Subject: Need to Alert Youth to AIDS Danger Is Dilemma For Administration Date: Published: 11/21/86 130 lines Source: Wall Street Journal. Copyright Dow Jones & Co. Inc. Need to Alert Youth to AIDS Danger Is Dilemma For Administration Cautious on Sex Education --- By Joe Davidson Staff Reporter of The Wall Street Journal WASHINGTON -- The growing urgency of the sensitive health problem of acquired immune deficiency syndrome in the U. S. is raising an equally touchy political dilemma for the Reagan administration. The administration is under pressure from a recent report by its own Surgeon General, Dr. C. Everett Koop, to begin a widespread program of explicit sexual education for elementary school students about how AIDS is transmitted. "We can no longer afford to sidestep frank, open discussions about sexual practices -- homosexual and heterosexual," Dr. Koop declares. But promoting explicit explanations about sex -- especially in relation to gay men, who have the highest risk of getting AIDS -- would anger the Reagan constituency of conservatives and the Christian Right, many of whom already oppose sex-education programs in schools. Larry Pratt, president of the Committee to Protect the Family, wants President Reagan to repudiate Dr. Koop's proposal. If the president endorses the proposal, Mr. Pratt says, it "would be held against him." Nevertheless, federal officials concede that there is strong pressure to ease a current policy against backing explicit sex-education programs on AIDS. Wednesday, the American Academy of Family Physicians said it strongly supports comprehensive sex education in elementary schools. The key to what is acceptable is the standard of the local community, says Dr. Gary Noble, the coordinator of AIDS programs at the Department of Health and Human Services. "What may be inappropriate today," Dr. Noble says, "may be appropriate tomorrow." Groups formed to educate gay men about the disease complain that current federal guidelines are so restrictive that they thwart effective education among those who need it most. The federal Centers for Disease Control in Atlanta has funded "risk reduction" projects by eight groups formed to educate gay men about AIDS, but the use of explicit material is prohibited. The Centers' guidelines say: "Audio-visual materials and pictorials ... should communicate risk reduction messages by inference rather than through any display of the anogenital area of the body or overt depiction of the performance of 'safer sex' or 'unsafe sex' practices." "We're dealing with an issue where explicit discussion about sexual practice is very necessary," complains Lee Kochems, executive director of the Gay Men's Health Crisis in New York, one of the groups that received funding. The Centers rejected requests for explicit projects by both the New York group and an Atlanta group called AID Atlanta. The Atlanta group holds "safe-sex parties," which are explicit without involving actual sexual activity, according to the Rev. Kenneth South, AID Atlanta's executive director. The New York group produced a videotape showing explicit homosexual activity. However, "times have changed," says Dr. Ward Cates, director of the Centers' division of sexually transmitted diseases. "We don't want to be pornographic or erotic in federally funded material," he says, but "some of those activities may now be in an arena that would be allowable for federal funding." He says the report by Dr. Koop and a similar one recently by the Institute of Medicine, a private, federally chartered organization based here, "represent dramatic steps forward" in developing policy recommendations. The Koop report says explicit education on the dangers of AIDS is needed because of the disease's huge potential danger. It will have a "devastating" impact on all segments of society, not just homosexuals, the report says. By the end of 1991, 270,000 cases of the disease will have occurred in the U. S. and 179,000 people in this country will have died from the ailment, according to the report. The Institute of Medicine report also calls for "a massive, coordinated educational program" against AIDS and warns that it "will not be cheap." It calls the current government effort "woefully inadequate." Although federal funding is rising annually, it isn't increasing rapidly enough to meet the Institute's goal of a $2 billion anti-AIDS program by 1990, involving education, public health and research efforts and financed primarily, though not entirely, by the federal government. Rep. Henry Waxman, the chairman of the House Health and Environment Subcommittee, says the two reports may encourage "the budget and political people" within the Reagan administration to heed the urgings of its health officers and devote greater attention to the AIDS crisis. "The administration has been slow to act," says the California Democrat, "even though their public health people have been pleading for more public funds and urgency." For now, the administration, in a reversal, is supporting increased spending for current AIDS programs. After unsuccessful efforts earlier this year to rescind some AIDS funding, the White House Office of Management and Budget is expected to recommend full funding for HHS's $471 million program to combat AIDS in fiscal 1988, which begins next Oct. 1. The attempt to cut back funding this year as part of across-the-board budget cutting was "in retrospect, probably not a good idea," says one Reagan budget official. AIDS funding, because of HHS and congressional efforts, has increased rapidly to almost $411 million a year for fiscal 1987 from $5.5 million in fiscal 1982. Critics of the administration efforts applaud the increased funding to fight AIDS. "It's a national problem and it requires a national response," says Mr. Kochems of the Gay Mens' Health Crisis. But he says more candid education is still needed. The administration policy on AIDS education is still in flux, as demonstrated by the arms-length response to Dr. Koop's report by his boss, Dr. Robert Wyndom, assistant secretary for health. Dr. Wyndom says the Public Health Service, which he also heads, is working on its own "very aggressive" educational package and Dr. Koop's suggestions will be considered in that. But Dr. Wyndom declines to adopt Dr. Koop's report as the agency's position. "We certainly accept it," he says. "I don't know if you'd call it endorsement." (This article is made available here by Dow Jones Co. for the personal and non-commercial use of callers to this bbs, in the hope that it will be of some help to those who are suffering from the disease and others who are seeking to help them.)