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Koop Warns of an 'Explosion' of AIDS Among Teen-Agers

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WASHINGTON--The country is facing a future "explosion'' in the number of teen-agers with acquired immune deficiency syndrome, Surgeon General C. Everett Koop and other medical experts warned a House panel last week.

Newly compiled statistics from New York City underscore the threat AIDS poses to heterosexual teen-agers, especially blacks and Hispanics, a pediatrician told the hearing of the Select Committee on Children, Youth, and Families.

"If we wait and experience what we did with the gay community, we will clearly be treating a disaster, rather than heading it off,'' said Karen Hein, an associate professor of pediatrics at Albert Einstein College of Medicine.

As part of her presentation, Dr. Hein released statistics from the New York City health department showing that young people there who have AIDS are less likely to be white or homosexual than victims nationwide.

"Although the total number of adolescent cases is small, nonetheless, the means of acquisition points to a very different pattern than is present in adults or the nation as a whole,'' Dr. Hein's testimony reads.

"This emerging pattern is particularly alarming,'' her statement continues, "because much of the publicity in the printed and electronic media has been geared to and has attracted the attention of middle- and upper-class white adults, rather than inner-city minority youths.''

She said the New York City statistics show that only 39 percent of the 79 New Yorkers between the ages of 12 and 21 with AIDS contracted the deadly disease through homosexual activity. In contrast, nearly two-thirds of all victims nationwide are homosexual or bisexual.

Twenty-three percent of the New York youths were listed as having contracted AIDS through intravenous-drug use, while 13 percent were female sexual partners of males in high-risk groups. An additional 13 percent had received tainted blood products. No source of infection was listed for the remaining cases.

Dr. Hein noted that although 13 times as many males as females have developed AIDS nationwide, the ratio for the New York City youths is just 2.8 males to every female. Heterosexual transmission accounts for only 4 percent of all AIDS cases nationwide, she said, but the number of such cases is increasing at a greater rate than for other groups.

Other trends in the city's statistics were also cause for concern, she said. Nationally, 60 percent of all AIDS victims are white. But 80 percent of New York City youths with AIDS are black or Hispanic--groups that are traditionally poorer and are less likely to receive adequate medical care.

She added that, in Central Africa, where equal numbers of men and women have fallen victim to the disease, female teen-agers between 15 and 19 have the highest rates of testing positive for exposure to the AIDS virus.

Teen-agers, said Dr. Hein, are "at high risk because of normal psychological development,'' which makes them likely to experiment with sexual activity.

Koop Stresses Abstinence

Earlier in the hearing, Dr. Koop told the committee that the best lesson AIDS education can offer is sexual abstinence, and that both families and educators should stress to their children the need to postpone sex until marriage.

"I believe that it is possible to focus on preadolescent youngsters and produce a generation of teenagers who will remain abstinent until they develop a mature, monogramous relationship,'' he said in submitted testimony. "I recommend that parents establish the biological and moral basis for sexual activity early, so that when their children become teenagers they will make decisions about their sexual behavior that can eliminate the risk of getting AIDS.''

Unfortunately, he said, the push for monogamy is not popular with teenagers.

"I was talking to a group of teenagers recently about this problem of being monogamous and I said, 'I mean long-term monogamous,' '' the Surgeon General told the select committee. "And this girl said, 'How long? A semester?' ''

In particular, Dr. Koop said, it is a challenge for the health community to reach poor, inner-city youths. Under questioning by the the representatives he admitted that "we're nowhere with that population.''

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