AIDS: Getting It Wrong

Los Angeles County supervisors have made a serious mistake in rejecting their AIDS Commission recommendation for an aggressive educational program to the intravenous-drug community. Their action is the more regrettable because it took place against the background of cheers from some in the black community who clearly do not comprehend the immensity of the threat, particularly to minority communities.

Four of the five supervisors saw the proposed distribution of condoms and of bleach, for cleaning needles, as measures that would appear to sanction drug addiction. That conclusion ignores the experience in other AIDS-affected areas where this very program, in some cases amplified by the distribution of clean needles, has helped effect behavior changes and has not by any measure served to encourage drug use.

“We’ll know before this is over who’s standing for family values and who’s standing with the perverts, that’s for sure,” the board was told by Ezola Foster, chairwoman of the Black Americans for Family Values. That misses the point. The proposed program was directed at those who already have abandoned the values that she cherishes and who, by their behavior, threaten the entire community. The greatest threat of the spread of AIDS to the community at large is from sexual contact with those involved in intravenous drug use. It is to break that spread into the heterosexual community that the stark education program, including the distribution of condoms and bleach, was recommended. It has worked elsewhere. Nothing else has shown the same results. The problem does not respond to sweet talk and appeals.

The disdain of the supervisors for this sort of education had earlier been reflected in the board’s hostility to explicit language in AIDS materials directed at high-risk groups. There again the effectiveness of explicit materials, and the ineffectiveness of traditional forms of communication, has been demonstrated beyond a doubt, according to public-health officials.

The supervisors will benefit from reading a new policy statement on explicitness in AIDS prevention material adopted Wednesday by the state AIDS Leadership Committee. It recommended that the use of “whatever language, illustrations or demonstrations, which their local experts feel necessary, be used to effect behavior change.” The committee acknowledged that some of the materials will prove “offensive to some individuals,” but it concluded that “such offense is both unavoidable and is an acceptable social price to pay for the intended societal benefits.”

Resistance to the county drug proposal from some black leaders was the more regrettable because the black community in the nation has suffered the most, with blacks accounting for 67% of the cases transmitted by heterosexual activity and 61% of the infected children--largely cases involving intravenous drug use.