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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

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PRESENTED TO THE ANNUAL MEETING OF THE
NATIONAL SCHOOL BoarDS ASSOCIATION
SAN FRANCISCO, CALIFORNIA
Aprit 4, 1987
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(GREETINGS TO HOSTS, GUESTS, FRIENDS, ETC.)

IT’S MY PLEASURE TO BE HERE THIS AFTERNOON TO ADDRESS ONE OF
THE MOST IMPORTANT NATIONAL ORGANIZATIONS IN AMERICAN EDUCATION.
THE EDUCATION OF OUR CHILDREN IS ABSOLUTELY CRUCIAL TO 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.

HENCE, I LOOK UPON THIS OPPORTUNITY TO SPEAK HERE TODAY AS
ONE OF THE MOST IMPORTANT PRESENTATIONS I WILL MAKE THIS YEAR,

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 198] We’VE SEEN THE OFFENDING VIRUS IN A MICROSCOPE AND
WE’VE NAMED AND RENAMED IT, IT’S CURRENT BIOMEDICAL NAME IS
"HUMAN IMMUNODEFICIENCY VIRUS.’ OR H.1,V,

A SCREENING TEST WAS ALSO DEVELOPED TO DETERMINE IF THE VIRUS
TS 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,
THOSE ARE YOUR TAX DOLLARS, OF COURSE...BUT I WANT TO ASSURE
THAT, IN THIS CASE ANYWAY, THEY’RE BEING WELL-SPENT,

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.

MAKE NO MISTAKE ABOUT IT. AIDS IS FATAL AND IT 1S
SPREADING,

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.
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,

I 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,
SOME OF YOU MAY FEEL YOU HAVE TO MAKE SUCH A DECISION AND
THAT IT IS WISE AND NECESSARY TO DO SO. THAT MAY OR MAY NOT BE
SO, BUT THE REASON HAS TO BE SOMETHING OTHER THAN HEALTH BECAUSE
-- PURELY ON THE GROUNDS OF PUBLIC HEALTH -- IT WOULD NOT BE A
VERY GOOD DECISION AT ALL,

AS 1 STATED IN MY REPORT, SUCH DECISIONS SHOULD BE MADE ON AN
INDIVIDUAL CASE-BY-CASE BASIS. IT IS A BALANCING ACT BETWEEN THE
NEEDS OF MANY CHILDREN AND THE RIGHTS OF A FEW, RESPECTING AND
HONORING THE CONFIDENTIALITY OF THE CHILD AND HIS OR HER FAMILY
ARE PARAMOUNT ACTIONS,..BUT THEY DO CONFLICT, AT TIMES. WITH THE
NEED TO PROTECT THE JUVENILE VICTIM,

THE PECULIAR CHARACTERISTIC OF THE AIDS VIRUS ALSO EXPLAINS
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
LIFESTYLE 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.
10

I KNOW THIS IS MUCH EASIER FOR ME, TRAINED IN SCIENCE AND
MEDICINE, TO EXPLAIN TO YOU THAN IT MAY BE FOR YOU -- AND FOR
PARENTS AND SCHOOL PERSONNEL -- TO UNDERSTAND...AND ACCEPT,

 

BUT THE TRUTH IS THE TRUTH,..AND WE AMERICANS HAVE ALWAYS
CHOSEN TO FOLLOW THE TRUTH, NO MATTER HOW UNCOMFORTABLE THAT MAY
BE, RATHER THAN FOLLOW AN UNTRUTH, NO MATTER HOW EASY THAT MIGHT
BE.

BELIEVE ME. THIS IS NO ROSE GARDEN. BUT THERE IT IS.
ll

THE SECOND LARGEST GROUP OF CARRIERS OF THE AIDS VIRUS --
ABOUT ONE-FOURTH OF THE TOTAL -- ARE DRUG ABUSERS WHO BORROW DIRTY
INTRAVENOUS NEEDLES OR OTHER CONTAMINATED PARAPHERNALIA FROM OTHER
ADDICTS WHO ALREADY HAVE AIDS,

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. BUT. AS YOU
MAY KNOW BY NOW, THIS IS NO LONGER AN EXCLUSIVE CLUB,
12

LATELY THERE'S BEEN A RISE IN THE NUMBER OF AIDS CASES
REPORTED AMONG HETEROSEXUAL MEN AND WOMEN WHO ARE NOT I.V. DRUG
ABUSERS.

IN FACT, THE EVIDENCE SUGGESTS THAT THEIR HETEROSEXUAL
ACTIVITY ALONE SEEMS TO BE THEIR SINGLE RISK FACTOR.

AS OF LAST WEEK, ABOUT 4 PERCENT OF ALL AIDS REPORTS SO FAR
INVOLVED THESE TYPES OF HETEROSEXUAL MEN AND WOMEN, 1,200
CASES, YOU MIGHT SAY, “THAT'S NOT MUCH.”

HOWEVER, WHILE THE OVERALL NUMBER OF AIDS CASES WILL PROBABLY
INCREASE 9-FOLD OVER THE NEXT FIVE YEARS, THE NUMBER OF AIDS CASES
INVOLVING HETEROSEXUALS WILL INCREASE ABOUT 20-FOLD,
13

ANOTHER FACT THAT IS EMERGING WITH MORE CLARITY IS THE
INCIDENCE OF THE DISEASE AMONG BLACKS AND HISPANICS. IN THE
POPULATION GENERALLY, i 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 NOT 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,
14

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,

WHAT DO ALL THESE PIECES OF INFORMATION SUGGEST? I THINK
THEY MEAN THAT THE DEMOGRAPHY OF THE DISEASE OF AIDS IS CHANGING
»» AND DRAMATICALLY,
15

AT ONE TIME WE WERE CONCERNED PRIMARILY -- ALMOST EXCLUSIVELY
-- WITH THE POPULATIONS AT RISK HERE IN SAN FRANCISCO, IN 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,
16

ATLANTA HAD 25 THEN AND 221 LAST YEAR,

BOSTON, 38,..AND 187 LAST YEAR,

IN ALL, 17 CITIES HAVE EACH REPORTED MORE THAN 300 CASES OF
AIDS SINCE THE COUNTING BEGAN IN 1981,

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 ‘8/7,
HIO HAD 179 DURING THE SAME PERIOD,

ARKANSAS... 32.

MISSISSIPPI,..28, AND SO ON,
17

I BEGAN MY REMARKS THIS AFTERNOON BY SAYING THAT I CONSIDER
THES OPPORTUNITY ONE OF THE MOST IMPORTANT I’LL HAVE ALL YEAR.
AND THESE FIGURES ARE PART OF THE REASON,

T WANT TO ALERT ALL OF YOU -- FROM WHATEVER STATE OR
TERRITORY... FROM WHATEVER MAJOR CITY OR SMALL TOWN -- THAT THE
DISEASE OF AIDS IS NO LONGER “POSSIBLY HEADED IN YOUR DIRECTION,”

IT HAS PROBABLY ALREADY ARRIVED,

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,
18

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...
19

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.
20

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 10 BELIEVE
THAT,

NOW THEY MUST,
21

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 1S 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?

THOSE ARE THE KEY QUESTIONS, AND LET ME ASSURE YOU THAT WE
IN PUBLIC HEALTH AND IN THE FEDERAL GOVERNMENT LOOK TO YOU -- NOT
TO OURSELVES -- FOR THE ANSWERS,

MAY I, HOWEVER, BE PERMITTED A PERSONAL STATEMENT, BEFORE
AIDS EDUCATION BEGINS, A CHILD SHOULD BE GIVEN INFORMATION
RELATIVE TO HIS OR HER OWN SEXUALITY, AND INSTEAD OF CALLING IT
"SEX EDUCATION.” 1’D LIKE IT CALLED SOMETHING LIKE STUDIES IN
HUMAN DEVELOPMENT,
I THINK CHILDREN SHOULD BE LEARNING ALL ABOUT THEMSELVES...
THEIR UNBELIEVABLE COMPLEXITY, AND ESPECIALLY OF THEIR OWN GREAT
VALUE, IF THEY ARE PROPERLY TAUGHT THEIR OWN WORTH, WE CAN EXPECT
THEM TO TREAT THEMSELVES,..AND OTHERS...WITH GREAT RESPECT.

HUMAN DEVELOPMENT INSTRUCTION SHOULD KEEP PACE WITH -- AND
NOT ANTICIPATE -- THEIR INDIVIDUAL DEVELOPMENT AND CURIOSITY.

EDUCATION IN THIS COUNTRY HAS BEEN AND MUST CONTINUE TO BE A
CONCERN AND RESPONSIBILITY OF STATES AND COMMUNITIES. WHAT I
OFFER YOU TODAY -- I SINCERELY HOPE -- IS INFORMATION FOR YOUR
GUIDANCE. WHAT YOU DO WITH IT IS -- LITERALLY AND LEGALLY -- YOUR
BUSINESS.

THE FEDERAL ROLE. HOWEVER, IS IMPORTANT AS FAR AS GETTING
FACTUAL, SCIENTIFICALLY ACCURATE INFORMATION INTO THE HANDS OF
YOUR TEACHING STAFF, AND I CAN TELL YOU THAT THIS YEAR THE PUBLIC
HEALTH SERVICE IS INVESTIUNG A MILLION DOLLARS IN JUST SUCH AN
ACTIVITY: GETTING YOU THE FACTS. HERE ARE SOME EXAMPLES:
23

* LAST DECEMBER OUR CENTERS FOR DISEASE CONTROL, THE LEAD
AGENCY IN OUR EDUCATIONAL EFFORTS. BROUGHT TOGETHER AN AD HOC
GROUP OF ADVISORS DRAWN FROM ORGANIZATIONS SUCH AS THE AMERICAN
ACADEMY OF PEDIATRICS, THE NATIONAL CONGRESS OF P.T.A.s. THE
NATIONAL EDUCATION ASSOCIATION, THE SCHOOL BOARD OF THE CITY OF
NEW YORK, AND SO ON,

THIS GROUP MOVED AHEAD AND BROUGHT FORTH A SET OF GUIDELINES
FOR TEACHING ABOUT AIDS IN THE NATION’S SCHOOLS BUT TO DO IT INA
WAY THAT IS RESPONSIVE TO -- AND CONSISTENT WITH -- THE NEEDS OF
THE COMMUNITY,
24

* UNDER A GRANT FROM C.D.C, THE INDIANA DEPARTMENT OF
HEALTH AND INDIANA UNIVERSITY HAVE JOINTLY PRODUCED A MANUAL ON
AIDS FOR STUDENTS AND TEACHERS, AND COPIES OF THIS ARE ALREADY
AVAILABLE FROM C.D.C. IN ATLANTA. 1 MIGHT ADD THAT OUR ENTIRE
EDUCATION PROGRAM HAS HAD THE PERSONAL ENCOURAGEMENT OF A FORMER
GOVERNOR OF INDIANA AND NOW THE SECRETASRY OF HEALTH AND HUMAN
SERVICES, DR, OTIS R. BOWEN.

AND DR. BOWEN HAS MADE IT QUITE CLEAR THAT HIS DEPARTMENT
PERCEIVES EDUCATION AS AN ACTIVITY THAT IS “LOCALLY DETERMINED”
AND “CONSISTENT WITH PARENTAL VALUES” EXPRESSED WITHIN EACH
COMMUNITY.
25

IN THE FOREWORD TO OUR OVERALL EDUCATION PLANNING DOCUMENT,
WHICH IS AVAILABLE TO ANYBODY WHO WRITES IN FOR IT, DR. BOWEN
EXPRESSLY SAYS THAT...

"ANY HEALTH INFORMATION DEVELEOPED BY THE FEDERAL GOVERNMENT
THAT WILL BE USED FOR EDUCATION SHOULD ENCOURAGE RESPONSIBLE
SEXUAL BEHAVIOR -- BASED ON FIDELITY, COMMITMENT, AND
MATURITY, AND PLACING SEXUALITY WITHIN THE CONTEXT OF
MARRIAGE.”

HE GOES ON TO SAY THAT SUCH INFORMATION “PROVIDED BY THE
FEDERAL GOVERNMENT” FOR SCHOOLS "SHOULD TEACH THAT CHILDREN
SHOULD NOT ENGAGE IN SEX” AND THAT SUCH INFORMATION “SHOULD BE
USED WITH THE CONSENT AND INVOLVEMENT OF PARENTS.”
26

I THOROUGHLY AGREE WITH SECRETARY BOWEN. AND I HOPE YOU DO,
TOO,

BUT I'VE SAID IT ANOTHER WAY, I BELIEVE CHILDREN SHOULD BE
TAUGHT TO BE ABSTINENT UNTIL THEY GROW UP, ASSUME THE ROLE OF A
RESPONSIBLE ADULT, AND FIND A MUTUALLY MONOGAMOUS RELATIONSHIP.
THAT DOESN’T SEEM TO BE TOO FAR-FETCHED. IN FACT. IT WAS ONCE THE
NORM FOR THIS COUNTRY AND A RETURN TO SUCH A NORM WOULD INSURE THE
END OF SEXUALLY TRANMSITTED AIDS.

* CONTINUING WITH OUR EDUCATION PLAN, WE ALSO WANT TO
ESTABLISH COOPERATIVE AGREEMENTS WITH STATE EDUCATION DEPARTMENTS
AND LOCAL SCHOOL DISTRICTS TO SUPPORT THEIR EFFORTS IN MOUNTING
PROGRAMS TO THAT TEACH ABOUT AIDS. THE PAPERWORK FOR THAT PROGRAM
TS MOVING THROUGH THE BUREAUCRACY EVEN AS I SPEAK,

THE INTERESTING THING ABOUT AIDS EDUCATION IS THAT THIS IS AN
AREA WHERE SCIENCE AND MORALITY ARE WALKING THE VERY SAME PATH,

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.
2/

BUT MOST CHILDREN WON’T REMAIN ABSTINENT AFTER THEY BECOME
ADULTS, SO -- AS I NOTED A MOMENT AGO -- WE MUST INTRODUCE THEM
TO THE NOTION OF THE VALUE OF -- AND I WOULD ALSO SAY THE BEAUTY
OF -- A FAITHFUL, MONOGAMOUS RELATIONSHIP...THE KIND OF RELATION-
SHIP 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,
28

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 I1.V. DRUG USER WHO BORROWS USED NEEDLES. IT
WOULD ALSO INCLUDE ANY SEXUALLY PROMISCUOUS PERSON -- WHETHER
HOMOSEXUAL OR HETEROSEXUAL,
29

* 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. SHORT OF MONOGAMY AND ABSTINENCE. CONDOMS SEEM
TQ OFFER THE BEST BARRIER TO THE TRANSMISSION OF AIDS,

IF WE ARE TRULY CONCERNED ABOUT THEIR LIVES AND THE FUTURE
LIFE OF OUR SOCIETY. THIS IS THE KIND OF INFORMATION WE NEED TO
GET ACROSS TO THOSE MEMBERS OF OUR TEENAGE POPULATION WHO, EACH
YEAR, ARE SUFFICIENTLY SEXUALLY ACTIVE TO PRODUCE OVER A MILLION
UNWANTED PREGNANCIES EACH YEAR.
30

1 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 FOR AMERICANS...ESPECIALLY FOR
PEOPLE SUCH AS YOURSELVES WHO CARE ABOUT YOUR COUNTRY AND UITS
FUTURE,

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,
31

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 1 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-
CING,

 

THANK YOU,

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