ORIGINAL

THE CURRENT CRIsis_IN AIDS

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 ON VIDEOTAPE
FEBRUARY 18, 1987
I APPRECIATE THIS OPPORTUNITY TO SPEAK WITH YOU ABOUT A NEW AND
VERY SERIOUS PUBLIC HEALTH MATTER,

I’M TALKING ABOUT AIDS,

LET ME TAKE JUST A MOMENT TO BRING YOU UP TO DATE ON THIS ISSUE,
AND THEN I WANT TO EXPLORE SOME OF THE KEY QUESTIONS THAT AIDS POSES
TO SOCIETY TODAY...AND TOMORROW,

FIRST,..A LITTLE HISTORY,

ALMOST SIX YEARS AGO, IN JUNE 1981, THE PUBLIC HEALTH SERVICE
RECEIVED REPORTS OF 5 CASES OF PNEUMOCYSTIS CARINII PNEUMONIA IN LOS

ANGELES,

NOW, FIVE CASES AREN'T MUCH... BUT THIS LETHAL DISEASE 1S SO RARE
THAT A HANDFUL OF CASES IN A SINGLE YEAR IS LIKE AN EPIDEMIC,

SOON THE SAME KIND OF REPORTS WERE TRICKLING IN FROM OTHER CITIES
AS WELL,
PUBLIC HEALTH INVESTIGATORS THEN REPORTED THAT PEOPLE WERE NOT
ONLY SICK WITH THIS VERY DANGEROUS FORM OF INFECTIOUS PNEUMONIA...
THEY WERE DYING FROM IT.

FOR SOME MYSTERIOUS REASON, THEIR BODIES WERE NOT FIGHTING BACK,

APPARENTLY THESE VICTIMS HAD ACQUIRED SOME KIND OF “BUG” -- A
VIRUS, MOST LIKELY -- THAT ATTACKED AND DESTROYED THEIR NATURAL IMMUNE
SYSTEMS.

WE’D NEVER COME UPON A SYNDROME QUITE LIKE IT BEFORE, WE GAVE IT
A LONG TITLE: THE “ACQUIRED IMMUNE DEFICIENCY SYNDROME.” BUT WE SOON
SETTLED JUST FOR THE INITIALS...A.1.D,S...,0R “AIDS,”

AND IT’S BEEN AIDS EVER SINCE,

YOU'VE READ THE STORIES AND HAVE SEEN IT ON TELEVISION, I’M SURE,

SO 1 WON’T GO THROUGH THE WHOLE HISTORY ALL OVER AGAIN. INSTEAD, I’LL
JUST TOUCH ON A FEW KEY POINTS:
FIRST OF ALL, WE'RE TALKING ABOUT A DISEASE THAT IS SPREADING AND
IS FATAL. IT NOW TAKES ABOUT A YEAR FOR THE NUMBER OF VICTIMS TO
DOUBLE. FOR EXAMPLE, AS OF JANUARY 1386, WE HAD A CUMULATIVE TOTAL OF
16,000 REPORTED CASES, TODAY THAT TOTAL IS 50,000.

OVER HALF OF THEM HAVE ALREADY DIED OF THE DISEASE...AND THE REST
WILL.

LAST YEAR WE ADDED 13,000 NEW CASES TO THE TOTAL. THIS YEAR WE
EXPECT TO ADD ANOTHER 23,000,

BY THE END OF 1990 THE CUMULATIVE TOTAL WILL BE OVER A QUARTER OF
A MILLION,

SECOND POINT: EVEN THOUGH SCIENTISTS HAVE HAD A LOOK AT THE AIDS
VIRUS, WE STILL DON’T KNOW PRECISELY WHAT IT IS,

IN 1984 THE SEARCH WAS NARROWED DOWN TO SOMETHING CALLED A “HUMAN
RETROVIRUS.” OUR SCIENTISTS AT THE NATIONAL CANCER INSTITUTE WERE
EVEN ABLE TO PIN-POINT A SPECIFIC ONE. THEY CALLED IT THE “HUMAN
T-CELL LYMPHOTROPIC VIRUS TYPE III,” OR SIMPLY “HTLV-IIT.”
THE SAME VIRUS SHOWED UP IN THE WORK OF THE PASTEUR INSTITUTE.
WHERE IT BECAME KNOWN AS THE “LYMPHADENOPATHY-ASSOCIATED VIRUS,” OR
"LAV,” SCIENTISTS NOW AGREE TO CALL IT BY THE SINGLE COMMON NAME OF
"HUMAN IMMUNODEFICIENCY VIRUS,” OR “H.T.V."

THE ABILITY TO RECOGNIZE THE VIRUS WAS A VERY IMPORTANT
DEVELOPMENT, ONCE YOU KNOW WHERE THe AIDS VIRUS IS, YOU'RE CAN THEN
RECOGNIZE THE PRESENCE OF ANTIBODIES SPECIFIC TO IT,

OF COURSE, THOSE ANTIBODIES AREN’T VERY EFFECTIVE, BUT THEY'RE
PRESENT NEVERTHELESS,

AS OF 1985 WE'VE HAD A TEST THAT CAN DETECT THE PRESENCE OF THESE
ANTIBODIES IN A PERSON'S BLOODSTREAM, ON THE BASIS OF SUCH TESTING SO
FAR, PLUS OTHER EPIDEMIOLOGICAL STUDIES, WE BELIEVE THERE ARE BETWEEN
A MILLION AND A MILLION-AND-A-HALF AMERICANS WITH THE AIDS VIRUS IN
THEIR SYSTEMS,
Wr

THEY HAVE AIDS... BUT THEY AREN’T YET SICK WITH AN AIDS-RELATED
DISEASE, SUCH AS PNEUMOCYSTIS CARINII PNEUMONIA OR KAPOSI’S SARCOMA OR
ANY OF THE VIRULENT MEGALOVIRAL DISEASES,

ONE MAJOR COMPLICATION IS THE LENGTH OF THE INCUBATION PERIOD.
IT APPARENTLY CAN BE ANYWHERE FROM A YEAR OR SO IN SOME PEOPLE TO 10
YEARS IN OTHERS, IF OUR COMPUTATIONS ARE CORRECT. SO WE STILL CAN’T
PREDICT DEFINITELY WHICH PERSON CARRYING THE AIDS VIRUS WILL OR WILL
NOT GET AN AIDS-RELATED DISEASE,

BUT THE RISK IS VERY, VERY HIGH. IN FACT, SOME RESEARCHERS NOW
FEEL THAT ANYONE WITH THE AIDS VIRUS WILL EVENTUALLY CONTRACT AN AIDS-
RELATED DISEASE...AND WILL DIE,
mn

THERE’S OTHER RESEARCH GOING ON AS WELL. ONE NEW EXPERIMENTAL
DRUG, AZIDOTHYMIDINE, OR A.Z,.T,, SEEMS TO PROLONG THE LIVES OF AIDS
VICTIMS DYING OF PNEUMOCYSTIS CARINII PNEUMONIA,

BUT I’M AFRAID THAT'S ALL A,Z,T. DOES..,.17 PROLONGS SOME LIVES,
IT DOES NOT SAVE THEM, WHAT WE NEED IS A VACCINE,

PEOPLE WANT TO KNOW WHEN AN EFFECTIVE VACCINE MIGHT BE
AVAILABLE, AND I HAVE TO TELL THEM THAT I DON’T SEE ONE IN THE NEAR
FUTURE,

WE'RE MOVING AHEAD ON THIS FRONT AS QUICKLY AS WE CAN, BUT SOME
THIS IS ONE THING THAT CANNOT BE RUSHED, WITHOUT CREATING MORE
PROBLEMS THAN WE ALREADY HAVE, WE NEED TO REMEMEBR THAT IT TOOK 19
YEARS TO DEVELOP THE HEPATITIS B VACCINE...AND THAT WAS A
COMPARATIVELY EASY VIRUS TO UNDERSTAND,
NOW, FOR MY THIRD POINT:

WE DON’T KNOW VERY MUCH ABOUT AIDS...BUT WE DO KNOW -- WITH
COMPLETE CERTAINTY -- THAT THE VIRUS IS TRANSMITTED FROM ONE PERSON TO
ANOTHER EITHER IN BLOOD OR IN SEMEN,

THIS IS ONE OF THE MOST IMPORTANT PIECES OF INFORMATION WE HAVE
SO FAR. IT EXPLAINS, FOR EXAMPLE, WHY THE INITIAL ALARM ABOUT AIDS
WAS SOUNDED AMONG HOMOSEXUAL AND BISEXUAL MEN, SOME SEX PRACTICES
AMONG THESE MEN NOT ONLY PRODUCE SEMEN BUT MAY ALSO CAUSE SOME
BLEEDING...AND, AGAIN, BLOOD AND SEMEN ARE THE ONLY TWO BODY FLUIDS
THAT CARRY THE LIVE AIDS VIRUS IN QUANTITIES SUFFICIENT TO BE
TRANSMISSABLE,

THAT INFORMATION ALSO EXPLAINS WHY 17 PERCENT OF ALL AIDS CASES
ARE INTRAVENOUS DRUG ABUSERS WHO USE A DIRTY NEEDLE THEY’ VE BORROWED
FROM ANOTHER ADDICT WHO ALREADY HAS AIDS,
WHEN WE FIRST BEGAN TO CONFRONT THE AIDS EPIDEMIC, THE PEOPLE AT
HIGHEST RISK WERE HOMOSEXUAL AND BISEXUAL MEN. 1’M AFRAID THEY STILL
ARE: 2 OF EVERY 3 CASES INVOLVE THESE MEN,

BUT NOWADAYS WE‘RE RECEIVING MORE AND MORE REPORTS OF THE AIDS
VIRUS OCCURRING AMONG HETEROSEXUAL MEN AND WOMEN WHO ARE NOT 1.V. DRUG
ABUSERS. IN FACT, THEIR HETEROSEXUAL ACTIVITY SEEMS TO BE THEIR ONLY.
RISK FACTOR,

AS OF LAST WEEK, 4 PERCENT OF ALL REPORTED AIDS CASES WERE OF
HETEROSEXUAL MEN AND WOMEN,..A PERCENTAGE, BY THE WAY, THAT'S
CLIMBING,

ANOTHER CONCERN IS THE RISE IN AIDS AMONG BLACKS AND HISPANICS,
BLACKS ACCOUNT FOR 12 PERCENT OF THE POPULATION, BUT THEY ACCOUNT FOR
25 PERCENT OF ALL AIDS CASES, SIMILARLY, HISPANICS ACCOUNT FOR 6
PERCENT OF THE U.S, POPULATION, BUT THEY ACCOUNT FOR 14 PERCENT OF ALL
AIDS CASES. SO THE DEMOGRAPHY OF THIS DISEASE IS AS COMPLEX AS THE
DISEASE ITSELF,
AND THAT LEADS ME TO MY FOURTH POINT: OUR SINGLE DEFENSE AGAINST
THIS DISEASE FROM THE VERY BEGINNING HAS BEEN INFORMATION AND
EDUCATION. AND IT STILL IS,

 

OVER THE PAST 5 YEARS, WE BEAMED INFORMATION ALMOST EXCLUSIVELY
TO HOMOSEXUAL AND BISEXUAL MEN, IT SEEMS TO HAVE BEEN EFFECTIVE...
THEIR BEHAVIOR SEEMS TO HAVE CHANGED, THE INCIDENCE OF OTHER SEXUALLY
TRANSMITTED DISEASES AMONG HOMOSEXUAL MEN HAS DECLINED,

BUT NOW WE NEED TO DIRECT OUR INFORMATION AND EDUCATION EFFORTS
OUT TO HETEROSEXUAL MEN AND WOMEN... WHICH IS TO SAY, TO SOCIETY AT
LARGE,

THAT'S VERY HARD TO DO IN THIS COUNTRY. WE*RE VERY LARGE AND
VERY DIVERSE,

SO WE’VE HAD TO SET SOME PRIORITIES AND MAKE SOME TOUGH CHOICES,
BUT I THINK WE MADE THE RIGHT CHOICE, WHEN WE DECIDED TO FOCUS ON
TELLING YOUNG PEOPLE THE FACTS ABOUT THE THREAT OF AIDS.
10

WHAT WE’RE DOING, THEN, IS SORTING OUT ALL THE INFORMATION THAT
CAN BE LIFE-SAVING FOR SEXUALLY ACTIVE PEOPLE -- AND THAT MEANS ANY
MALE OR FEMALE BETWEEN THE AGES OF 12 AND 80,

AND THEN WE‘RE FOCUSING ON THOSE PIECES OF INFORMATION THAT ARE
ESPECIALLY PERTINENT TO -- AND CAN BE READILY UNDERSTOOD BY -- YOUNG
PEOPLE.

THAT WAS THE UNDERLYING PLAN FOR THE SURGEON GENERAL’S REPORT ON
AIDS, WHICH I RELEASED LAST OCTOBER. LET ME TAKE JUST A MINUTE HERE
TO EXPLAIN HOW THAT REPORT CAME ABOUT,

 

EARLY IN FEBRUARY 1986, PRESIDENT REAGAN INSTRUCTED ME TO PULL
TOGETHER EVERYTHING WE KNEW ABOUT AIDS AND PUT IT INTO A PLAIN-ENGLI SH
REPORT TO THE AMERICAN PEOPLE. HE FELT THAT THERE WAS STILL TOO MUCH
CONFUSION AMONG THE AMERICAN PEOPLE ABOUT THE NATURE OF THIS IMPORTANT
THREAT TO PUBLIC HEALTH. HE ASKED ME TO DO WHAT I COULD TO SET Tht
RECORD STRAIGHT,
Il

FOR THE NEXT 8 MONTHS I MET WITH CONCERNED INDIVIDUALS AND GROUPS
FROM ACROSS THE SPECTRUM OF SOCIETY...

GROUPS LIKE THE NATIONAL EDUCATION ASSOCIATION AND THE NATIONAL
P.TsAsues

THE NATIONAL COUNCIL OF CHURCHES AND THE CHRISTIAN LIFE COMMISSION
OF THE SOUTHERN BAPTIST CONVENTION...

THE SYNAGOGUE COUNCIL OF AMERICA AND THE NATIONAL CONFERENCE OF
CATHOLIC BISHOPS...

1 TALKED WITH THE NATIONAL COALITION OF BLACK AND LESBIAN GAYS AND
THE WASHINGTON BUSINESS GROUP ON HEALTH....AND MANY, MANY OTHERS
»+.26 GROUPS IN ALL.

THEY WERE ALL EXTRAORDINARILY CANDID AND HELPFUL,
AFTER 8 MONTHS OF LISTENING AND WRITING, I DELIVERED MY REPORT TO
THE CABINET AND TO THE PRESIDENT. IT WAS ACCEPTED,..AND I RELEASED IT
TO THE AMERICAN PEOPLE ON OCTOBER 22, 1986,

INCIDENTALLY, AT NO TIME DID ANYONE SUGGEST TO ME THAT I MAKE A
LITTLE CHANGE HERE OR A LITTLE CHANGE THERE. THE FINAL REPORT I
RELEASED IN OCTOBER WAS THE EXACT SAME REPORT THAT I PERSONALLY WROTE
BETWEEN FEBRUARY AND SEPTEMBER OF LAST YEAR,

 

AND I CAN FURTHER ASSURE YOU THAT SINCE THAT TIME 1 HAVE HAD NO
MISGIVINGS ABOUT ANYTHING I WROTE,

T HOPE YOU’VE ALL READ IT, IF NOT, PLEASE GET OUT A PENCIL AND
TAKE DOWN THIS ADDRESS:

AIDS,,.POST OFFICE BOX 14252,,. WASHINGTON, D,C,..,20044

LET ME REPEAT THAT FOR YOU:

AIDS... POST OFFICE BOX 14252,,. WASHINGTON, D.C....20044
13

THERE IS MUCH SCIENTIFIC AND PUBLIC HEALTH INFORMATION IN THAT
REPORT, BUT ON THE BEHAVIORAL SIDE, THERE ARE ESSENTIALLY JUST TWO
MESSAGES AND I HOPE THEY REACH EVERY ONE OF THIS COUNTRY’S YOUNGSTERS.

THE FIRST MESSAGE 1S SIMPLE ENOUGH, IT SAYS...

FIND SOMEONE WHO IS WORTHY OF YOUR RESPECT AND YOUR LOVE,..GIVE
THAT PERSON BOTH...AND STAY FAITHFUL TO HIM OR HER,

IN OTHER WORDS, SHORT OF TOTAL ABSTINENCE, THE BEST DEFENSE
AGAINST AIDS IS TO MAINTAIN A FAITHFUL, MONOGAMOUS RELATIONSHIP IN
WHICH YOU HAVE ONLY ONE CONTINUING SEXUAL PARTNER,..AND THAT PERSON IS
AS FAITHFUL AS YOU ARE,

MY SECOND MESSAGE IS FOR PEOPLE WHO DON’T YET HAVE A FAITHFUL
MONOGAMOUS RELATIONSHIP FOR WHATEVER REASON. UNLESS YOU KNOW WITH
ABSOLUTE CERTAINTY THAT NEITHER YOU NOR YOUR PARTNER 1S CARRYING THE
AIDS VIRUS, YOU MUST USE CAUTION.
i4

REMEMBER, FROM THE VIEWPOINT OF EPIDEMIOLOGY, WHEN YOU HAVE SEX
WITH SOMEONE, YOU‘RE ALSO HAVING SEX WITH EVERYONE ELSE WITH WHOM THAT
PERSON HAS HAD SEX, AND, CONSIDERING THE LONG INCUBATION PERIOD FOR
THE AIDS VIRUS, WE’RE TALKING ABOUT THAT PERSON'S HISTORY OF SEXUAL
RELATIONS GOING BACK 10 YEARS. |

IF YOU DO DECIDE TO HAVE SEX WITH SOMEONE AND YOU ARE NOT
ABSOUTELY CERTAIN ABOUT HIS OR HER SEXUAL HISTORY, 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,,.AGAIN, FROM START TO FINISH,

A CONDOM WON'T PROVIDE 100 PERCENT PROTECTION -- FEW THINGS IN
LIFE DO -- BUT SO FAR IT SEEMS TO BE THE BEST PROTECTION AVAILABLE.

NOW, LET ME PAUSE FOR A MOMENT AND FOCUS ON AN ISSUE THAT IS
GAINING ALMOST AS MUCH ATTENTION AS THE AIDS VIRUS ITSELF. THE ISSUE
1S...HOW SHOULD WE EDUCATE OUR YOUNG PEOPLE ABOUT AIDS AND ABOUT THEIR
SEXUALITY. WHO SHOULD DO 17? AND WHEN?
15

FIRST OF ALL, I PREFER TO SPEAK ABOUT THE NEED FOR “AIDS EDUCA-
TION,”

1 TRULY BELIEVE WE NEED SUCH EDUCATION AT THE APPROPRIATE AGE
LEVEL IN THE SCHOOLS OF AMERICA,

BUT I ALSO RECOGNIZE THAT, FOR MANY YOUNG PEOPLE, SUCH EDUCATION
MAY BE FRIGHTENING...OR PUZZLING...OR BOTH,

HENCE, I BELIEVE THAT THE MOST SIGNIFICANT ACTION OUR SOCIETY
MIGHT TAKE TO PROTECT ITS YOUNG PEOPLE FROM THE MORTAL THREAT OF AIDS
IS TO PROVIDE THEM, FIRST OF ALL, WITH EDUCATION CONCERNING THEIR OWN
SEXUALITY... EDUCATION THAT IS FACTUALLY CORRECT, PERSONALLY SENSITIVE,
AND MORALLY STRONG,

MOST SCHOOLS NOW OFFER SOME MINIMUM KIND OF SEX EDUCATION DURING
THE JUNIOR HIGH OR MIDDLE SCHOOL YEARS AND THAT'S A GOOD THING,
ALTHOUGH IT MIGHT BE A LITTLE LATE. I PERSONALLY WOULD URGE THAT ThE
MATERIAL BE PRESENTED EARLIER, AMONG THE 9-, i0-, AND 11-YEAR-OLDS.
16

OF COURSE, DEVELOPMENTAL AGE 1S MORE IMPORTANT THAN CHRONOLOGICAL
AGE. ALSO, COMMUNITY STANDARDS, WHICH VARY FROM PLACE TO PLACE, MUST
BE TAKEN INTO ACCOUNT,

MY OWN PREFERENCE, ALSO, WOULD BE TO HAVE CHILDREN INTRODUCED 10
THE SUBJECT OF REPRODUCTIVE BIOLOGY WITHIN A MORE GENERAL DISCUSSION
OF THE NATURE OF SENSITIVE AND AFFIRMATIVE HUMAN RELATIONS,

THAT'S EASIER TO SAY THAN TO DO, 1 KNOW, AND FURTHERMORE, SOME
PARENTS GET UNEASY ABOUT HAVING THE SCHOOLS IMPART CERTAIN HUMAN
VALUES TO THEIR CHILDREN. THEY THINK THAT SUCH INSTRUCTION SHOULD BE
DONE AT HOME,

AND I AGREE, I ALWAYS HAVE, MY ADVICE TO PARENTS HAS ALWAYS
BEEN THIS:

THE SOCIAL AND SPIRITUAL DEVELOPMENT OF YOUR CHILDREN IS YOUR
BUSINESS. DON’T PASS IT UP...DON’T PASS IT BY..,BUT PASS IT ON.

MOST PARENTS AGREE WITH ME 100 PERCENT, BUT MANY OF THEM NEVER
DO MUCH MORE THAN AGREE WITH ME,
17

I’M SURE MANY PARENTS HAVE TROUBLE DEALING WITH THE PHYSIOLOGY
AND BIOLOGY OF SEX MAINLY BECAUSE THEY DIDN'T GET ANY OF THIS
INFORMATION WHEN THEY WERE KIDS EITHER, AND THEY FEEL INADEQUATE.

ALSO, IF PARENTS ARE TO EDUCATE THEIR CHILDREN ABOUT HUMAN
RELATIONSHIPS -- SEXUAL AND OTHERWISE -- THEY MUST FIRST UNDERSTAND
AND ACCEPT THE NATURE OF THEIR OWN. FOR MANY, THAT’S HARD 10 DO,

PARENTS -- ADULTS -- ARE NOT VERY GOOD ABOUT TALKING IO EACH
OTHER ABOUT THEIR SEXUALITY, THEY FEEL FRUSTRATED, GUILTY, AND EVEN
ANGRY ABOUT THEIR INABILITY TO DO THE THING THAT THEY KNOW --
INTELLECTUALLY AND EMOTIONALLY -- THEY SHOULD DO,

 

 

BUT THEY CAN'T,
18

NEVERTHELESSS, I WANT PARENTS TO TRY, 1 WANT PARENTS TO DO THIS
WITH COMPASSION,. WITH RESPECT AND WITH LOVE.,..AND WITH SOME UNDER-
STANDING NOT JUST OF THE CHILD WHO'S LISTENING...BUT ALSO OF THE ADULT
WHO IS SPEAKING,

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. BUT WHEN PARENTS CAN'T GET THE JOB DONE,
THEN 1 BELIEVE THERE’S A COMPELLING SOCIAL NEED FOR OUR SCHOOLS,
CHURCHES, SYNAGOGUES, AND OTHER COMMUNITY INSTITUTIONS TO DO WHATEVER
POSSIBLE TO PROVIDE OUR CHILDREN WITH THE INFORMATION THEY NEED 10
UNDERSTAND THEIR SEXUALITY AND HOW TO PROTECT THEMSELVES FROM AIDS,

I BELIEVE THAT EACH OF US -- IN OUR HOMES OR IN OUR SCHOOLS --
HAS THE MORAL RESPONSIBILITY TO PASS THAT INFORMATION ON TO OUR
CHILDREN,
19

OUR ONLY HOPE AS A NATION...AS A CIVILIZATION, ..IS THAT EVERY
AMERICAN WHO HEARS OR READS MY MESSAGE, WILL BELIEVE IT AND DO HIS OR
HER PART TO 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,

WHICH LEADS ME TO MY FINAL WORD. IT’S NOT MINE REALLY. IT’S THE
LAST SENTENCE OF THE BRIDGE OF SAN LUIS REY, THE LITTLE NOVEL WRITTEN
BY THORNTON WILDER. WILDER CONCLUDED HIS NOVEL BY OBSERVING...

"THERE IS A LAND OF THE LIVING AND A LAND OF THE DEAD AND THE ONLY
BRIDGE IS LOVE...THE ONLY SURVIVAL, THE ONLY MEANING,”
THANK YOU,

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