ADDRESS

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

e2esi9

PRESENTED TO THE JOINT SESSION OF THE LEGISLATURE
OF THE STATE OF TEXAS
AUsTIN, TEXAS
MarcH 26, 1987
MR. PRESIDENT, MR, SPEAKER...

IT IS AN HONOR AND A GREAT PRIVILEGE FOR ME TO ADDRESS THIS JOINT
SESSION OF THE LEGISLATURE OF THE STATE OF TEXAS.

AND WHILE YOUR INVITATION WAS ADDRESSED TO ME -- AND I WAS
PLEASED TO ACCEPT IT -- I AM HERE TODAY REPRESENTING NOT JUST MYSELF
BUT ALSO THE 5,000 OR SO PERSONNEL OF THE U.S. PUBLIC HEALTH
SERVICE. I WANT VERY MUCH TO SHARE THE HONOR OF THIS MOMENT WITH
THEM, BECAUSE SO MUCH OF WHAT I DO AND SAY IS THE PRODUCT OF THEIR
HARD WORK,

ALSO, I WANT TO ACKNOWLEDGE THE EXCELLENT RELATIONSHIP THAT
EXISTS BETWEEN THE PUBLIC HEALTH SERVICE AND THE LOCAL AND STATE
PUBLIC HEALTH OFFICERS HERE IN TEXAS, AND, IF I MAY, 1’D LIKE TO
RECOGNIZE THE SPECIAL ROLE PLAYED BY YOUR COMMISSIONER OF HEALTH. DR.
ROBERT BERNSTEIN, WHO HAS DONE SO MUCH TO FOSTER THOSE STRONG BONDS
BETWEEN OUR RESPECTIVE PUBLIC HEALTH STAFFS,
2

WE VALUE THE TALENT, THE EXPERTISE, AND THE FRIENDSHIP OF OUR
COLLEAGUES HERE IN TEXAS. AND I KNOW THEY APPRECIATE THE WORK WE DO
AS WELL,

THAT’S THE WAY IT HAS BEEN OVER THE YEARS AND I’M SURE THAT’S THE
WAY IT WILL CONTINUE TO BE IN THE FUTURE.

IT’S GOOD FOR THE PEOPLE OF TEXAS,..AND I KNOW IT’S GOOD FOR
AMERICA,

SO I TRULY APPRECIATE THIS OPPORTUNITY AND AM MINDFUL OF THE
HONOR YOU GIVE ME.

HOWEVER, AS I STAND BEFORE YOU IN THIS CHAMBER, I AM MOST MINDFUL
OF THE FOLLOWING...SINGLE...OVERWHELMING...AND PROFOUNDLY TRAGIC FACT:
3

THAT TEXANS WERE AMONG THE EIRST OF OUR CITIZENS, BACK IN 1980 AND
1981, TO BE IDENTIFIED AS BEING THE VICTIMS OF AIDS. THEY WERE
ALSO AMONG THE FIRST IN THIS COUNTRY TO DIE OF THAT DISEASE.

I AM DEEPLY, DEEPLY SORRY THAT ANYONE -- ANYWHERE IN THE WORLD -- HAS
HAD TO DIE OF THIS DISEASE. AND I AM GREATLY SADDENED, AS I KNOW WE
ALL ARE, THAT MANY MORE -- MANY TENS OF THOUSANDS MORE -- WILL DIE OF
THIS DISEASE IN THIS COUNTRY...AND HUNDREDS OF THOUSANDS MORE WILL DIE
AROUND THE WORLD,

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, DURING THAT TIME...
4

WE'VE SEEN THE OFFENDING VIRUS AND WE'VE NAMED AND RENAMED IT...

WE'VE DEVELOPED A TEST TO DETERMINE IF THE VIRUS IS PRESENT IN
SOMEONE’S BLOOD...

WE’VE BEEN ABLE TO GALVANIZE A LARGE, INTERNATIONAL ARMY OF
BIOMEDICAL RESEARCHERS, INCLUDING MANY MEN AND WOMEN OF GENIUS
WORKING IN LABORATORIES RIGHT HERE IN TEXAS...

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,
5

THAT LAST POINT IS EXTREMELY IMPORTANT, BECAUSE IT IS 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, TIMELY, ACCURATE INFORMATION IS VITAL... ESPECIALLY FOR
THE ELECTED RERPESENTATIVES OF A FREE PEOPLE.

WE ARE BEGINNING TO REALIZE THAT THE DISEASE OF AIDS -- AS IT
CONTINUES TO SPREAD THROUGHOUT OUR POPULATION -- WILL BE DRAWING EVER
MORE HEAVILY UPON THIS COUNTRY’S SOCIAL AND POLITICAL CAPITAL. AS WELL
AS UPON OUR MEDICAL AND FINANCIAL CAPITAL.

IT'S A DIFFICULT CHALLENGE FOR AMERICANS. BUT WE ARE A GOOD
PEOPLE. THROUGH TWO CENTURIES OF CHALLENGES OF MANY KINDS, THE
AMERICAN PEOPLE HAVE CLUNG T0 THEIR FUNDAMENTAL VALUES OF PERSONAL
FREEDOM, MUTUAL ASSISTANCE, AND NATIONAL UNITY,
6

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

BUT I FIRMLY BELIEVE THAT THOSE 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,

AND RIGHT HERE I MUST RECOGNIZE THE LEADERSHIP ALREADY
DEMONSTRATED BY THE STATE OF TEXAS, 1 THINK, FOR EXAMPLE, THAT THE
COMMISSIONER OF HEALTH’S “TASK FORCE ON AIDS.” HAS DONE AN EXCELLENT
JOB IDENTIFYING THE KEY ISSUES PRESENTED BY THIS DISEASE AND BY
SOUNDING THE ALERT NOT WITH TERMS OF FEAR AND HYSTERIA BUT WITH FACTS
AND GOOD TEXAN COMMON SENSE.
7

WHILE PREPARING FOR THIS VISIT, I LOOKED OVER THE RECOMMENDATIONS
OF THE TASK FORCE AND I THINK THIS STATE IS IN VERY GOOD HANDS INDEED.

BUT, LIKE THE REST OF US, YOU'VE ONLY BEGUN WHAT APPEARS TO BE A
LONG AND FEARFUL JOURNEY. ALL SIGNS POINT TO THIS DISEASE BEING A
BURDEN TO US FOR THE REST OF THIS CENTURY AT THE VERY LEAST,

NATIONALLY, WE’VE HAD 35,000 CASES OF THE DISEASE REPORTED SO
FAR, OVER HALF OF THEM HAVE DIED. AND MOST OF THE REST WILL.

THE TEXAS EXPERIENCE IS NO DIFFERENT: OVER 2,000 CASES SO FAR...
AND TWO-THIRDS OF THEM DEAD,..AND A BLEAK OUTLOOK FOR THE REST.

WE ANTICIPATE A CUMULATIVE TOTAL, NATIONALLY, OF MORE THAN A
QUARTER OF A MILLION REPORTED AIDS CASES BY 1991, YOUR OWN STATE
EPIDEMIOLOGISTS PREDICT THAT SOME 16,000 OF THEM WILL BE TEXANS,
8

THUS FAR, THE VAST MAJORITY OF AIDS VICTIMS HAVE BEEN
HOMOSEXUALS, BISEXUAL MEN, AND INTRAVENOUS DRUG ABUSERS.

BUT THIS IS NO LONGER AN EXCLUSIVE CLUB, AS OF LAST WEEK, ABOUT
4 PERCENT OF ALL AIDS REPORTS HAVE INVOLVED HETEROSEXUAL MEN AND WOMEN
WHO ARE NOT I.V. DRUG ABUSERS, APPARENTLY THEIR HETEROSEXUAL ACTIVITY
ALONE WAS THEIR SINGLE RISK FACTOR,

OUR STATISTICIANS ESTIMATE THAT THE OVERALL NUMBER OF AIDS CASES
WILL PROBABLY INCREASE S-FOLD OVER THE NEXT FIVE YEARS. THAT‘S A
STEEP CURVE.

HOWEVER, THEY SAY THE NUMBER OF AIDS CASES INVOLVING HETERO-
SEXUALS WILL INCREASE ABOUT 20-FOLD., THAT’S A VERY STEEP CURVE.
Q
J

ANOTHER TROUBLING FACT IS THE INCIDENCE OF THIS DISEASE AMONG
BLACKS AND HISPANICS, THE SIUTATION IS EXTREMELY SERIOUS AND WE'VE
GOT TO TALK ABOUT IT,

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 DISPRO-
PORTIONATE.
10

IN ADDITION, MORE THAN HALF THE NUMBER OF INFANTS WITH AIDS ARE
BLACK AND ANOTHER 24 PERCENT ARE HISPANIC, AGAIN, THESE ARE HIGHLY
DISPROPORTIONATE FIGURES, NEARLY ALL THESE CHILDREN RECEIVED 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 THE
NUMBER OF CASES 1S VASTLY UNDER-REPORTED,

THESE PIECES OF INFORMATION ARE ALL PART OF THE TOTAL PICTURE OF
A DISEASE THAT IS RELENTLESSLY REACHING FURTHER AND FURTHER INTO OUR
SOCIETY AND WE ARE PRACTICALLY POWERLESS T0 STOP IT,..OR EVEN SLOW IT
DOWN,
I]

IT WOULD APPEAR THAT THIS MIGHT BE THE TIME FOR REPRESENTATIVES
FROM ALL LEVELS OF GOVERNMENT -- FEDERAL, STATE, AND LOCAL -- AS WELL
AS FROM ALL CONCERNED INTERESTS IN THE PRIVATE SECTOR TO SIT DOWN
TOGETHER AND LOOK AT TWO VERY SERIOUS ISSUES FOR THE FUTURE:

FIRST OF ALL, THE COSTS OF THIS DISEASE TO OUR SOCIETY ARE ALREADY
HIGH.,.AND THEY ARE GOING TO GET ASTRONOMICAL, THE PRESENT COSTS
OF RESEARCH AND PATIENT CARE ARE ALREADY RUNNING IN THE HUNDREDS
QF MILLIONS OF DOLLARS. BEFORE ANOTHER DECADE PASSES, THEY COULD
BE IN THE TENS OF BILLIONS,

SOME OF OUR EXPERTS ESTIMATE THAT AS EARLY AS 1991 THE TOTAL
NATIONAL BILL FOR THE CARE OF AIDS PATIENTS WILL BE $16 BILLION A
YEAR...OR NEARLY TWICE WHAT WE’RE SPENDING THIS YEAR TO SUPPORT
ALL THE PROGRAMS OF THE ENTIRE U.S, PUBLIC HEALTH SERVICE. HOW
WILL THIS MONEY BE RAISED? HOW WILL IT BE SPENT? WHAT KINDS OF
PRIORITIES SHOULD WE SET FOR OURSELVES?
12

AND A RELATED QUESTION IS THE ROLE OF INSURANCE. WITH A DISEASE
SUCH AS AIDS... WITH ITS ENORMOUS POTENTIAL FOR BANKRUPTING A
COMMUNITY'S HEALTH CARE SYSTEM...WE NEED TO TALK ABOUT THE ROLE
THAT INSURANCE OUGHT TO PLAY,..OR OUGHT NOT TO PLAY. IN THE CASE
OF INSURANCE, AS THROUGHOUT THIS ISSUE OF FINANCING THE COSTS OF
AIDS, WE DARE NOT HAVE DECISIONS MADE BY DEFAULT OR BY INDECISION,

SECONDLY, I THINK WE HAVE TO TAKE ANOTHER LOOK AT HOW WE CARE FOR
THE TERMINALLY ILL PATIENT WITH AIDS, WE CAN'T CONTINUE INDEFIN-
ITELY TO SET ASIDE BEDS FOR THEM IN OUR ACUTE CARE AND GENERAL
HOSPITALS, THE COSTS -- IN BOTH DOLLARS AND PERSONNEL -- WILL
SIMPLY OVERWHELM OUR HOSPITAL AND SOCIAL SERVICE SYSTEMS. YET, WE
KNOW THAT THE PERIOD OF DEBILITATION AND DYING CAN Be PROLONGED
AND THAT EACH AIDS PATIENT REQUIRES SOME KIND OF CARE EVERY
REMAINING DAY OF HIS OR HER LIFE. WE NEED TO DETERMINE JUST WHAT
LEVELS OF CARE ARE NEEDED AND HOW WE WILL PROVIDE THAT CARE IN A
COMPASSIONATE, PROFESSIONAL, AND RESOURCE-EFFECTIVE MANNER,
13

RIGHT NOW, WE’RE DOING A GREAT DEAL OF EXPERIMENTATION IN THE
MATTER OF PATIENT CARE, AND I HAVE NOTHING BUT TOTAL ADMIRATION
FOR THE DEDICATED HEALTH PERSONNEL WHO’VE BEEN INVOLVED SO FAR,
BUT WE’VE GOT TO MAKE SURE THAT THESE DIFFERENT APPROACHES ARE
RECOGNIZED AND UNDERSTOOD AND...WHEN THEY’RE SEEN TOGETHER IN
CONTEXT... THAT THEY POINT US IN SOME HELPFUL AND HOPEFUL
DIRECTIONS,

T BELIEVE THE TIME MAY BE NOW UPON US TO ENGAGE IN THIS KIND OF
NATIONAL DIALOGUE ON FINANCES AND PATIENT CARE BECAUSE THE AMERICAN
PEOPLE ARE GAINING A CLEARER UNDERSTANDING OF THE THREAT POSED TO THEM
BY THIS DISEASE AND ARE, THEMSELVES, TRYING TO WORK THROUGH THE
ISSUES,
14

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 -- 1 MET
QUIETLY AND PRIVATELY WITH INDIVIDUALS AND GROUPS FROM ACROSS THE
SPECTRUM OF SOCIETY...

GROUPS LIKE THE NATIONAL EDUCATION ASSOCIATION AND THE NATIONAL
Pil Avia,

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,
15

T HAD GOOD MEETINGS WITH THE REPRESENTATIVES OF LOCAL, COUNTY,
STATE, AND TERRITORIAL HEALTH OFFICIALS..,26 GROUPS IN ALL,

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

AFTER 8 MONTHS OF LISTENING AND WRITING, I DELIVERED MY REPORT 10
THE WHITE HOUSE LATE LAST SEPTEMBER. THE DOMESTIC POLICY COUNCIL
ACCEPTED IT...AND, OF COURSE, THE PRESIDENT ACCEPTED IT,

I WANT TO ASSURE YOU THAT AT NO TIME IN THIS HIGH-LEVEL REVIEW
PROCESS DID ANYONE TINKER WITH IT. THE FINAL PUBLISHED REPORT I
RELEASED ON OCTOBER 22 WAS THE EXACT SAME REPORT THAT I PERSONALLY
WROTE BETWEEN FEBRUARY AND SEPTEMBER OF LAST YEAR,
16

THE 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.

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 QUR
YOUNG PEOPLE THE FACTS ABOUT AIDS AND ABOUT THEIR OWN SEXUALITY. THE
OBJECTIVE IS TO MAKE THEM A LOT MORE RESPONSIBLE IN THEIR RELATION-
SHIPS 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?
17

MOST EDUCATORS AGREE THAT ANY EDUCATIONAL PROGRAM IN THIS AREA
OUGHT TO BE PART OF A COMPREHENSIVE CURRICULUM IN SCHOOL HEALTH EDU-
CATION. SUCH A CURRICULUM USUALLY INCLUDES INFORMATION ON NUTRITION,
DENTAL HEALTH, PHYSICAL FITNESS, ACCIDENT PREVENTION, AND SO ON,

THE INFORMATION THAT IS AIDS-RELATED OUGHT TO BE EVERY BIT AS
FACTUALLY CORRECT AND PERSONALLY SENSITIVE AS THE REST OF THE
CURRICULUM,

SCIENCE AND GOVERNMENT CAN HELP PROVIDE THE FACTUALLY CORRECT
INFORMATION. AND, AS A MATTER OF FACT, THE FEDERAL GOVERNMENT IS
ALREADY SPENDING CLOSE TO $100 MILLION TO BRING TOGETHER THE FACTS
ABOUT AIDS AND DELIVER THEM TO THE AMERICAN PEOPLE.

BUT IN OUR AMERICAN TRADITION, JUDGMENTS AS TO THE SENSITIVITY
AND MORALITY OF A PARTICULAR CURRICULUM ARE LEFT TO FAMILIES AND
COMMUNITIES TO DECIDE.
18

I DO HAVE SOME OBSERVATIONS, HOWEVER, THAT ARE DRAWN FROM THE
COLLECTIVE EXPERIENCE OF HEALTH AND MENTAL HEALTH EXPERTS WHO HAVE
BEEN WORKING IN THIS AREA FOR A LONG TIME,

WITH MANY OF THEM I SHARE THE SAME DISCOMFORT WITH THE TERM “SEX
EDUCATION.” IT HAS, BY NOW, FAIRLY LIMITED CONNOTATIONS IN THE PUBLIC
MIND, PEOPLE HEAR THE PHRASE, “SEX EDUCATION,” AND THEY IMMEDIATELY
THINK OF CLASS HOURS DEVOTED TO HUMAN REPRODUCTIVE BIOLOGY...WHAT MANY
YOUNG PEOPLE THEMSELVES CALL “ORGAN RECITALS.”

MOST SCHOOLS NOW OFFER THIS MINIMUM KIND OF SEX EDUCATION SOME
TIME DURING THE JUNIOR HIGH OR MIDDLE SCHOOL YEARS AND THAT’S A GOOD
THING, ALTHOUGH IT MIGHT BE A LITTLE LATE.
19

I HAVE URGED THAT THE MATERIAL BE PRESENTED EARLIER. AMONG 9-,
10-, AND 11-YEAR-OLDS.

OF COURSE, DEVELOPMENTAL AGE IS MORE IMPORTANT THAN CHRONOLOGICAL
AGE, AND, AGAIN, COMMUNITY STANDARDS MUST BE TAKEN INTO ACCOUNT, AND

THESE VARY FROM PLACE 10 PLACE,

YOUNG CHILDREN ARE EXTREMELY CURIOUS ABOUT THEMSELVES, AS THEY
SHAPE THEIR OWN IDENTITIES. THEY ARE ALSO KINDER AND MORE GENEROUS
THAN OLDER CHILDREN...OR EVEN THAN MOST ADULTS, FOR THAT MATTER,

THEY ARE, ABOVE ALL, SUSCEPTIBLE TO BEING LOVED AND 10 OFFERING
MUCH LOVE IN RETURN,

AND SEX EDUCATION WITHOUT THE CONCEPT OF LOVE AND RESPONSIBILITY
IS LIKE A PIECE OF PIE THAT'S ALL CRUST AND NO FILLING.
20

MY OWN PREFERENCE, THEREFORE, IS TO HAVE OUR CHILDREN INTRODUCED
TO THE SUBJECT OF REPRODUCTIVE BIOLOGY WITHIN THE CONTEXT OF LEARNING
ABOUT ADULT RELATIONSHIPS THAT ARE LOVING, CARING, RESPECTFUL, AND
CONSIDERATE,

SUCH RELATIONSHIPS INCLUDE SOME FULFILLING SEXUAL ACTIVITY, BUT
THEY ARE NOT DEFINED ONLY BY THAT ACTIVITY. THERE’S MUCH MORE TO
HUMAN RELATIONSHIPS THAN JUST “GOOD SEX.” AND YOUNG PEOPLE OUGHT TO
BE TOLD THAT,

EVERYONE DREAMS OF SUCH A RELATIONSHIP, THE NOVELIST CALLS IT
"TRUE LOVE.” THE SOCIOLOGIST CALLS IT “MARITAL FIDELITY.” THE
SURGEON GENERAL CALLS IT “MONOGAMY.”
21

AND STRICTLY FROM A PUBLIC HEALTH POINT OF VIEW, THE BEST DEFENSE
AGAINST AIDS, SHORT OF TOTAL ABSTINENCE, IS TO MAINTAIN 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.

TO PARAPHRASE MR. LEE IACOCCA, I SAY...
IF YOU HAVE A MONOGAMOUS RELATIONSHIP...KEEP IT.
IF YOU DON’T HAVE ONE, GET IT,
MY ADVOCACY OF MONOGAMY MAY SOUND LIKE A MORALITY LESSON, BUT IN

OUR BATTLE AGAINST AIDS, IT JUST SO HAPPENS THAT -- IN ADDITION TO

EDUCATION -- YOU CAN COUNT SCIENCE AND MORALITY AS OUR MOST POWERFUL
ALLIES,
22

FOR INDIVIDUALS WHO DON’T YET HAVE A FAITHFUL MONOGAMOUS
RELATIONSHIP FOR WHATEVER REASON, I ADVISE ABSTINENCE, AND MY ADVICE
IS STRAIGHTFORWARD ENOUGH: IF YOU DON’T KNOW WHAT YOU’RE DOING...OR
WITH WHOM YOU'RE DOING IT...THEN DON’T DO Il.

I BELIEVE THAT’S NOT ONLY GOOD PUBLIC HEALTH DOCTRINE, IT’S ALSO
GOOD SCIENCE. AND THERE ARE SOME WHO MIGHT ARGUE IT WAS GOOD MORALS
AS WELL,

FINALLY, THERE ARE MANY INDIVIDUALS WHO DON’T HAVE A MONOGAMOUS
RELATIONSHIP AND WHO WON’T REMAIN ABSTINENT, TO THEM 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,

MY ADVICE TO THEM IS SIMPLE ENOUGH:
23

* DON’T HAVE SEX WITH SOMEONE WHO ALREADY HAS AIDS. THAT OUGAT
TO BE OBVIOUS.

* DON’T SHARE NEEDLES IF YOU “SHOOT” DANGEROUS DRUGS, BUT
BETTER STILL. DON’T “SHOOT” DRUGS AT ALL.

* DON'T HAVE SEX WITH SOMEONE WHO INDULGES IN HIGH-RISK
BEHAVIOR, THAT WOULD INCLUDE HOMOSEXUALS, INTRAVENOUS DRUG USERS,
AND PROSTITUTES AND OTHERS WHO HAVE MANY DIFFERENT SEX PARTNERS,
OBVIOUSLY THE SAME MESSAGE GOES TO ANY OF THOSE HIGH-RISK
INDIVIDUALS AS WELL,

* AND FINALLY, IF YOU DO DECIDE TO HAVE SEX WITH SUCH AN INDI-
VIDUAL ANYWAY -- A DECISION CARRYING PROFOUNDLY SERIOUS HEALTH
CONSEQUENCES -- THEN, IF YOU’RE A MAN, AT LEAST USE A CONDOM FROM
START TO FINISH. IF YOU’RE A WOMAN, MAKE SURE YOUR MALE PARTNER
USES A CONDOM.
24

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

IF SEXUALLY ACTIVE PEOPLE WILL HEED THESE MESSAGES, THEY WILL
ACHIEVE A HIGH DEGREE OF PROTECTION AND MOST LIKELY WON'T BE INFECTED
WITH THE AIDS VIRUS,

I’M SHARING THESE THOUGHTS WITH YOU TODAY BECAUSE I BELIEVE THAT
EACH OF US -- IN OUR HOMES OR IN OUR SCHOOLS -- HAS THE RESPONSIBILITY
TO PASS THAT INFORMATION ON TO OUR CHILDREN. I PERSONALLY WOULD
PREFER THAT THIS BE DONE BY PARENTS IN THE HOMES OF AMERICA,

T SAY THAT, KNOWING FULL WELL THAT MANY PARENTS SIMPLY CAN'T DO
IT, THEY DIDN'T RECEIVE A SOLID FOUNDATION IN HUMAN SEXUALITY AND
REPRODUCTIVE BIOLOGY WHEN THEY WERE CHILDREN EITHER.
25

ALSO, MOST PARENTS -- AND ADULTS IN GENERAL -- ARE NOT VERY GOOD
ABOUT TALKING 10 EACH OTHER ABOUT THEIR SEXUALITY. ThEY FEEL
FRUSTRATED, GUILTY, AND EVEN ANGRY BECAUSE THEY ARE UNABLE TO DO ThE
THING THAT THEY KNOW -- INTELLECTUALLY AND EMOTIONALLY -- THEY SHOULD.
DO: TALK TO THEIR CHILDREN ABOUT SEX,

BUT THEY CAN'T.

AND WITH THE DIVORCE RATE STILL HIGH IN THIS COUNTRY, IS IT ANY
WONDER THAT MANY PARENTS ARE UNABLE TO TELL THEIR CHILDREN ABOUT THE
FULL-DIMENSIONAL RICHNESS OF AN IDEAL HUMAN RELATIONSHIP?

STILL, IT REMAINS AS MY SINCEREST WISH THAT THE PARENTS OF THIS
COUNTRY WILL BE THE PRIMARY TEACHERS OF SEX AND HUMAN RELATIONS TO THE
CHILDREN OF THIS COUNTRY,
26

AND IF THEY CAN’T, THEN OUR SCHOOLS, CHURCHES, SYNAGOGUES, AND
OTHER COMMUNITY INSTITUTIONS MUST BE PRE- PARED TO DO WHATEVER
POSSIBLE TO PROVIDE OUR CHILDREN WITH THE BEST AVAILABLE INFORMATION
1+ +PHYSICAL, SEXUAL, EMOTIONAL, AND PSYCHOLOGICAL .,,70 HELP THEM
NEGOTIATE THEIR OWN WAY THROUGH THE HUMAN CONDITION AND NOT BECOME
VICTIMS OF IGNORANCE AND DISEASE... ESPECIALLY THE LETHAL DISEASE OF
AIDS,

YOU, AS RESPONSIBLE LEGISLATORS, ALSO HAVE A VERY IMPORTANT ROLE
TO PLAY. EVERYTHING I’VE MENTIONED SO FAR -- EDUCATION AND PATIENT
CARE AND RESEARCH AND FINANCES -- MUST BE PRESSED INTO THE BATTLE
AGAINST AIDS,

BUT THESE THINGS MUST BE DONE WITHIN THE FRAMEWORK OF AMERICAN
LAW AND TRADITION, AND THE LEGISLATIVE RECORD MUST BE WRITTEN IN THE
INDELIBLE INKS OF COMPASSION AND DUTY.
2/7

LADIES AND GENTLEMAN, I’VE DELIVERED THIS MESSAGE -- AND
VARIATIONS OF IT -- MANY TIMES IN THE PAST FEW MONTHS. BUT IT DOESN’T

GET ANY EASIER,

IT’S ESSENTIALLY A GRIM MESSAGE AND I GUESS I’M A GRIM COURIER,

I ONLY HOPE THAT EVERYONE WHO HEARS MY MESSAGE, WILL BELIEVE IT
AND DO HIS OR HER PART 10...

STOP THE SPREAD OF AIDS...

PROTECT AND SAVE THE LIVES OF PEOPLE AT RISK, INCLUDING
UNSUSPECTING YOUNG PEOPLE...

AND RETURN HUMAN SEXUALITY BACK TO ITS RIGHTFUL PLACE: PART OF THE
TOTAL COMPLEX OF HUMAN, CARING, INTERPERSONAL RELATIONS,

THANK YOU,

Ht # # #
Acquired Inmmnodeficiency Syndrome (AIDS)
Summary of Cases Meeting the CDC Surveillame Definition

Surveillance Report - 02/27/87

5. Reported Cases of AIDS and Case-Fatality Rates by Half-Year of Diagrosis.

Half-Year Nunber of Nutber of Case-Fatali
of Diagrosis Cases Deaths Rate
Before 1980 0 0 ----
1980 Jan -June 0 0 ----

July-Dec 2 2 1008
1981 Jan ~June 1 1 1008
July-Dec 7 6 8%
1962 Jan ~hre 8 7 88%
July-Dec 2 2 TR
1983 Jan ~Jure bs 0) 46 92%
July-Dec 7 72 92%
1964 Jan -Jure 140 1% 8%
July-Dec 190 10 8R
1985 Jan -June 23 8
July-Dec 255 72
1986 Jan ~June 46 26 53s
July-Dec 447 B1 2%
1987 Jan -Feb 27 61 7 lis