYSTERY, SO, WHILE WE KNOW QUITE A BIT ABOUT IT, AIDS COULD STILL
SURPRISE US LATER ON,

ONCE IT INVADES THE HUMAN BODY, THE AIDS VIRUS --
TECHNICALLY, THE HUMAN IMMUNODEFICIENCY VIRUS, OR H.1.V. -- GOES
AFTER TWO TARGETS,
1
ONE TARGET IS THE BRAIN AND THE CENTRAL NERVOUS SYSTEM,

HERE, THE AIDS VIRUS ITSELF APPARENTLY BRINGS ON A DETERIORATION
OF THE CENTRAL NERVOUS SYSTEM. HENCE, TO THE ALREADY LONG LIST
OF DISEASES AND CONDITIONS CAUSED BY AIDS, WE’VE HAD TO ADD
DEMENTIA.

BUT THE CENTRAL NERVOUS SYSTEM IS NOT WHERE THE AIDS VIRUS
HAS BEEN DOING ITS WORST DAMAGE FOR THE PAST 6 YEARS.

THE AIDS VIRUS MOST COMMONLY FEEDS ON -- AND DESTROYS --
ITS OTHER TARGET: THOSE WHITE BLOOD CELLS THAT ARE THE BASIS OF
OUR HUMAN IMMUNE SYSTEM. |
LD
ONCE THE VIRUS FINDS THAT TARGET AND ATTACKS, THE PERSON
WITH THE VIRUS BECOMES AN EASY MARK FOR THE NEXT INFECTIOUS

DISEASE OR CANCER THAT COMES ALONG.

AND THOSE DISEASES ARE WHAT ATTACK AND KILL AIDS PATIENTS
vs DISEASES SUCH AS PNEUMOCYSTIS CARINII PNEUMONIA, KAPOSI'S
SARCOMA, CYTOMEGALOVIRAL INFECTIONS, “VALLEY FEVER” OR
PROGRESSIVE COCCIDIOMYCOSIS, HISTOPLASMOSIS, ATYPICAL
TUBERCULOSIS, CANDIDIASIS OF THE ESOPHAGUS AND THE RESPIRATORY
TRACT, ULCERATIVE HERPES, AND SO ON,
13
SINCE THE AIDS VIRUS FEEDS ON WHITE BLOOD CELLS, THE VIRUS

APPEARS WHERE THERE ARE HIGH CONCENTRATIONS OF SUCH CELLS. AND
THOSE CELLS ARE FOUND MAINLY IN TWO BODY FLUIDS -- BLOOD AND
SEMEN -- BUT ALSO APPEARS IN VAGINAL FLUIDS,

THAT INFORMATION ALSO HELPS US UNDERSTAND HOW THE AIDS VIRUS
TS SPREAD FROM PERSON TO PERSON:

THIS DISEASE IS SPREAD WHEN ANY AIDS-INFECTED BLOOD AND/OR
SEMEN FROM ONE PERSON ENTERS INTO ANOTHER PERSON’S BODY AND
IS ABSORBED INTO HIS OR HER BLOODSTREAM,
1 |
NEEDLESS TO SAY, THE TRANSMISSION OF THE AIDS VIRUS DOESN‘T

HAPPEN IN ANY CASUAL WAY. YOU TRANSMIT -- OR CATCH -- AIDS ONLY
IF YOU DO SOMETHING THAT WILL PASS AIDS-INFECTED BLOOD AND/OR
SEMEN BETWEEN YOU AND SOMEONE ELSE.

THE TRANSMISSION OF THE VIRUS TAKES PLACE’ IN FOUR DIFFERENT
WAYS.

ONE WAY WAS THROUGH BLOOD TRANSFUSIONS. MOST CHILDREN WITH
AIDS OR CARRYING THE VIRUS RECEIVED IT THROUGH A CONTAMINATED
BLOOD TRANSFUSION OR THROUGH CONTAMINATED CLOTTING FACTORS, MADE
FROM BLOOD, THAT ARE USED FOR THE TREATMENT OF HEMOPHILIA. SO,
QNE WAY WAS THROUGH BLOOD TRANSFUSIONS.
15
IT SAY “WAS” BECAUSE IN 1985 WE DEVELOPED A VERY GOOD BLOOD
TEST THAT DETECTS THE PRESENCE OF ANTIBODIES TO THE AIDS VIRUS IN
A SAMPLE OF A PERSON’S BLOOD,

THAT SOUNDS SORT OF ROUNDABOUT -- AND IT 1S, BECAUSE,
REMEMBER, THERE’S STILL MORE ABOUT AIDS VIRUS THAT WE DON'T KNOW
THEN WE DO KNOW,

THEREFORE, WE HAVE TO LOOK FOR A CONCENTRATION OF ANTIBODIES
TO THE AIDS VIRUS TO TELL US THAT THE VIRUS ITSELF IS PRESENT,
IT'S LIKE KNOWING THERE’S A KILLER NEARBY BECAUSE YOU SEE HIS
SHADOW ON THE WALL,
16
IN ANY CASE, RIGHT NOW, THANKS TO TWO TESTS -- A SCREENING

TEST AND A CONFIRMATION TEST -- OUR BLOOD SUPPLY IS JUST ABOUT AS
SAFE AS WE CAN MAKE IT. AND THAT GOES FOR CLOTTING FACTORS AS
WELL.

THE ODDS TODAY OF GETTING A CONTAMINATED UNIT OF TRANSFUSED
BLOOD ARE BETWEEN 1 IN 40,000 AND 1 IN 250,000. COMPARE THOSE
ODDS WITH, SAY, DEATH ON THE HIGHWAY: THAT’S 1 IN 5,900, OR
BEING KILLED PLAYING SOCCER: YOUR CHANCES ARE 1 IN 25,000 FOR
THAT,
17
SO EVEN THE VERY CONSERVATIVE ESTIMATE OF 1 CHANCE IN

40,000 THAT YOU’LL GET A TRANSFUSION OF AIDS-CONTAMINATED BLOOD
MEANS -- IN THE REAL WORLD -- THAT SUCH A POSSIBILITY IS
EXTREMELY REMOTE. AND THAT WAS SOMETHING WE COULDN'T DECLARE

| JUST A COUPLE OF YEARS AGO.

THAT LEAVES THREE WAYS TO CATCH AIDS. AND THESE ARE MUCH
MORE SIGNIFICANT FOR SOCIETY TODAY.

THE MOST COMMON OF THESE THREE IS THROUGH SEXUAL INTER-
COURSE. A MAN WITH AIDS CAN PASS THE VIRUS TO HIS SEXUAL
PARTNER THROUGH HIS SEMEN. UNFORTUNATELY, THE PROCESS CAN BE
THAT SIMPLE. AND, AGAIN UNFORTUNATELY, THE VIRUS CAN BE PASSED
THE OTHER WAY, TOO: FEMALE-TO-MALE.
18
AS A RESULT, PROSTITUTES HAVE CONTRACTED AIDS BY HAVING

VAGINAL INTERCOURSE WITH A MAN INFECTED WITH THE AIDS VIRUS,

IT’S POSSIBLE THAT THEY, IN TURN, HAVE PASSED THE VIRUS ON
TO OTHERS, AS A RESULT, I WOULD GUESS THAT A FEW UNSUSPECTING
WIVES AND SWEETHEARTS HAVE BEEN GIVEN THE VIRUS AS WELL,

BUT CERTAIN SEX PRACTICES NOT ONLY PRODUCE SEMEN. THEY ALSO
CAUSE BLEEDING. THIS IS PARTICULARLY TRUE DURING ANAL
INTERCOURSE, WHEN TISSUES TEND TO BE RUPTURED, BLEEDING OCCURS,
AND A MAN’S AIDS-INFECTED SEMEN THEN DIRECTLY ENTERS HIS
PARTNER’S BLOODSTREAM.
19
ANAL INTERCOURSE IS MOST OFTEN PRACTICED BY HOMOSEXUALS AND

BISEXUAL MALES. TODAY, LOOKING BACK TO 1981, IT’S NO LONGER
SURPRISING THAT THOSE FIRST 5 CASES OF AIDS INVOLVED “OTHERWISE
HEALTHY HOMOSEXUALS.”

INDEED, OVER THE PAST 7 YEARS, 2 OUT OF EVERY 3 PERSONS
WITH AIDS HAVE BEEN EITHER HOMOSEXUALS OR BISEXUAL MALES.

BUT PLEASE REMEMBER THAT HOMOSEXUALITY ... BY ITSELF ...
DOES NOT CAUSE AIDS, JUST AS HETEROSEXUALITY ... BY ITSELF
1a DOES NOT CAUSE SYPHILIS.
20
THERE ARE, AFTER ALL, AN ESTIMATED 12 MILLION HOMOSEXUALS IN

THE U.S. POPULATION AND IT IS APPEARS THAT MOST OF THEM -- LIKE
MOST AMERICANS IN GENERAL -- ARE MONOGAMOUS ... THEY ARE NOT

_ SEXUALLY PROMISCUOUS ... AND THEY DO NOT ENGAGE IN THE ROUGHER
KINDS OF SEXUAL INTERCOURSE.

AND SO... THOSE HOMOSEXUALS DO NOT HAVE AIDS AND THEY'LL
PROBABLY NEVER GET IT.

IN FACT, THEY'RE JUST AS FRIGHTENED OF THE DISEASE AS
THE REST OF US ARE.
21
WHAT IT COMES DOWN TO IS THIS: WE'RE FIGHTING A DEADLY

DISEASE ... WE’RE NOT FIGHTING THE PEOPLE WHO HAVE IT ... OR THE
PEOPLE WHO WE THINK MIGHT HAVE IT.

THAT’S ALWAYS BEEN AN IMPORTANT PUBLIC HEALTH PRINCIPLE IN
THIS COUNTRY. AMERICA HAS TAKEN ON SOME PRETTY DIFFICULT
DISEASES OVER THE YEARS -- SMALLPOX, POLIO, LEPROSY, MEASLES,
SYPHILIS -- BUT IN NOT ONE OF THOSE CASES DID WE ATTACK THE
PEOPLE WHO WERE SICK ... JUST THE SICKNESS ITSELF.

AND I CAN ASSURE YOU, AS YOUR SURGEON GENERAL, WE’RE NOT
GOING TO CHANGE NOW-... AIDS OR NO AIDS.
fata!
ZZ
I SAID THERE WERE FOUR WAYS TO GET AIDS. ONE WAS THROUGH
TRANSFUSED BLOOD, WHICH IS NO LONGER A PROBLEM. THE SECOND WAY
IS THROUGH SEXUAL INTERCOURSE ... ESPECIALLY -- BUT NOT

EXCLUSIVELY -- ANAL INTERCOURSE.

AND NOW THE THIRD WAY IS TO SHARE NEEDLES AND SYRINGES
ALREADY USED BY AN AIDS-INFECTED DRUG ADDICT.

I’M TOLD THAT THIS IS A VERY COMMON PRACTICE AMONG INTRA-
VENOUS DRUG ABUSERS ... IT’S AN EXPRESSION OF CAMARADERIE, AMONG
OTHER THINGS, AND DOESN’T SEEM RELATED TO THE COST OR
AVAILABILITY OF DRUG-PARAPHERNALIA,
23
BUT EXACTLY HOW IS THE VIRUS TRANSMITTED BY THIS MEANS?
AGAIN, IT’S UNFORTUNATELY QUITE SIMPLE.

AFTER A PERSON INJECTS THE DRUG INTO HIS OR HER VEIN, A TINY
DROP OF BLOOD IS OFTEN LEFT BEHIND IN THE NEEDLE OR EVEN FURTHER
UP, IN THE SYRINGE ITSELF,

IF THE USER IS INFECTED WITH AIDS, SOME OF THAT VIRUS WILL
BE IN THAT DROP OF BLOOD, ALSO, AND FROM WHAT WE CAN GATHER SO
FAR, IT APPEARS THAT THE AIDS VIRUS CAN REMAIN ALIVE IN SUCH A
SITUATION FOR SEVERAL HOURS AT THE VERY LEAST ... AND POSSIBLY A
DAY OR TWO AT THE MOST.
ou
THE NEXT PERSON USING THAT NEEDLE AND SYRINGE TO “SHOOT UP”
WILL GET THAT DROP OF BLOOD ALONG WITH HIS OR HER “FIX.” AND THE

AIDS VIRUS WILL BE RIGHT THERE WITH IT. Q.E.D,

AT THE LAST COUNT, 1 OUT OF EVERY 4 PERSONS WITH AIDS --
OVER 14,000 PEOPLE SO FAR -- HAS BEEN AN INTRAVENOUS DRUG
ABUSER.

THE FOURTH AND FINAL WAY TO GET AIDS IS TO BE BORN OF A
MOTHER WHO HAS AIDS. SO FAR, OVER 660 CHILDREN IN THIS COUNTRY
HAVE BEEN BORN WITH AIDS.
25
IN THOSE CASES, THE AIDS VIRUS -- ALREADY IN THE MOTHER’S

BLOODSTREAM -- SIMPLY MIGRATES INTO THE CHILD’S BLOODSTREAM
SOMETIME DURING PREGNANCY OR DURING CHILDBIRTH ITSELF.

THOSE, THEN, ARE THE FOUR WAYS BY WHICH A PERSON CAN BECOME
INFECTED WITH THE AIDS VIRUS. NOTICE, PLEASE, ‘THAT NONE OF THEM
INVOLVES A CASUAL ACT ON ANYONE’S PART.

A PERSON CAN SHARE SOMEONE ELSE’S WATER GLASS, BATH TOWEL,
TOILET SEAT, CAFETERIA UTENSILS, SWEATSHIRT, PEN, PENCILS, AND
COMPUTER KEYBOARD ... AND NOT GET AIDS. |
26
YOU MIGHT CATCH A COLD. OR YOU MIGHT CATCH THE FLU.

BUT YOU WON'T CATCH AIDS.

OBVIOUSLY, FROM A PUBLIC HEALTH POINT OF VIEW, THERE IS NO
REASON TO EXCLUDE FROM SCHOOL ANY STUDENT OR TEACHER WITH AIDS,

YOU MAY DO IT FOR OTHER REASONS ... REASONS WHICH MAY OR MAY
NOT BE FAIR TO THE PEOPLE INVOLVED ... BUT THEY WOULD NOT BE

PUBLIC HEALTH REASONS.

SO FAR, I’VE TALKED ABOUT THE VIRUS AND HOW IT ATTACKS THE
HUMAN NEUROLOGICAL AND IMMUNE SYSTEMS. BUT WE ARE NOT TOTALLY
DEFENSELESS AGAINST THE AIDS VIRUS.
2/
WE MAY LACK A SAFE AND EFFECTIVE VACCINE AGAINST AIDS, BUT

A FEW OTHER DEFENSES ARE AVAILABLE.

ONE OBVIOUS DEFENSE IS SIMPLY TO STAY AWAY FROM INTRAVENOUS
DRUG ABUSE. I DON’T THINK THAT REQUIRES ANY MORE COMMENT FROM
ME, PARTICULARLY BEFORE THIS AUDIENCE OF MEN AND WOMEN WHO HAVE
BEEN ON THE FRONT-LINE FIGHTING DRUG ABUSE IN OUR COUNTRY YEAR IN
AND YEAR OUT.

SO LET ME MOVE ON TO THE NEXT KIND OF DEFENSIVE BEHAVIOR,
WHICH INVOLVES AN UNDERSTANDING OF HUMAN SEXUALITY.
28
FIRST, I WILL CONFESS THAT I AM PROFOUNDLY SADDENED BY THE

IDEA THAT WE MUST EXPLAIN HUMAN RELATIONSHIPS AND HUMAN
SEXUALITY TO A NEW GENERATION OF GIRLS AND BOYS -~ $O THAT THEY
VOID CO F SEASE.

AND YET ... WE MUST.

AND OUR FIRST RECOMMENDATION OUGHT TO BE ABSTINENCE FROM
SEX.

I GRANT THAT SEXUAL ABSTINENCE MAY NOT WORK FOR EVERYONE.
IF IT DID, THAT WOULD BE THE END OF THE HUMAN RACE.
2¢
BUT SEXUAL ABSTINENCE IS A VERY GOOD IDEA FOR YOUNGSTERS OF
SCHOOL AGE. TODAY -- IN THE PRESENCE OF THE DEADLY AIDS EPIDEMIC
-- I THINK WE. AS ADULTS, MUST STEP FORWARD AND HELP OUR CHILDREN
ADDRESS THE PHENOMENON OF THEIR OWN SEXUALITY IN A CARING,
DEVELOPMENTAL WAY,

AND OUR MESSAGE OUGHT TO INCLUDE THE WISDOM OF CHOOSING TO
BE SEXUALLY ABSTINENT, WHILE STILL IN SCHOOL,

FOR THE REST OF US ... ME... YOU... YOUR CONGREGATIONS ...
ABSTINENCE MAY NOT BE THE BEHAVIOR OF CHOICE. WHAT THEN?
30
THEN THE NEXT BEST THING IS MONOGAMY ... ONE PERSON, ONE
MATE: FIND SOMEONE TO WHOM YOU CAN GIVE YOUR LOVE AND RESPECT
AND TRUST ... SOMEHOW WHO WILL GIVE THE SAME IN RETURN ... AND

STAY WITH THAT PERSON FOREVER.

SUCH A MONOGAMOUS RELATIONSHIP IS NOT LIKELY TO BE INFECTED
AND CONSUMED BY AIDS ... OR BY ANY OTHER DISEASE EITHER.

OF COURSE, A NUMBER OF PEOPLE ARE MONOGAMOUS -- BUT IN
SEQUENCE: THAT IS, THROUGH DIVORCE AND RE-MARRIAGE, FOR EXAMPLE,
AN INDIVIDUAL MAY HAVE ONE ... TWO... OR MORE MONOGAMOUS
PARTNERS DURING HIS™ OR HER ADULT LIFETIME.
31
AND THEN THERE ARE THE PEOPLE WHO FOR WHATEVER REASONS, DO
NOT HAVE A LOVING, MONOGAMOUS RELATIONSHIP -- AND PERHAPS NEVER
WILL HAVE, YET, THEY, TOO, MAY WANT TO EXPRESS THEIR OWN

SEXUALITY FROM TIME TO TIME AND THAT'S A NORMAL ENOUGH DESIRE.
WHAT OF THESE INDIVIDUALS?

FOR THEM WE RECOMMEND THAT THEY PROTECT THEMSELVES, AND, AT

THE PRESENT TIME, THE ONLY EFFECTIVE PROTECTION AVAILABLE IS THE
LATEX CONDOM,
32

THE CONDOM IS NOT ONE-HUNDRED-PERCENT-PERFECT, I’VE NEVER
CLAIMED THAT IT WAS, HOWEVER. WHEN IT IS USED CORRECTLY -- THAT
TS, WHEN THE LATEX CONDOM IS WORN FROM START TO FINISH DURING
SEXUAL INTERCOURSE, WITH A LITTLE SPERMICIDE ADDED ON THE TIP AND
ON THE SIDES -- IT DOES PROVIDE AN EFFECTIVE BARRIER AGAINST THE
TRANSMISSION OF THE AIDS VIRUS. CONDOMS, AS GADGETS, ARE MORE
RELTABLE THAN THE PEOPLE WHO USE THEM,

ABSTINENCE ... MONOGAMY ... AND THE USE OF THE LATEX CONDOM
SEEM TO BE OUR BEST DEFENSES AGAINST THE TRANSMISSION OF THE AIDS
VIRUS THROUGH SEXUAL INTERCOURSE,
33
THAT'S A DIFFICULT MESSAGE TO DELIVER TO ADULTS. IT’S EVEN

MORE DIFFICULT TO DELIVER TO YOUNG PEOPLE, ESPECIALLY CHILDREN IN
ELEMENTARY AND MIDDLE SCHOOL.

BUT IT’S A LIFESAVING MESSAGE AND, THEREFORE, WE ARE DUTY-
BOUND TO DELIVER IT.

AS I’VE PRESENTED IT SO FAR, THE MESSAGE DOES HAVE A NASTY
CLINICAL SIDE TO IT. BUT A THOUGHTFUL EDUCATIONAL PROGRAM
DEALING WITH SEXUALITY AND AIDS PREVENTION SHOULD ALSO TOUCH UPON
SOME NON-CLINICAL CONCEPTS, SUCH AS SEX WITH RESPONSIBILITY ...
SEX WITH CARING i SEX WITH JUSTICE ... AND SEX WITH SELF-
RESPECT AND WITH MUTUAL RESPECT.
34
FROM A PUBLIC HEALTH POINT OF VIEW, THEN, THIS IS ALL THERE
IS TO A BASIC INFORMATION PACKAGE CONCERNING AIDS: WHAT IT IS,
HOW IT’S TRANSMITTED, AND HOW TO PROTECT YOURSELF AGAINST IT,

IT’S ALL IN THE BROCHURE WE SENT YOU,

I BELIEVE THAT WE ADULTS ARE MORALLY OBLIGATED TO TELL YOUNG
PEOPLE THE FACTS ABOUT AIDS. BUT THOSE FACTS DO NOT EXIST IN A
VACUUM. YES, WE NEED TO TELL YOUNG PEOPLE THE FACTS ABOUT AIDS
1s. BUT WE MUST ALSO TELL THEM THE FACTS ABOUT HUMAN DECENCY AND
LOVE AND MUTUAL RESPECT AND RESPONSIBILITY. AND WHAT BETTER TIME
TO INJECT YOUR OWN ETHICAL, MORAL, AND RELIGIOUS BELIEFS THAN
WHILE THE BROCHURE I MENTIONED IS READ AND STUDIED BY THE FAMILY.
35

THAT CAN PRODUCE THE KIND OF ADULT THAT OUR SOCIETY NEEDS
TODAY. AND TOMORROW... EVEN MORE SO,

WITH YOUR HELP -- WE WILL HAVE THOSE ADULTS TOMORROW ...
ALIVE AND WELL AND LIVING IN AMERICA,

THANK YOU,