October 22, 1986

C. Everett Koop, M.D.
Surgeon General of the
United States
U.S. Public Health Service
716G Hubert Humphrey Building
200 Independence Avenue, S.W.
Washington, D.C. 20201

AIDS
Action
Council

Dear Dr. Koop:

On behalf of the Council,  I congratulate and commend you on the
excellent report to the nation on AIDS that you released today.
Your press conference this morning, your extemporaneous answers
to questions and the report itself were and are accurate, timely
and tuned to the long-term -- as they should be.  The report
will do much to combat fear and hysteria, and, we hope, to
encourage rational, scientifically-based responses to this
crisis.  I would especially commend your statement that, as a
nation, we are fighting a disease not people.  Your sensitivity
to the need that everyone must be concerned, and must unite to
fight AIDS together, will be very persuasive, I'm sure.   The
Council will certainly do everything it can to urge widespread
usage of your report and its findings.

One area of concern to us in the report -- one we believe may
require further explanation from you to the press and public --
is your statement on page 17 that those who suspect they may
have been exposed to HIV virus "should have a blood test."

Such a blanket recommendation cannot be made, in our judgment,
unless it is accompanied by extremely clear cautions about the
potentially very serious negative ramifications of obtaining a
positive or a negative test result, the need for absolute
confidentiality (or better, anonymity) of test results, and the
irreducible requirement for extensive,
individuals who choose to be tested.   ongoing counselling of
                        Simply to send people out
to be tested without informing them in advance of these
factors is potentially to expose millions to unwarranted complex
discrimination, loss of jobs and insurance or worse.   We are
certain that, in the spirit of fairness and accuracy with which
you have written an otherwise first-rate report, you will want
to clarify the issue of testing,
for the American public.      confidentiality and counselling

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Letter to the Surgeon General
October 22, 1986
Page 2

Thank you again for a fine report.  Let us know if we can be
helpful in any way in making certain that it is widely
distributed.  We are grateful to have been included among the
groups which advised you on the report's contents, and we look
forward to a continuing close association.

Warm personal regards,

Ga y B.  MacDonald
k J
Ex cuti e Director