Dr. Elders’ Silence Equals More Death : Rationalization--deadly on AIDS--now comes to teen sex.

As the world becomes more peaceful, America becomes more dangerous. The new HBO movie “And the Band Played On” reminds us that virtually every sector of society fiddled while AIDS blazed out of control, from a Legionnaire’s Disease-type viral outbreak in 1981 into the killer of 194,000 Americans.

As Randy Shilts, author of the 1987 book on which the movie is based, wrote: “The federal government viewed AIDS as a budget problem, local public health officials saw it as a political problem, gay leaders considered AIDS a public-relations problem and the news media regarded it as a homosexual problem that wouldn’t interest anybody else. Consequently, few confronted AIDS for what it was: a profoundly threatening medical crisis.”

Today, AIDS drenches American culture, leaving its indelible, melancholy stain and changing behavior patterns forever. Tragically, the increasing realism of gays about AIDS is being matched by continuing obfuscation from the public-health Establishment on another, potentially greater threat to the commonweal: teen promiscuity and pregnancy.

Larry Kramer, the writer and activist, and Joycelyn Elders, the new surgeon general, are leaders in the fight against, respectively, AIDS and teen-age pregnancy. That’s where the similarity ends, because Kramer and Elders have adopted very different strategies. Kramer has witnessed the HIV holocaust and offers a message of remorse and reform. Elders, charged with saving a generation of inner-city kids, seems to think that for them, the band can indeed keep playing on.

Kramer shrewdly chose Playboy to deliver his epitaph to the hedonism the magazine celebrates. In an interview in the September issue, Kramer said: “I don’t know if sex will ever again be as it was in the ‘60s and ‘70s--even if AIDS is cured.”

Hugh Hefner seemed like a radical three decades ago when he launched his editorial crusade for “The Playboy Philosophy” of sexual liberation. Soon, American culture surpassed him. Everyone from the Village People to Madonna pushed the edge of the social, and then the epidemiological, envelope. Kramer is no prude. But like the Ancient Mariner, he has a story to tell: “The body should be able to do what it wants and enjoy what it wants to enjoy. But it would appear that Mother Nature doesn’t allow that.”

A few years ago, Jeremiah Denton (R-Ala.) was laughed out of the Senate for promoting “chastity centers.” And a conservative who invoked “Mother Nature” as a reason not to do something would be vilified. But Kramer has credibility; he is a radical who has been radicalized further, coming full circle to monogamy and abstinence.

Joycelyn Elders is just a radical. As the first black woman surgeon general, she would be uniquely qualified to preach a Malcolm X-like message of respect and restraint. Elders and her liberal allies say this is foolish, because there’s no stopping the adolescent sex drive. So instead, she says things like, “We’ve taught our children in driver’s education what to do in the front seat, and now we’ve got to teach them what to do in the back seat.” That’s the sort of flimsy rationalization that gays used to justify the promiscuous, lethal bathhouse culture.

The bottom line for Elders and the multibillion-dollar sexual-industrial complex is this: They don’t want to do anything that would undermine the sexual revolution. There’s just one problem. Thousands of children are dying, and millions more are being born into lives of dependency and hopelessness. Pointers and precautions mean little to teen-agers; only a change in values will keep the next generation from getting sick and/or pregnant.

On other issues, the left knows better. Guns are also part of the inner-city scene. Yet nobody except maybe the NRA says that we must be realistic and accept “the gun lifestyle.” We don’t shrug our shoulders and say that since gunplay is inevitable, let’s just issue everyone a safety manual and a bulletproof vest. But condoms are to sex what body armor is to guns: a placebo that doesn’t protect over the long run. Girls, especially poor black girls, are victims of many things, but we do them no favor by accommodating destructive, even suicidal, behavior.

When lives are stake, public figures must take an honest stand, even if means bucking permissive trends. It’s called leadership. It’s also called saving lives. Kramer’s words ring true beyond the realm of AIDS. In the face of social calamity, silence always equals death.