REMARKS

BY

C, EVERETT KOOP, M,D,, SC,D,
   SURGEON GENERAL
UtS, PUBLIC HEALTH SERVICE

       PRESS CONFERENCE
THE AIDS BROCHURE AND THE NATIONAL MAILING

PRESENTED AT
PRESS CONFERENCE

MAY 4, 1988


  ON OCTOBER 22, 1986, AT A PRESS CONFERENCE MUCH LIKE THIS
ONE, I DISCUSSED THE SURGEON GENERAL'S REPORT ON AIDS WHICH HAD
BEEN REQUESTED BY THE PRESIDENT, THAT REPORT IS AS VALID TODAY
AS THE DAY IT WAS WRITTEN, THUS FAR, APPROXIMATELY 19,2 MILLION
COPIES HAVE BEEN DISTRIBUTED: SOME BY REQUEST ON THE PART OF
INDIVIDUALS OR CORPORATE GROUPS AND OTHERS HAVE BEEN SENT BY
CONGRESSMAN TO THEIR CONSTITUENTS, IN ADDITION, THE SURGEON
GENERAL'S REPORT ON AIDS HAS BEEN REPRINTED IN MAGAZINES AND
NEWSPAPERS ABOUT 20 MILLION TIMES,

  THE CONTINUING REQUESTS FOR THIS DOCUMENT>AND THE POSITIVE
RESPONSE WE HAVE RECEIVED LED THE UNITED STATES CONGRESS TO
MANDATE THAT THE DEPARTMENT OF HEALTH AND HUMAN SERVICES, THROUGH
THE PUBLIC HEALTH SERVICE'S CENTERS FOR DISEASE CONTROL
DISTRIBUTE A NATIONAL MAILING OF INFORMATION ON AIDS TO ALL
UNITED STATES HOUSEHOLDS, THIS WAS ENACTED ON DECEMBER 22, 1987,


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  THE PUBLIC HEALTH SERVICE HAS COMPLIED, AND NOW FOR THE
FIRST TIME IN OUR NATION'S HISTORY, THE FEDERAL GOVERNMENT IS
SENDING INFORMATION ON A SEXUALLY TRANSMITTED DISEASE TO EVERY
HOME IN AMERICA, WE ARE TAKING THIS STEP BECAUSE THE EPIDEMIC OF
MISUNDERSTANDING ABOUT HOW AIDS IS SPREAD AND HOW IT IS NOT
SPREAD SEEMS, AT TIMES, AS DIFFICULT TO CONTROL AS THE EPIDEMIC
ITSELF,

  IN SPITE OF A STEADY FLO'd OF INFORMATION FROM THE UNITED
STATES PUBLIC HEALTH SERVICE,.THROUGH ITS VARIOUS PUBLICATIONS
AND SPOKESPERSONS, THE AMERICAN PUBLIC HAS BEEN WHIPSAWED BY
PUBLICATIONS FROM THE PRIVATE SECTOR ACCUSING THE GOVERNMENT OF
CIRCULATING INACCURATE INFORMATION AND SUGGESTING EITHER THAT WE
HAVE SERIOUSLY OVER-ESTIMATED THE PROBLEM ON THE ONE HAND OR THAT
WE HAVE WITHHELD INFORMATION ON THE TRANSMISSION OF AIDS ON THE

OTHER,


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  THESE REPORTS, FROM VARIOUS AUTHORS, COULD NOT BE FURTHER
FROM THE TRUTH, THE UNITED STATES PUBLIC HEALTH SERVICE HAS
ALWAYS BEEN UPFRONT WITH THE AMERICAN PUBLIC ABOUT ITS KNOWLEDGE
OF AIDS AND WE HAVE NEVER GOTTEN BEYOND OUR SCIENTIFIC BASE IN
MAKING PREDICTIONS ABOUT THE FUTURE,

  ALTHOUGH I THINK WE HAVE MADE SUBSTANTIAL PROGRESS THROUGH
OUR EDUCATIONAL CAMPAIGN ON AIDS, STUDIES TELL US THAT THERE ARE
STILL MILLIONS OF AMERICANS WHO BELIEVE YOU CAN GET AIDS FROM
MOSQUITOS, BLOOD DONATIONS FOR TRANSFUSION, TOILET SEATS, AND
SITTING NEXT TO A CHILD IN SCHOOL,


  THE CURRENT BROCHURE WHICH HAS BEEN DESCRIBED TO YOU BY
SECRETARY BOWEN IS DESIGNED TO PROVIDE FACTS, TO QUIET FEARS, AND
BY DOING THESE THINGS TO LESSEN DISCRIMINATION AGAINST THOSE WHO
HAVE AIDS OR CARRY THE VIRUS,

  THE LANGUAGE OF THIS BROCHURE IS CLEAR, IT TELLS ALL
AMERICANS THAT AIDS IS NOT TRANSMITTED FROM INSECTS, BY DONATING
BLOOD, FROM A KISS, OR FROM SALIVA, SWEAT, TEARS, URINE OR BOWEL
MOVEMENTS,


  THE NATIONAL AIDS MAILING ALSO ADDRESSES A MORE SERIOUS
PROBLEM, TOO MANY PEOPLE STILL BELIEVE THAT THERE IS AN
IMAGINARY WALL THAT PROTECTS CERTAIN GROUPS OF INDIVIDUALS FROM
THE AIDS VIRUS THROUGH SEXUAL INTERCOURSE OR THE SHARING OF
PARAPHERNALIA IN THE ABUSE OF ILLEGAL DRUGS,

  WE ARE ENDEAVORING TO MAKE EVERYONE UNDERSTAND THAT WHO YOU
ARE HAS NOTHING TO DO WITH THE DANGER YOU FACE OF BECOMING
INFECTED WITH THE AIDS VIRUS, WHAT DOES MATTER IS WHAT YOU DO,


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  SEXUAL INTERCOURSE AND SHARING NEEDLES AND SYRINGES IN
SHOOTING DRUGS ARE WHAT SPREAD AIDS, TRYING TO ESTIMATE YOUR
CHANCES OF CATCHING THE VIRUS BASED ON THE LATEST MAGAZINE
ARTICLE OR NEWSPAPER STORY IS LIKE PLAYING RUSSIAN ROULETTE, BY
FOLLOWING ADVICE IN THE BROCHURE, THE READER CAN INSURE THAT HE
OR SHE WILL NOT BE INFECTED BY AIDS THROUGH SEXUAL TRANSMISSION
AND NEEDLE SHARING,

  BECAUSE AIDS IS PRIMARILY A SEXUALLY TRANSMITTED DISEASE,
THIS MAILING SPEAKS IN FRANKSIMPLE, CLEAR LANGUAGE ABOUT ORAL,
VAGINAL, AND ANAL INTERCOURSE AS WELL AS THE PROPER USE OF
CONDOMS, THIS IS INFORMATION THAT EVERY SEXUALLY ACTIVE AMERICAN
SHOULD KNOW,


  ONE OF THE COMMENTS I FREQUENTLY HEAR FROM PEOPLE WHO SHOULD
KNOW BETTER IS THAT EVENTUALLY AIDS WILL AFFECT EVERYBODY, WHAT
THESE WELL MEANING PEOPLE MEAN IS THAT THE EFFECTS OF THE AIDS
EPIDEMIC, SUCH AS THE DISCRIMINATION AGAINST INDIVIDUALS, THE
COST OF THE DISEASE, THE ETHICS OF THE-DISEASE. AND THE THREAT TO
OUR SOCIAL COHESION GJILL AFFECT EVERYONE, THIS BROCHURE WILL
MAKE IT CLEAR THAT IT IS IOT AIDS THAT WILL EFFECT EVERYONE, BUT
THE EFFECT OF THE EPIDEMIC OF AIDS THAT WILL EFFECT EVERYONE,

  A CAREFUL READING OF THIS BROCHURE SHOULD ENABLE THE READER
TO SEPARATE TRUE HEALTH INFORMATION FROM VARIOUS POLITICAL
AGENDAS PROMOTED AT THE EXPENSE OF THE PUBLIC'S HEALTH,


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   I HAVE FREQUENTLY STATED THAT IN THE ABSENCE OF A VACCINE OR
A CURE FOR AIDS, THE ONLY WEAPON WE HAVE IS INFORMATION AND
EDUCATION, INFORMATIOi'l ALOHE IS NOT ENOUGH TO PREVENT THE SPREAD
OF THE HIV,  IN ORDER TO BE EFFECTIVE AS AN EDUCATIONAL TOOL,
THIS BROCHURE MUST BE READ, IT MUST BE UNDERSTOOD, IT MUST.BE
DISCUSSED, THE INFORMATION CONTAINED THEREIN MUST BE SHARED WITH
OTHERS, THE HOUSEHOLD MAILING OF UNDERSTANDING AIDS IS THE
CLOSEST WE CAN COME TO MAKING SOMETHING REQUIRED READING IN EVERY
AMERICAN HOME, I HOPE THAT PARENTS, GRANDPARENTS, CHILDREN AND
TEENAGERS WILL SET A TIME WHEN THEY CAN SIT DOWN TOGETHER AND
REVIE\i THE INFORMATION IN THESE EIGHT PAGES,

  I WOULD HOPE THAT SCHOOLS COULD DO THE SAME THING IN
CLASSROOMS WHERE THE AGE IS APPROPRIATE,


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   I WOULD HOPE THAT INDIVIDUALS WOULD DISCUSS THE CONTENTS OF
THIS BROCHURE WITH FRIENDS AND WITH CO-WORKERS,

   AND THAT LEADS ME TO SAY SOMETHING THAT MUST CERTAINLY BE
OBVIOUS BY THIS TIME TO THE PRESS, USUALLY WHEN WE DELIVER SUCH
A BROCHURE TO THE PRESS, THE CONTENTS IS UNDER EMBARGO UNTIL'A
CERTAIN TIME ON A CERTAIN DATE, WITH THIS BROCHURE WE HAVE DONE
SOMETHING ENTIRELY NEW IN THE MANAGEMENT OF OUR PUBLIC AFFAIRS,
WE ARE GIVING YOU ADVANCE COPIES LONG BEFORE IT WILL APPEAR IN
THE MAIL SLOTS IN THE HOMES OF AMERICA AND INSTEAD OF ASKING YOU
TO HOLD IT CLOSE UNTIL A LATER DATE, WE ARE DOING JUST THE
OPPOSITE AND ASKING YOU TO GIVE IT AS MUCH PUBLICITY AS YOU
POSSIBLY CAN BECAUSE WE WANT THE AMERICAN PUBLIC TO BE AWARE OF
THE BROCHURE THAT WILL EVENTUALLY BE FOUND IN THEIR MAILBOX AND
WE WANT THEM TO BE INTERESTED ENOUGH, CONCERNED ENOUGH, AND
INDEED CURIOUS ENOUGH TO READ IT AND READ IT 'CAREFULLY AND SHARE
IT IN DISCUSSIONS WITH OTHERS AS I HAVE ALREADY SUGGESTED, NO
ONE CAN DO THIS AS WELL AS YOU, WE NEED YOU,


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   I WOULD LIKE TO ADD A WORD ABOUT HOW MUCH EFFORT WENT INTO
THE PREPARATION OF THIS BROCHURE, LET ME MENTION FOUR SPECIFIC
ISSUES THAT WERE UNDER CONSTANT DISCUSSION BETiEEN OLGIVY AND
MATHER AND THOSE OF US WHO ARE CONCERNED ABOUT THE CONTENT OF

THIS BROCHURE,

   FIRST, PEOPLE RUN HOT AND COLD ON AIDS, THERE IS A PARADOX
WHEN IT COMES TO CONSUMER ATTENTION, ON THE ONE HAND, PEOPLE ARE
CONCERNED ABOUT AIDS: THEY WANT DEFINITIVE INFORMATION ON A
NUMBER OF AREAS, -- PARTICULARLY FROM THE GOVERNMENT, ON THE
OTHER HAND, AIDS IS NOT A TRUE PRIORITY IN THEaLIVES OF MOST
PEOPLE, MOST AMERICANS ARE MORE CONCERNED ABOUT OTHER THINGS,
THE NATIONAL MAILING HAD TO REACH OUT TO READERS, PRESENT VITAL
INFORMATION IN TERMS THEY COULD ACCEPT AND UNDERSTAND, AND
ATTEMPT TO LOOK AT THE SUBJECT THROUGH THEIR EYES, EVERYTHING
ABOUT THE BROCHURE HAD TO ENCOURAGE READERSHIP AND REVIEW,


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  SECOND, PEOPLE, IN GENERAL, ARE RELUCTANT READERS, THEY
GLANCE MORE THAN THEY READ, UNLESS THEY HAVE AN OVERPOWERING
DESIRE TO LEARN, THEY TEND NOT TO STUDY BUT INSTEAD THEY SKIM
OVER, THEY GLANCE AT, THEY READ PICTURE CAPTIONS, AND SO ON, WE
HAD AN OBLIGATION TO TRY TO REACH EVERYONE WHO SA\J THE
BROCHURE, WE ATTEMPTED TO DEVELOP A LAYOUT WITH AN APPEAL TO
GLANCING READERS AND NOT JUST SERIOUS STUDENTS OF AIDS, WE TRIED
TO MAKE IT PROCLAIM "NE KNOW WHAT YOU'RE INTERESTED IN, -- HERE
IT IS, READ IT,"


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  THIRD, AIDS IS A COMPLEX SUBJECT, IT IS REALLY SCORES OF
SUBJECTS IN ONE,  IT HAS MANY DIFFERENT FACETS AND IT CANNOT BE
OVER SIMPLIFIED, AIDS CANNOT BE REDUCED TO ONE SIMPLE NOTION
LIKE "DON'T START FOREST FIRES"; "DON'T DRINK AND DRIVE"; OR
"DON'T USE DRUGS",  AIDS IS EVER SO MUCH MORE COMPLEX, EACH
DIFFERENT ASPECT SEEMS TO BE AS IMPORTANT AS THE NEXT AND EACH
ONE CAN HAVE A LIFE OR DEATH RELEVANCE, WE HAD TO FACE THE
OBLIGATION OF NOT ARBITRARILY ASSIGNING IMPORTANCE TO ONE TOPIC
OVER ANOTHER, ON THE ONE HAND, NOR ON THE OTHER, TO BURY
INFORMATION SUCH AS HIDING FACTS IN SMALL TYPE AND LONG
PARAGRAPHS WHEN THAT INFORMATION MIGHT BE EXACTLY WHAT THE READER
NEEDS TO KNOW,, WE HAD THE OPTION, AND WE TRIED TO USE IT, OF
GIVING THE READER THE CHOICE OF WHAT HE WANTED TO PICK AND
CHOOSE,


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  FOURTH, WE WANTED THIS TO BE A CHATTY DOCUMENT NOT A MEDICAL
SEMINAR AND INDEED NOT A SERMON, CERTAINLY THE CONTENT WAS
CRUCIAL BUT SO WAS THE TONE OF VOICE, THE ADVICE COULDN'T BE
IMPRACTICAL OR UNWORKABLE AND EVEN THOUGH THE SCIENTISTS AND THE
MORALISTS WALK HAND IN HAND IN THE CONTROL OF AIDS, WE COULD NOT
MAKE MORAL JUDGEMENTS,

   I THINK WE SUCCEEDED IN USING SIMPLE LANGUAGE, SIMPLE WORDS,
AND USED THEM IN A CARING, CONVERSATIONAL, COUNSELLING TONE SO
THAT THE INFORMATION PROVIDED COULD BE APPLIED TO THE READER'S
LIVES, WE KNEW WE SHOULDN'T SOUND LIKE RESEARCHERS OR PREACHERS,
BUT WE EVEN TRIED NOT TO SOUND LIKE GOVERNMENT OFFICIALS


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  AS TO LAYOUT THEN, EACH TOPIC HAS BEEN GIVEN RELATIVELY
EQUAL IMPORTANCE, INDIVIDUAL SECTIONS ARE BROKEN OUT, ASSIGNED
EQUAL STATUS, AND DISPLAYED ACCORDINGLY, NOTHING IS BURIED,

  WE APPEAL FIRST TO THE GLANCING READER, THIS IS NOT A
MEDICAL TEXT AND WE KNOW READERS WON'T STUDY IT, THEREFORE, THE
LAYOUT ENCOURAGES READERSHIP BY PROMINENTLY DISPLAYING SUBJECT
MATTER,

  INASMUCH AS VERY FEW ILLUSTRATIONS ARE RELEVANT TO THE NEEDS
OF THE READER, WE THINK THE LAYOUT ACKNOiiLEDGES THE DIFFICULTY IN
HANDLING A PRIMARILY VERBAL PRESENATION THROUGH VARIETY,
INFORMALITY, AND ATTRACTIVENESS,


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  A GREAT DEAL OF TECHNICAL KNOWLEDGE WENT INTO THE TYPOGRAPHY
WHICH MIGHT BE SUMMARIZED AS BEING SIMPLE, PLEASING, AND YET
TRADITIONAL,

  THE PHOTOGRAPHS ARE INTENDED TO IMPROVE THE PRESENTATION BY
INTRODUCTING REAL LIVING PEOPLE IN A CREDIBLE HUMAN WAY,
CAPTIONS IN THE FIRST PERSON MAKE A POINT, AND IN DOING SO, SHARE
A PREVENTIVE IDEA OR DEBUNK A MYTH,


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  FINALLY, THE PHOTOGRAPHY AVOIDS TARGETTING AND WE HOPE
YOU'LL THINK THE PEOPLE IN THE PHOTOGRAPHS REPRESENT THE AMERICAN
MOSAIC AND ENCOURAGE ACCEPTANCE OF THE BROCHURE BY ALL AMERICANS
BY AVOIDING STEREOTYPES OR IMPLYING THAT INDIVIDUALS ARE MEMBERS
OF GROUPS PRACTICING HIGH-RISK BEHAVIOR,

  I THINK YOU WILL ALL AGREE THAT I HAVE BEEN LAVISH IN MY
PRAISE OF THE WAY THE PRESS HAS HANDLED THE SUBJECT OF AIDS IN
THE PAST, I REALLY DON'T KNOW HOW YOU SUSTAINED THE INTEREST OF
THE PUBLIC FOR AS LONG AS YOU HAVE AND NOW WE NEED YOU ONCE
AGAIN, YOU'VE DONE A CREDIBLE JOB IN EDUCATION, BECAUSE OF ALL
THIS, AND BECAUSE I SINCERELY BELIEVE IT, I HOPE THAT YOU WILL
JOIN ME AND GET BEHIND THIS EFFORT AND DO EVERYTHING YOU CAN TO
MAKE THE AVERAGE AMERICAN EAGER TO FIND THIS BROCHURE IN HIS
MAIL, BE SURE TO TELL HIM IT'S COMING, AND PLEASE NOT CALL US
FOR AN ADVANCE COPY,