Federal Guidelines For AIDS Courses Stress Abstinence
The Reagan Administration last week released a long-awaited national plan for AIDS education that emphasizes teaching students to avoid the disease by postponing sex until marriage.
Those who do not abstain from sex, the plan adds in a separate section, should know that using condoms "can reduce the risk of transmission of the AIDS virus.''
The Administration's blueprint for educating the public on acquired immune deficiency syndrome also promises the development of curricular guidelines for AIDS instruction in the schools, new programs for black and Hispanic youths, and a computerized bibliography of materials on the deadly disease. Those and other elements of the plan would be used as local communities saw fit.
The unexpected release of the document on March 16 followed six months of preparation by federal agencies. That process was marked by considerable debate over the extent to which the plan should stress the role of traditional moral values in halting the spread of the disease.
Secretary of Health and Human Services Otis R. Bowen made the plan public just hours after members of the Congress, speaking at a hearing, chided federal health officials for not moving faster to develop an AIDS-education strategy.
Critics of the federal government's role so far in addressing the AIDS epidemic were quick to describe the strategy as "too little, too late.'' Among those expressing that view was Leon Eisenberg, who served on the National Academy of Sciences panel that last year called for a "massive'' $1-billion education effort on the disease.
"What is disappointing about the plan is its diffidence,'' said Dr. Eisenberg, a faculty member at the Harvard Medical School.
"If you don't come out and say sex education has to be part of every public-school program, that's a disappointment,'' he said.
And Congressional sources contended that the plan added "nothing really new'' to the campaign against AIDS.
Four Groups Targeted
The 59-page document outlines a strategy that targets four groups: school- and college-age students; the general public; those deemed most at risk for contracting the disease, such as intravenous-drug users, homosexuals, and their sexual partners; and health workers.
The report emphasizes the importance of sexual abstinence and monogamy in the prevention of AIDS, and strongly urges educators to communicate that view to children.
In language that echoes a White House memorandum on the subject made public last month, the document says several times that any AIDS materials provided to schools by the federal government should tell children to avoid sex, and that parental consent should be required for children to receive AIDS instruction. (See Education Week, March 4, 1987.)
Those provisions were added partly at the insistence of Education Department officials, according to sources in the Congress and the department.
In contrast, the plan downplays references to so-called "safe sex'' techniques, such as the use of condoms. Such references appear only once, in a section separate from the one dealing with school-based programs.
"Be aware that condoms sometimes fail,'' the document warns. "The failure rate may be 10 percent when used as a contraceptive.''
The tug of war between officials favoring an emphasis on "safe sex'' and those determined to stress traditional family values was at the heart of the delay in completing the plan, according to those involved in the process.
They noted that one group, including Secretary of Education William J. Bennett and Attorney General Edwin Meese 3rd, wanted to put the AIDS message primarily in a moral context. Another group, represented by Surgeon General C. Everett Koop, while not disputing the value of sexual fidelity and abstinence, wanted the plan to include more information on sexual precautions for those most at risk of contracting the disease.
A number of experts on AIDS outside the Administration have argued that it is unrealistic to expect young people to practice sexual abstinence.
"You have to say sex using condoms and appropriate spermicidal jellies will help prevent AIDS,'' Dr. Eisenberg said.
Such information, he maintained, should be "brought forcefully to the attention of the public in explicit language.''
Elements of Blueprint
Specific proposals recommended in the Administration's blueprint include:
- A national media campaign on the disease.
- A set of suggested curricular guidelines, now being drawn up by the Centers for Disease Control in Atlanta. Officials of the C.D.C. said last week that they did not know when the guidelines would be ready.
- The convening of a national conference on AIDS education in the schools, scheduled to take place in August.
- Establishment of an annotated, computerized bibliography of relevant educational materials, programs, research, and other resources.
- A national survey to find out what high-school students already know about the disease.
- Assistance for communities in setting up programs concentrating on black and Hispanic youths.
"Material for those groups needs to be culturally sensitive, and they are disproportionately represented in the numbers of AIDS cases,'' said Ellen Casselberry, a spokesman for the Public Health Service. Eight out of 10 children with the disease are black or Hispanic, federal officials have reported.
The federal role in such efforts, Secretary Bowen said, is primarily to provide accurate information about the disease. Decisions about how and when to teach children about AIDS should be made in local communities, he stressed.
National organizations, state education and health departments, and private groups would also be enlisted in the efforts, the plan states.
Nearly 32,000 Americans have developed AIDS since 1981; almost 18,000 have died from it.
Because those numbers are increasing exponentially and no known cure exists, Dr. Bowen wrote in an introduction to the plan, "our best hope today for controlling the AIDS epidemic lies in educating the public about the seriousness of the threat, the ways the AIDS virus is transmitted, and the practical steps each person can take to avoid acquiring or spreading it.''
'Really Nothing New'
The plan's release did little to silence those on Capitol Hill who have accused federal agencies of dragging their feet on AIDS education.
"There's really nothing new in it,'' said Linda Valleroy, an aide to Representative Ted Weiss, Democrat of New York, who chaired last week's hearing on the plan.
She said a completed draft of the document circulated among federal officials for months as departments disagreed and called for revisions.
At the hearing, Mr. Weiss said he had "a suspicion'' that the federal government had not yet spent all the money the Congress authorized for AIDS education in 1986. This year, $79.5 million has been set aside for that purpose, and President Reagan has proposed increasing that allocation to $104 million in fiscal 1988.
In contrast to U.S. efforts, Ms. Valleroy said, some countries with lower incidences of the disease, such as Denmark, Great Britain, Sweden, and Switzerland, have already launched major public-education campaigns to combat the disease.
Dr. Eisenberg added that the Administration was "coming out with something that would have been ahead of its time five years ago.''
Now, he said, the plan was "too little, too late.''
Free copies of the "Information/Education Plan To Prevent and Control AIDS in the United States'' are available by writing the Office of Public Inquiries, Centers for Disease Control, Building 1, Room B63, 1600 Clifton Road, N.E., Atlanta, Ga. 30333.