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AIDS anp BEHAVIOR: THE NEED FoR EDUCATION

 

THE SURGEON GENERAL ’S REPORT

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

PRESENTED TO THE CONFERENCE ON AIDS and Pustic Poticy
SPONSORED BY THE AMERICAN MEDICAL ASSOCIATION

CHICAGO, ILLINOIS
Aprit 21, 1987
(GREETINGS TO HOSTS, GUESTS, FRIENDS, ETC.)

I’M PLEASED TO JOIN YOU THIS MORNING AS PART OF THIS CONFER-
ENCE ON AIDS. THE FORMAT IS VERY MUCH LIKE THE “WORKSHOP” FORMAT
I HAVE USED ON A NUMBER OF OCCASIONS,

THE PROCESS WORKS, I CAN ASSURE YOU. DEDICATED HEALTH PRO-
FESSIONALS JUST LIKE YOURSELVES HAVE GONE THROUGH THIS PROCESS IN
A VARIETY OF "SURGEON GENERAL’S WORKSHOPS” DEALING WITH HANDI-
CAPPED CHILDREN, ORGAN TRANSPLANTS, PORNOGRAPHY, FAMILY VIOLENCE,
AND PEDIATRIC AIDS.

AND THE RESULTS HAVE BEEN UNIFORMLY GOOD...WITH BROAD AND
POSITIVE EFFECTS UPON PUBLIC HEALTH POLICY IN OUR COUNTRY. SINCE
THAT IS THE SAME OBJECTIVE FOR THIS WORKSHOP AS WELL. I BELIEVE
YOU’RE ON THE RIGHT TRACK AND I LOOK FORWARD TO YOUR RESULTS.
AT THOSE “SURGEON GENERAL’S WORKSHOPS,” I HAVE GIVEN THE
“CHARGE” TO THE PARTICIPANTS. BUT TODAY. I HAVE A REPRIEVE.
RIGHT AFTER MY PRESENTATION, OUR GOOD FRIEND. DR. ROY SCHWARZ,
WILL BE GIVING YOU THE “CHARGE” TO LEARN AS MUCH AS POSSIBLE IN
THE FEW HOURS AVAILABLE...AND THEN TO PROCESS THAT INFORMATION
INTO A SERIES OF CONCLUSIONS OR RECOMMENDATIONS,

IT’S A VERY RIGOROUS FORMAT. AND I AM POSITIVE THAT MANY OF
YOU WILL BECOME ALTERNATELY ANGRY AND ELATED AND FRUSTRATED AND
DELIGHTED WITH THE PROCESS,

BUT STICK WITH IT, THE PROCESS DOES WORK...1T REALLY WILL
DRAW OUT THE VERY BEST THINKING FROM THIS EXTRAORDINARY ASSEMBLY
OF EXPERTS.

AND NOW,..TO WORK.
FIRST OF ALL, I’M DELIGHTED THAT DRS. OSBORNE AND SILVERMAN
HAVE PRECEDED ME ON THE PROGRAM THIS MORNING. NOW THAT THEY'VE
BROUGHT YOU UP TO DATE ON THE NATURE OF AIDS AND THE EXTENT OF IT
AS AN EPIDEMIC, I WILL FOCUS MORE DIRECTLY ON THE GENESIS OF THE
“SURGEON GENERAL’S REPORT ON AIDS” AND ITS IMPLICATIONS FOR
EDUCATION.

AGAIN, WE NEED TO LOOK MORE CLOSELY AT THE EVOLVING
DEMOGRAPHY OF THE DISEASE TO UNDERSTAND WHAT SHOULD BE DONE
NEXT. SO I WILL QUICKLY REVIEW THAT PICTURE FOR YOU,

AS YOU KNOW BY NOW, TWO-THIRDS OF ALL AIDS VICTIMS ARE
HOMOSEXUALS OR BISEXUAL MEN,

THE SECOND LARGEST GROUP -- ABOUT ONE-FOURTH OF THE TOTAL --
ARE DRUG ABUSERS WHO BORROW USED INTRAVENOUS NEEDLES OR OTHER
CONTAMINATED PARAPHERNALIA FROM OTHER ADDICTS WHO MAY ALREADY HAVE
AIDS,
HOMOSEXUALS, BISEXUAL MEN, AND INTRAVENOUS DRUG ABUSERS
COMPRISE THE VAST MAJORITY OF AIDS VICTIMS SO FAR. BUT, AS YOU'VE
ALSO HEARD, THIS IS NO LONGER AN EXCLUSIVE CLUB,

I’M REFERRING, OF COURSE, TO THE RISE IN THE NUMBER OF AIDS
CASES REPORTED AMONG HETEROSEXUAL MEN AND WOMEN WHO ARE NOT I.V.
DRUG ABUSERS. 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
HAVE INVOLVED HETEROSEXUAL MEN AND WOMEN. THAT’S ONLY 1,200 CASES
AND, COMPARATIVELY SPEAKING, IT’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.
ANOTHER DEMOGRAPHIC 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 I,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,

AS BAD AS THESE NUMBERS ARE, WE HAVE TO CONFESS THAT THE
SITUATION MAY BE EVEN WORSE BECAUSE OF UNDER-REPORTING.

NOT ONLY THE DEMOGRAPHY OF AIDS IS CHANGING... THE GEOGRPAnY
OF AIDS IS CHANGING, ALSO,

AT ONE TIME WE WERE CONCERNED ALMOST EXCLUSIVELY WITH THE
POPULATIONS AT RISK IN SAN FRANCISCO, LOS ANGELES, AND NEW YORK
CITY. AND WHILE THESE CITIES STILL HAVE THE HIGHEST NUMBERS OF
AIDS CASES, THEY’RE NO LONGER ALONE,

IN ALL, 17 CITIES HAVE EACH REPORTED MORE THAN 300 CASES OF
AIDS SINCE THE COUNTING BEGAN IN 1981, THE LIST INCLUDES HOUSTON,
PHILADELPHIA, ATLANTA. BOSTON, CHICAGO, AND SEATTLE.
ONE OR MORE CASES HAVE BEEN REPORTED IN ALL 50 STATES, GUAM,
THE TRUST TERRITORY. THE VIRGIN ISLANDS. AND THE DISTRICT OF
COLUMBIA,

THEREFORE, I THINK IT IS APPROPRIATE FOR US WHO HAVE THIS
INFORMATION 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,
1 WANT TO MAKE THIS POINT WITH AS MUCH EMPHASIS AS POSSIBLE
BECAUSE. UNFORTUNATELY, THERE ARE STILL SOME PEOPLE -- INCLUDING
PHYSICIANS -- WHO INSIST IT’S A FALSE SCARE...THAT IT'S A PROBLEM
FOR "THOSE PEOPLE” AND NOT FOR THE REST OF AMERICA...OR THAT A FEW
SIMPLE LAWS WILL FIX EVERYTHING IN SHORT ORDER,

THAT KIND OF TALK IS VERY DANGEROUS,

LET ME SAY RIGHT HERE THAT I'VE BEEN PART OF PRESIDENT
REAGAN'S ADMINISTRATION FROM ITS VERY FIRST YEAR. I HAVE OBSERVED
BUT I’VE ALSO PLAYED A ROLE IN HELPING SHAPE THE CONSERVATIVE
POLICIES THIS GOVERNMENT HAS PURSUED,

I CAN ASSURE YOU THAT THE PEOPLE WORKING FOR THE PRESIDENT --
AND THAT INCLUDES THIS SURGEON GENERAL -- ARE THE UNLIKELIEST
BUNCH OF PEOPLE TO ADVANCE ANY FALSE PUBLIC HEALTH SCARES. THAT'S
RIDICULOUS ON THE FACE OF IT,
IN ADDITION, THE PERSONNEL OF THE U.S, PUBLIC HEALTH SERVICE,
WHO HAVE BEEN SHOULDERING THE BURDEN OF THIS DISEASE FOR THE PAST
6 YEARS, ARE THE SAME PEOPLE WHO WERE ON THE FRONT-LINE WITH
LEGIONNAIRE’S DISEASE... WITH TOXIC SHOCK SYNDROME...AND WhO
PROVIDED THE LEADERSHIP THAT RID THE WORLD OF SMALLPOX. THE LIST
OF THEIR ACHIEVEMENTS IS ENDLESS.

AND TO IMPLY -- MUCH LESS SAY OUTRIGHT -- THAT THESE EXPERTS
ARE PROMOTING A FALSE SCARE OR THAT THEY’RE NOT TELLING THE WHOLE
TRUTH, AND SO ON, IS SIMPLY UNFORGIVABLE.

YOU’LL BE HEARING A NUMBER OF P.H.S. PEOPLE TODAY AND
TOMORROW. 1 FEEL PROUD TO BE COUNTED AMONG THEM AND I DEEPLY
RESENT THE DISSERVICE TO THEM -- AND TO THE AMERICAN PEOPLE -- BY
SOME CRITICS WHO PROFESS TO BE SCIENTISTS BUT. IN SO DOING, DEFAME
THE VERY TERM,
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AND THERE ARE NO SIMPLE ANSWERS TO THIS DISEASE...UNLESS YOU
AGREE TO THROW OUT 200 YEARS OF A COMPASSIONATE DEMOCRATIC
TRADITION AND THE DOCUMENTS THAT PRODUCED IT,

IVE HEARD AND READ DOZENS OF PROPOSALS FOR DRACONIAN
SOLUTIONS TO THE AIDS EPIDEMIC, AND 1 USED TO SAY THAT THEY WERE
PUT FORWARD BY WELL-MEANING PEOPLE. BUT THEY AREN'T. BY
CONTRAST, THE VAST MAJORITY OF THE AMERICAN PEOPLE ARE WELL-
MEANING AND THEY WON’T TOUCH ANY OF THE MEDICO-LEGAL CHARLATANRY
OFFERED UP BY A FRIGHTENED, MISINFORMED, AND DIVISIVE MINORITY.

NOW, OF COURSE I AGREE THAT THE AIDS VIRUS IS PASSED ALONG BY
PEOPLE WHO DO THINGS THAT THEY OUGHT NOT TO DO. I DON’T CONDONE
INTRAVENOUS DRUG ABUSE AND I FLATLY OPPOSE THE KIND OF SEXUAL
PROMISCUITY THAT ENDANGERS A PERSON'S PHYSICAL, MENTAL, EMOTIONAL.
AND SPIRITUAL HEALTH,
ll

BUT RIGHT NOW I WANT TO STOP THE CHAIN OF TRANSMISSION OF THE
AIDS VIRUS. AND I WANT TO STOP IT IN A WAY THAT IS EFFECTIVE YET
CONSISTENT WITH AMERICAN LAW AND TRADITION.

THEREFORE, I WANT TO DO THE JOB WITH THE HELP OF GOOD SCIENCE
AND GOOD EDUCATION,

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 WITH THE BEST WEAPON
AVAILABLE: THEIR INTELLIGENT BEHAVIOR,

AND IF 1 DIDN’T THINK THAT PRACTICING PHYSICIANS WERE
ESSENTIAL TO THAT EFFORT, I WOULDN’T BE HERE. ‘BUT I AM...AND YOU
ARE.
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IT WAS, BY THE WAY, FOR THAT VERY PURPOSE -- THAT IS, 10
INCREASE PUBLIC UNDERSTANDING AND, THEREBY. CHANGE PUBLIC BEHAVIOR
-- 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...

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

] MET WITH THE CHRISTIAN LIFE COMMISSION OF THE SOUTHERN
BAPTIST CONVENTION AND THE SYNAGOGUE COUNCIL OF AMERICA...
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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 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 TO THE WHITE HOUSE LATE LAST SEPTEMBER. THE DOMESTIC
POLICY COUNCIL ACCEPTED IT...AND, OF COURSE, THE PRESIDENT
ACCEPTED IT,

AND LET ME ADD THAT IT WAS ACCEPTED EXACTLY AS I WROTE IT. I
KNOW THAT THOSE OF YOU WHO ARE FAMILIAR WITH WASHINGTON MAY FIND
THAT STATEMENT HARD TO BELIEVE, BUT IT’S TRUE.
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AND I’LL TELL YOU SOMETHING EVEN MORE ASTOUNDING. NO ONE HAS
ASKED ME TO PUT OUT A REVISED SECOND EDITION EITHER. NO SECOND-
GUESSING...NO SECOND THOUGHTS,

THE PRESIDENT TOLD ME TO DO WHAT I HAD TO DO. AND I DID
IT, HE’S GIVEN ME ALL THE SUPPORT I’VE NEEDED,,..HE’S BEEN
ABSOLUTELY TERRIFIC,..AND THE WHITE HOUSE PRESS OFFICER. MR,
MARLIN FITZWATER, HAS EVEN REFERRED MEMBERS OF THE WHITE HOUSE
PRESS CORPS TO ME FOR ANSWERS TO THEIR QUESTIONS, WHAT MORE CAN
YOU ASK?

SO 1 FEEL VERY GOOD ABOUT THE REPORT FOR ALL THOSE REASONS.
BUT I ALSO FEEL GOOD ABOUT IT BECAUSE THE REPORT HAS ACCOMPLISHED
TWO VERY IMPORTANT THINGS, AS FAR AS THE PUBLIC IS CONCERNED:
15

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 OUR YOUNG PEOPLE THE FACTS ABOUT AIDS,

HOWEVER. BEFORE AIDS EDUCATION BEGINS, A CHILD SHOULD BE
GIVEN INFORMATION RELATIVE TO HIS OR HER OWN SEXUALITY, AND
INSTEAD OF CALLING IT “SEX EDUCATION.” I’D LIKE IT CALLED
SOMETHING LIKE STUDIES IN HUMAN DEVELOPMENT.
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I THINK CHILDREN SHOULD BE LEARNING ALL ABOUT THEMSELVES ALL
THE TIME...LEARNING ABOUT THEIR UNBELIEVABLE COMPLEXITY, AND
ESPECIALLY OF THEIR OWN GREAT VALUE, I THINK MOST PHYSICIANS TRY
TO DO THIS WITH THEIR OWN YOUNG PATIENTS BECAUSE IT’S JUST GOOD
BASIC MEDICAL PRACTICE.

BUT NOW THIS KIND OF PRACTICE HAS AN ADDITIONAL, SPECIAL
MEANING, BECAUSE IF CHILDREN ARE PROPERLY TAUGHT THEIR OWN WORTH,
WE CAN EXPECT THEM TO TREAT THEMSELVES...AND OTHERS... WITH GREATER
RESPECT.

AND WHEREVER YOU HAVE SELF-RESPECT AND MUTUAL RESPECT YOU DO
NOT HAVE DRUG ABUSE AND SEXUAL PROMISCUITY.
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EDUCATION IN THIS COUNTRY HAS BEEN AND MUST CONTINUE TO BE A
CONCERN AND RESPONSIBILITY OF STATES AND COMMUNITIES. THE FEDERAL
ROLE, HOWEVER, IS TO ASSIST OUR STATES AND COMMUNITIES BY MAKING
AVAILABLE TO THEM THE LATEST FACTUAL, SCIENTIFICALLY ACCURATE
INFORMATION,

THIS YEAR THE PUBLIC HEALTH SERVICE WILL SPEND A HUNDRED
MILLION DOLLARS ON THE DISSEMINATION OF FACTS ABOUT AIDS.

I MIGHT ADD THAT, IN THE FOREWORD TO OUR NEW P.H.S, EDUCATION
PLAN, THE SECRETARY OF HEALTH AND HUMAN SERVICES, DR. OTIS R.
BOWEN, EXPRESSLY SAYS THAT...
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"ANY HEALTH INFORMATION DEVELOPED 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.”

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

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. I DON’T THINK THAT’S TOO MUCH
TO ASK OF OUR CHILDREN. IN FACT, IF MEMORY SERVES ME RIGHT. THAT
KIND OF BEHAVIOR WAS ONCE THE NORM FOR THIS COUNTRY.

AND A RETURN TO SUCH A NORM WOULD SPELL THE END OF SEXUALLY
TRANMSITTED AIDS.
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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 CHILDREN DO GROW UP. AND, AS ADULTS, MOST OF THEM WON’T
REMAIN ABSTINENT, THEREFORE, WE MUST INTRODUCE THEM TO THE NOTION
OF THE VALUE OF -- AND 1 WOULD ALSO SAY THE BEAUTY OF -- A FAITH-
FUL, 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,
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TO THOSE INDIVIDUALS WHO WON’T ABSTAIN, BUT WHO DON’T 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 I,V. DRUG USER WHO BORROWS USED NEEDLES. IT
WOULD ALSO INCLUDE ANY SEXUALLY PROMISCUOUS PERSON -- WHETHER
HOMOSEXUAL OR HETEROSEXUAL.
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* BUT IF YOU DO DECIDE TO HAVE SEX WITH SUCH AN INDI-
VIDUAL, THEN, IF YOU’RE A MAN, USE A CONDOM FROM START 10
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
TO 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 ARE
SEXUALLY ACTIVE ENOUGH TO PRODUCE OVER A MILLION UNWANTED
PREGNANCIES EACH YEAR,
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I‘VE ALWAYS FELT THAT THIS EDUCATION TASK 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 DO IT,
HENCE, OUR SCHOOLS, CHURCHES, SYNAGOGUES, CLINICS, AND OTHER
COMMUNITY INSTITUTIONS MUST STEP IN TO DO WHAT’S NEEDED,..AND
WHAT‘S RIGHT,

THIS IS WHERE A GREAT MANY PHYSICIANS -- AS PARENTS, AS
COMMUNITY LEADERS, AS POLICY-MAKERS IN CLINICS AND HOSPITALS, AND
AS PROVIDERS OF PRIMARY PATIENT CARE -- PHYSICIANS CAN HAVE A VERY
POSITIVE AND LIFE-SAVING IMPACT UPON OUR YOUNG PEOPLE.

IT’S A DIFFICULT CHALLENGE FOR ALL OF US. 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,
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THOSE VALUES 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
REMAIN AS 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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