~ ORIGINAL

BIOS 3

ADDRESS
By
C, Everett Koop. M.D., Sc.D,
SURGEON GENERAL
OF THE
U.S, PuBLic HEALTH SERVICE
U.S, DEPARTMENT OF HEALTH AND HUMAN SERVICES

CEO

PRESENTED AT CARDOZO HIGH SCHOOL
WASHINGTON, D.C,
FEBRUARY 25, 1988
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(GREETINGS TO HOSTS, GUESTS, FRIENDS, ETC.)

FOR ALMOST TWO YEARS NOW, I’VE BEEN GIVING THE AMERICAN
PEOPLE THE FACTS ABOUT AIDS.

_ AND THE FACTS ARE NOT VERY NICE.

NO DOUBT YOU'VE HEARD OR READ QUITE A BIT ABOUT THIS
DISEASE ALREADY. SO WHAT I’M GOING TO DO THIS MORNING IS TO
BRING YOU UP TO DATE ON SOME OF THESE FACTS AND SHARE WITH YOU MY
FEELINGS ABOUT THE IMPORTANCE OF THIS INFORMATION,
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THEN WE‘LL HAVE SOME QUESTIONS AND I’LL HAVE A CHANCE TO

HEAR YOUR POINTS OF VIEW, ALSO.

FIRST OF ALL, THE VIRUS WE‘RE DEALING WITH IS STILL
SOMETHING OF A MYSTERY TO OUR SCIENTISTS -- AND TO SCIENTISTS
AROUND THE WORLD. WE’RE SO USED TO HAVING SCIENTISTS TELL US
EVERYTHING WE NEED TO KNOW ... AS SOON AS WE NEED TO KNOW IT...
THAT IT’S HARD TO IMAGINE SOMETHING LIKE AIDS COMING ALONG AND
BEING A PUZZLE TO THE BEST MINDS IN RESEARCH.

AND IT’S BEEN THAT WAY FOR 6 YEARS!
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BUT UNFORTUNATELY THAT'S STILL THE CASE. AND THAT’S WHY WE

DON’T HAVE A VACCINE YET THAT WILL PROTECT PEOPLE FROM
CONTRACTING AIDS. SO IF YOU'RE IGNORING ALL THE WARNINGS ABOUT
AIDS ... THINKING THAT A VACCINE OR A MAGIC DRUG IS RIGHT AROUND
THE CORNER AND YOU’LL BE PROTECTED IF YOU CATCH IT ... YOU'D
BETTER THINK AGAIN.

THE ONLY THING THAT’S AROUND THE CORNER ... IS ANOTHER
CORNER,

 
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WE DON’T KNOW EVERYTHING ABOUT THE DISEASE OF AIDS -- BUT WE

KNOW ENOUGH TO TAKE IT VERY, VERY SERIOUSLY. FOR EXAMPLE...

* AIDS IS VIRTUALLY FATAL: 93 PERCENT OF THE PEOPLE WHO
WERE DIAGNOSED AS HAVING AIDS BACK IN 1981 HAVE SINCE DIED OF THE
DISEASE. IN MEDICINE, A DEATH RATE OF 93 PERCENT IS AS BAD AS A
RATE OF 100 PERCENT.

* THE SECOND THING WE KNOW IS WHERE TO LOOK FOR THIS
DISEASE. ONE PLACE IS THE BRAIN AND THE CENTRAL NERVOUS SYSTEM,
YOU MAY HAVE HEARD OR READ ABOUT THAT BECAUSE IT’S BEEN IN THE
NEWS LATELY. BUT, AS BAD AS THAT IS, THAT’S NOT WHERE THE AIDS
VIRUS HAS BEEN DOING ITS WORST DAMAGE FOR THE PAST 6 YEARS,
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THE AIDS VIRUS FEEDS ON -- AND DESTROYS -- THOSE SPECIAL

WHITE BLOOD CELLS THAT ARE THE BASIS OF OUR IMMUNE SYSTEM,
THAT’S WHY AIDS IS A KILLER DISEASE. LET ME EXPLAIN THAT.

WHEN ANY STRANGE BUG INVADES THE HUMAN BLOODSTREAM, YOU GET
SICK. BUT THEN YOUR WHITE BLOOD CELLS GO INTO ACTION AND KILL
THE INVADERS ... AND YOU GET WELL. IT’S AS SIMPLE AS THAT,

BUT THE AIDS VIRUS IS DIFFERENT. WHEN THIS VIRUS ENTERS THE
BODY, IT HEADS RIGHT FOR THE WHITE BLOOD CELLS -- AND KILLS THEM,
WHEN THAT HAPPENS, YOU ARE AN EASY TARGET FOR ANY DISEASE THAT
COMES ALONG,
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REMEMBER, FOR THE MOST PART, AIDS ITSELF DOESN’T KILL YOU,

THE AIDS VIRUS JUST MAKES IT POSSIBLE FOR ANYTHING ELSE TO KILL
YOU INSTEAD,

SINCE THE AIDS VIRUS FEEDS ON WHITE BLOOD CELLS, IT APPEARS
WHERE YOU FIND HIGH CONCENTRATIONS OF SUCH CELLS. AND THAT
OCCURS MAINLY IN TWO BODY FLUIDS: BLOOD AND SEMEN,

SINCE THIS [IS THE CASE, WE THEREFORE ALSO KNOW THE WAYS IN
WHICH THE AIDS VIRUS [S SPREAD. IT’S SPREAD WHEN ANY AIDS-
INFECTED BLOOD AND/OR SEMEN FROM ONE PERSON GETS INTO THE
BLOODSTREAM OF ANOTHER PERSON.
/
THAT'S SOMETHING THAT DOES NOT HAPPEN BY ACCIDENT. YOU

TRANSMIT -- OR CATCH -- AIDS ONLY IF YOU DO SOMETHING THAT WILL
PASS AIDS-INFECTED BLOOD AND/OR SEMEN BETWEEN YOU AND SOMEONE
ELSE,

YOU CAN SHARE WATER GLASSES, BATH TOWELS, TOILET SEATS,
SWEATSHIRTS, AND PET DOGS AND CATS WITH OTHER PEOPLE ... AND YOU

WON'T GET AIDS. YOU MAY GET A COLD OR YOU MAY CATCH THE FLU,

BUT THAT’S NOT HOW YOU’LL GET AIDS,
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THEN EXACTLY HOW IS THE VIRUS PASSED FROM PERSON TO PERSON?

THERE HAVE BEEN ONLY FOUR WAYS,

ONE WAY WAS THROUGH BLOOD TRANSFUSIONS. THAT WAS A PROBLEM
UNTIL 1985, WHEN WE DEVELOPED A VERY GOOD BLOOD TEST TO DETECT
THE PRESENCE OF ANTIBODIES TO THE VIRUS AND, THEREFORE, THE
PRESENCE OF THE AIDS VIRUS ITSELF.

TODAY, OUR BLOOD SUPPLY IS AS SAFE AS WE CAN MAKE IT,
GETTING AIDS FROM A BLOOD TRANSFUSION IS NOW AN EXTREMELY REMOTE

POSSIBILITY. WE COULDN’T SAY THAT JUST A COUPLE OF YEARS AGO.

THAT LEAVES THREE WAYS THAT ARE STILL IMPORTANT,
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THE MOST COMMON OF THESE THREE IS THROUGH SEXUAL

INTERCOURSE. A MAN WITH AIDS WILL PASS THE VIRUS TO HIS SEXUAL
PARTNER THROUGH HIS SEMEN.

BUT CERTAIN SEX PRACTICES NOT ONLY PRODUCE SEMEN, THEY ALSO
CAN CAUSE BLEEDING. THIS IS PARTICULARLY TRUE DURING ANAL
INTERCOURSE.

THE HUMAN RECTUM WAS JUST NOT DESIGNED FOR THAT KIND OF
THING. IT IS EASILY TORN DURING ANAL INTERCOURSE, CAUSING
BLEEDING. AGAIN, THE INFECTED SPERM OF THE MAN MAY DIRECTLY
ENTER HIS PARTNER'S BLOODSTREAM AT THAT POINT.
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ANAL INTERCOURSE IS MOST OFTEN PRACTICED BY HOMOSEXUALS AND

BISEXUAL MALES. THAT ACCOUNTS FOR THE FACT THAT 2 OUT OF EVERY 3
VICTIMS OF AIDS ARE EITHER HOMOSEXUALS OR BISEXUAL MALES.

HOWEVER, HOMOSEXUALITY BY ITSELF DOES NOT CAUSE AIDS. IN
FACT, WE KNOW THAT MANY HOMOSEXUALS DO NOT ENGAGE IN THESE
ROUGHER KINDS OF SEXUAL INTERCOURSE. AND SO, THEY DON’T HAVE
AIDS.

AND THEY'RE AS FRIGHTENED OF THE DISEASE AS THE REST OF US
ARE.
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WHAT IT COMES DOWN TO IS THIS: WE’RE FIGHTING A DEADLY

DISEASE ... WERE NOT FIGHTING THE PEOPLE WHO HAVE IT. THAT
DIFFERENCE HAS ALWAYS BEEN IMPORTANT TO AMERICANS, WHETHER
WE'VE BEEN FIGHTING SMALLPOX, POLIO, MEASLES, SYPHILIS, OR
ANYTHING ELSE.

IN NONE OF THOSE CASES DID WE ALSO FIGHT THE PEOPLE WHO
WERE SICK.

AND I CAN ASSURE YOU, AS YOUR SURGEON GENERAL, WE‘RE NOT
GOING TO CHANGE NOW ... AIDS OR NO AIDS.
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T SAID THERE WERE THREE WAYS TO GET AIDS. ONE WAS THROUGH

SEXUAL INTERCOURSE -- ESPECIALLY, BUT NOT EXCLUSIVELY ANAL
INTERCOURSE,

THE SECOND WAY IS BY SHARING THE NEEDLES AND OTHER
CONTAMINATED DRUG “WORKS” OF AN AIDS-INFECTED DRUG ADDICT,

WHAT HAPPENS IN THOSE CASES IS THAT A TINY DROP OF
CONTAMINATED BLOOD IS LEFT IN THE NEEDLE. THE NEXT PERSON USING
THAT NEEDLE TO “SHOOT UP” WILL GET THAT DROP OF BLOOD ALONG WITH
THE DRUG,
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THE THIRD WAY TO GET AIDS IS TO BE BORN OF A MOTHER WHO HAS

AIDS. AT LAST COUNT, OVER 600 CHILDREN IN THIS COUNTRY WERE
BORN WITH AIDS. IN THOSE CASES, THE AIDS VIRUS WAS ALREADY IN
THE MOTHER’S BLOODSTREAM AND PASSED INTO THE CHILD’S BLOODSTREAM
SOMETIME DURING THE PREGNANCY OR DURING CHILDBIRTH ITSELF.

HOW DO WE KNOW THE EXTENT OF THE AIDS EPIDEMIC?

THE U.S. PUBLIC HEALTH SERVICE GETS REPORTS FROM AROUND THE
COUNTRY EVERY WEEK. WE SORT OUT AND ANALYZE THESE REPORTS AND
THAT GIVES US A CLEARER, MORE DETAILED PICTURE AS TO WHERE THE
AIDS EPIDEMIC IS JUST TAKING OFF AND WHERE IT’S AT ITS WORST.
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FOR EXAMPLE, WE KNOW THAT OVER 53,000 PEOPLE HAVE CAUGHT

THE AIDS VIRUS SINCE JUNE 1981. WE KNOW THAT ABOUT TWO-THIRDS OF
THEM HAVE BEEN HOMOSEXUALS AND BISEXUAL MALES.

AND WE KNOW THAT ANOTHER 25 PERCENT ARE DRUG ADDICTS WHO
“SHOOT” DANGEROUS DRUGS INTO THEIR BLOODSTREAMS, USING OTHER
PEOPLE’S CONTAMINATED NEEDLES.

IN OTHER WORDS, ABOUT 9 OF EVERY 10 PEOPLE WITH AIDS ARE
EITHER HOMOSEXUALS, BISEXUAL MALES, OR INTRAVENOUS DRUG ABUSERS,
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AND I°M SORRY TO SAY THAT WE‘VE ALSO LEARNED FROM THESE

WEEKLY REPORTS THAT MINORITIES IN AMERICA ARE PROPORTIONATELY
SUFFERING THE MOST FROM THIS DISEASE,

FOR EXAMPLE, IN THE GENERAL POPULATION OF THE UNITED STATES,
1 OF EVERY 8 EVERY AMERICANS IS BLACK. HOWEVER, 2 OF EVERY 8
AMERICANS WITH AIDS IS BLACK ... OR 25 PERCENT OF ALL PERSONS
WITH AIDS.
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BLACKS COMPRISE 15 PERCENT OF THE HOMOSEXUALS AND BISEXUAL

MALES WITH AIDS...

43 PERCENT OF ALL DRUG ADDICTS WITH AIDS ARE BLACK...
BLACK CHILDREN MAKE UP 54 PERCENT OF ALL CHILDREN WITH
AIDS...

BLACKS MAKE UP 70 PERCENT OF ALL THE HETEROSEXUALS WITH
AIDS. MOST OF THESE ARE WOMEN WHO ARE EITHER THE
SEXUAL PARTNERS OF MEN WITH AIDS OR THEY ARE
PROSTITUTES WHO PICKED UP THE VIRUS FROM AIDS-
INFECTED CLIENTS...
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AND NEARLY 90 PERCENT OF ALL BABIES NOW BORN WITH AIDS ARE

BLACK,

THESE ARE VERY, VERY HIGH FIGURES. THEY INDICATE THAT BLACK
AMERICANS ARE SUFFERING DISPROPORTIONATELY FROM THE EPIDEMIC OF
AIDS.

HERE IN THE BLACK COMMUNITY ... RIGHT HERE ... IS AMERICA’S
FRONT LINE IN THE BATTLE AGAINST AIDS. ALL LEVELS OF GOVERNMENT
-- FEDERAL, STATE, AND LOCAL -- ARE DOING WHAT THEY CAN,
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BUT GOVERNMENT IS NOT GOING TO SOLVE THIS PROBLEM BY ITSELF.

THE AIDS EPIDEMIC IN THE BLACK COMMUNITY CAN ONLY BE SOLVED BY
THE PEOPLE WHO LIVE IN THAT COMMUNITY.

IT CAN BE DONE THROUGH EDUCATION, WHICH SHOULD CONVINCE
PEOPLE NOT TO ENGAGE IN HIGH-RISK BEHAVIOR, SUCH AS ANAL
INTERCOURSE OR NEEDLE-SHARING,

WITHOUT A VACCINE, THE ONLY WAY TO FIGHT THE DISEASE OF AIDS

IS THROUGH PUBLIC EDUCATION ... ESPECIALLY EDUCATION OF OUR YOUNG
PEOPLE,
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THAT’S WHY I’M HERE IN CARDOZO HIGH SCHOOL THIS MORNING,

T BELIEVE THAT BLACK WOMEN AND BLACK MEN ARE CONCERNED ABOUT THE
HAVOC THAT AIDS IS BRINGING TO THEIR COMMUNITY AND WANT TO DO
SOMETHING ABOUT IT.

THEREFORE, 1 WANT TO HELP THE PEOPLE OF THIS COMMUNITY
UNDERSTAND THE THREAT THAT'S IN THEIR MIDST AND ALSO HELP THEM
BEGIN TO TAKE ACTION AGAINST IT,

AIDS IS DANGEROUS. IT IS FATAL. AND IT IS SPREADING, THE
AIDS VIRUS IS SPREADING FASTEST, HOWEVER, AMONG BLACK AMERICANS.
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BUT YOU -- EACH OF YOU INDIVIDUALLY AND ALL OF YOU ALL

TOGETHER -- HAVE THE POWER TO STOP THE DISEASE RIGHT IN ITS
TRACKS,

 

YOU CAN MAKE SURE -- THROUGH YOUR OWN BEHAVIOR -~ THAT YOU

ARE NEVER AT RISK AND THAT THE PEOPLE YOU LOVE AND RESPECT ARE
NEVER AT RISK EITHER,

THE TIME TO MAKE THAT PROMISE TO YOURSELF, TO YOUR FRIENDS
AND FAMILY, AND TO YOUR COMMUNITY -- IS RIGHT NOW,
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BUT WHAT IS REALLY INVOLVED HERE, IF YOU DO MAKE THAT

PROMISE -- AND KEEP IT? I’VE TALKED ABOUT SOME THINGS YOU SHOULD
NOT DO. BUT WHAT ARE THE THINGS YOU SHOULD DO TO AVOID CATCHING
AIDS?

THE FIRST AND BEST DEFENSE AGAINST THE VIRUS IS NOT TO HAVE
SEX AT ALL ... WITH ANYONE. AND FOR YOUNG PEOPLE STILL IN
SCHOOL, I THINK THAT’S STILL THE BEST ANSWER.

BUT IT’S NOT A GOOD ANSWER FOR MOST ADULTS. SO THE NEXT-
BEST THING TO DO IS TO FIND THAT ONE SPECIAL PERSON WHOM YOU LOVE
AND RESPECT -- AND WHO LOVES AND RESPECTS YOU IN RETURN -- AND BE
FAITHFUL TO HIM OR TO HER.
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THAT’S CALLED “MONOGAMY” AND, FOR MOST PEOPLE, IT’S THE ONLY

SAFE WAY TO LIVE IN THE “AGE OF AIDS” ... OR, FOR THAT MATTER, AT
ANY TIME.

BUT IF YOU HAVEN’T FOUND THE RIGHT PERSON YET, THEN YOU MUST
TAKE PRECAUTIONS IF YOU HAVE SEX WITH OTHER PEOPLE. REMEMBER, AS
FAR AS YOUR HEALTH IS CONCERNED, WHEN YOU HAVE SEX WITH SOMEBODY,
IT’S THE SAME AS HAVING SEX WITH EVERYONE THAT HE OR SHE HAS HAD
SEX WITH UP TO THEN,
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THEREFORE, JUST TO BE SURE, IF YOU’RE A MAN, YOU SHOULD WEAR

A CONDOM FROM START TO FINISH. IF YOU'RE A WOMAN, YOU SHOULD
MAKE SURE YOUR PARTNER WEARS A CONDOM FROM START TO FINISH,

CONDOMS ARE NOT THE PERFECT ANSWER. BUT NOTHING IN LIFE IS
PERFECT. SO FAR, HOWEVER, THE PROPER USE OF A CONDOM IS A
PERSON'S BEST DEFENSE AGAINST THE PASSING OF THE AIDS VIRUS
DURING SEXUAL INTERCOURSE.

 

AS FAR AS NEEDLE-SHARING IS CONCERNED, THE BEST DEFENSE IS,
OF COURSE, NOT TO “DO DRUGS” AT ALL. PERIOD. IF YOU ARE ON
DRUGS NOW, GET HELP AND GET OFF DRUGS,
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BUT UNTIL YOU ARE CLEAN OF DRUGS, DO NOT USE SOMEONE ELSE’S

NEEDLES OR OTHER “DRUG WORKS.”

I HOPE YOU REMEMBER AND FOLLOW THIS ADVICE. I’M OFFERING IT
TO YOU BECAUSE, AS YOUR SURGEON GENERAL, I WANT YOU TO LIVE FULL
AND LONG LIVES. I DON’T WANT TO LOSE ANY OF YOU TO THE DREAD
DISEASE OF AIDS,

THANK YOU. AND NOW, IF THERE ARE ANY QUESTIONS, I’D BE GLAD
TO ANSWER THEM,
HHE# #