This article contains explicit descriptions of some sexual practices which will, no doubt, be offensive to many readers. We, too, find it distasteful. Nevertheless, we feel that our readers have the right to know precisely what is being discussed in the AIDS education debate.

When U.S. Surgeon General, C. Everett Koop M.D., issued his Report on Acquired Immune Deficiency Syndrome (AIDS) in late October, it received immediate approval from the national media in the United States, and wide endorsement from leaders in the homosexual community.

Factual errors

Several months later, however, critics are charging that Koop’s report has made AIDS, with its homosexual connection; a “politically protected disease” and experts are taking exception to the factual errors contained in the report.

Writing in the National Review, Wayne Lutton (himself co-author of a book on AIDS, now in its second edition) sums up the reaction:

“Conservatives who have applauded Dr. Koop’s previous public stands on abortion, Baby Doe, and cigarette smoking are likely to experience a deep sense of dismay – indeed of betrayal – once they become familiar with his work on AIDS. The Report contains a number of serious factual errors and omissions. Koop’s so-called strategy for containing AIDS – a combination of sex education for children and the use of condoms – has the potential for causing incalculable harm.”

The following are among the now-disputed statements in the government-endorsed report.

“Although the AIDS virus has been found in tears and saliva, no instance of transmission from these body fluids has been reported.” (p. 25)

As early as 1984, the British medical journal The Lancet, reported a case of a man infecting his wife through transmission of saliva (He had contracted AIDS through a blood transfusion). Researchers reported that saliva was the only known risk factor in this case.

Casual contact

“You cannot get AIDS from casual social contact” (p.21). “We know that family members living with individuals who have the AIDS virus do not become infected except through sexual contact.”  (p. 13).

That claim was made after the second, within-family transmission of AIDS was reported in The Lancet in September 1986, a report which was widely reported by international wire services and was thus known in the U.S.

“Couples who maintain mutually faithful monogamous relationships are protected from AIDS through sexual transmission. If you have been faithful for at least five years and your partner has been faithful, too, neither of you is at risk …. This is true for both heterosexual and homosexual couples (p.16).

Those statements appear unduly optimistic since elsewhere in the Report we find, “It is difficult to predict the number who will develop ARC (AIDS-related complex) or AIDS because symptoms sometimes take as long as nine years to show up.”  Furthermore, as Lutton points out in the National Review, “Medical researchers agree that the AIDS virus appeared in the U.S. about 11 years ago, which is why the CDC in 1985 asked all males who had had even one homosexual encounter within the previous ten years not to donate blood. Researchers also believe that the AIDS virus may incubate 15 years, or longer, before the onset of clinical manifestations of disease. As Washington, D.C., neurologist Richard Restak cautioned, ‘The incubation period is sufficiently lengthy to cast doubt on any proclamations, no matter how seemingly authoritative, in regard to the transmissibility of the illness.’ “

Wrong strategy

Errors in fact aside, perhaps the most controversial aspect of Dr. Koop’s report is his solution to combat AIDS. His advice, to promote the use of condoms and to start sex education in grade school, is also being promoted enthusiastically in Canada.

Koop and others are assuring the public that use of a condom will prevent AIDS transmission. However, last November the Washington Times interviewed Dr. Theresa Crenshaw, president of the American Association of Sex Educators, who argues that promoting condoms as the solution to AIDS can have “fatal consequences.”

“To promote condoms as allowing completely safe sex without qualifying information can cause errors in judgment with possible fatal consequences, especially when used by AIDS patients,” she said.

In an editorial in the November issue of  Medical Aspects of Human Sexuality Dr. Crenshaw wrote that condoms have a 10 per cent failure rate in preventing pregnancy. “Since a virus is much smaller than sperm,” she continued, “the failure rate of a condom in protecting against AIDS virus transmission may be expected to be even higher.”

Lethal behaviour

A failure rate of 10 per cent in preventing pregnancy does, of course, refer to condom use during ordinary intercourse. Wayne Lutton argues that the failure rate for condoms in preventing AIDS (primarily transmitted through anal intercourse) could well be much higher. He says that, during anal intercourse, “condoms may rupture up to half the time …By advising people that sex is safe where AIDS is present – if only they use condoms – Dr. Koop may be guilty of inducing people to engage in dangerous – perhaps lethal – behaviour.”

Wrong assumptions

In the growing controversy surrounding AIDS education in the schools not only are these serious errors in the basic premise overlooked, but wrong assumptions as to the effect of such education are made, while the difficulty of explaining such explicit sexual information to impressionable young children is glossed over.

AIDS education will be integrated into existing sex education programmes, starting this fall from grade 7 in Ontario. However, sex education, with its emphasis mainly on contraceptive techniques and skills, and its weak handling of traditional moral values, has yet to be proven to be the significant factor in lowering the teen pregnancy rate.

Many studies, including a 1986 study from Planned Parenthood Ontario, have shown that lower teen pregnancy rates appear to be linked more closely with, among other factors, higher education and changes in teenage girls’ perceptions of their future career opportunities and adult roles.

In addition, teenage girls frequently acknowledge that their lack of contraceptive use is due to complicated emotional reasons and not to ignorance of methods or to unavailability.

AIDS education may well have similarly disastrous results:  more teens will feel encouraged to experiment, even with homosexual partners. The number will be further swollen if homosexual practices are taught as morally neutral, as an acceptable “lifestyle” (perhaps from fear of a backlash from the homosexual rights lobby).

More than one critic in the U.S. has already commented that it is comparable to teaching children how to administer illegal drugs with sterile equipment in order to prevent infection, rather than encouraging them to “just say no.”

Explicit information

Clearly, explicit reference in the classroom to sexual practices will appall the majority of parents. And yet AIDS education requires that the public becomes aware of anal intercourse, anilingus and fellatio, swallowing semen, urine and feces, “fisting,” and other horrors. Will schoolchildren also be taught that such practices are common, or will they merely be told to avoid “ingesting bodily fluids” (e.g. semen and saliva) as some have delicately stated it?  How many children will challenge their teacher to explain what “ingesting bodily fluids” means, only to be told that the teacher may discuss this in class but may meet them privately after?

Playing it safe?

At the same time as experts plan how to teach school children about “safe sex” the latest government reports acknowledge that explicit educational campaigns among homosexual adults, do not change significantly the levels of promiscuity and of irresponsibility in that segment of the population. If this, the highest-risk group, responds so limply to the campaign, how much less effective it will be among those accustomed to ignore teachers’ advice is not hard to imagine. They are far more likely to regard the propaganda as official encouragement, disclaimers aside, to promiscuity.

A recent Health and Welfare “Canada Disease Weekly Report” (January 24, 1987), discusses the results of a “safe sex” campaign among Montreal’s homosexual population.

The slogan, “Play Safe,” was printed on buttons, posters and T-shirts. Pamphlets on “safe sex” and condom use were distributed to nearly 30 homosexual bars, clubs and saunas, and condom-vending machines were installed in these establishments. Officials rule the campaign a success, primarily because of a high response to a follow-up questionnaire in which 75.4 per cent of the respondents stated that the campaign had influenced their sexual behaviour (they had used a condom).

As no before-and-after figures are given, the report appears in a very strange light. The optimism in the text is simply not borne out in the accompanying statistics. One is left with the impression that the whole is a cover-up, a whitewash. The reality is, then, either that matters are far worse and more advanced than any of us suspect (not likely), or that the experiment was conducted incompetently and no-one thought to get the comparison data, or – which is most likely – that the data were collected but are suppressed because they show the experiment failed and the campaign had negligible effect.

Risky behaviour

The statistical tables presented in the Report show, in fact, that the Montreal homosexuals who answered the questionnaire still indulge in highly risky and promiscuous sexual behaviour, even though a high percentage reported correct knowledge on how AIDS is transmitted and also acknowledged that the campaign had “influenced” their sexual behaviour.

Up to 10 partners

Of the 839 respondents (aged from 14 to 65, the majority being between 20 and 39 years), only 69 indicated that they had been celibate during the month following the campaign. Another 54 said that they had 10 partners during that time, 144 said 4 to 9, 511 reported 1 to 3 partners, and 36 reported one partner. Moreover, 109 homosexuals indicated that they had also had heterosexual “relations” during this time. Since the figures of numbers of partners and number of respondents don’t correspond, one wonders how many more partners the missing 25 respondents had.

The Montreal survey is the first such carried out to establish homosexual behaviour patterns in Canada. There is, therefore, no chance to compare with earlier studies of homosexual promiscuity, although Canadian levels are said to be substantially the same as in other countries.

A tentative comparison between heterosexual and homosexual patterns can be drawn by looking at the January 1987 Maclean’s Decima Poll. In this survey, nine per cent of heterosexuals claimed no sexual partners in the last year (Montreal homosexuals: 6.6 per cent in the last month). But 71 per cent of those polled claimed one sexual partner (Montreal: 4.4 per cent). A further 8 per cent said they had two to three partners (Montreal, one to three partners, 63.1 per cent): and 6 per cent of heterosexuals said that they had four or more partners (Montreal homosexuals: 17.5 per cent claimed 4 to 9 partners, 6.6 per cent claimed 10 partners).

Maclean’s says its annual poll shows a “small but significant decline in the level of sexual activity over the past three years. The trend, Maclean’s suggests, indicates fear of AIDS infection. However, the poll does not indicate whether its respondents were a mix of heterosexuals and homosexuals, although one can surmise from the accompanying article and interviews that heterosexual responses were sought. The comparisons drawn, therefore, should only be read as tentative.

There is no doubt that AIDS is a disease that affects everyone, not just the homosexual population. We are all concerned about finding the best means of disease prevention, and the best and most compassionate ways of caring for those already infected. The argument is coming down to whether or not the current solutions will be effective in the long run.

Teen aid promotes chastity

Although they have not been widely adopted as yet, there are existing sex education programmes that are proving to be very effective in helping teens to deal with their sexuality. These programmes show teens how to develop respect for their fertility and give them techniques to reinforce chastity in their dating relationships.

Teen Aid, developed in Spokane Washington, is now spreading rapidly in schools throughout Western Canada. The programme is acceptable in both public and separate schools. Another American programme, Love and Live, is being reviewed among Catholic parents in Ontario, anxious to ensure that Catholic doctrine is preserved in sex education programmes in their schools.

Both programmes present the concept of chastity as possible, livable and good. They ensure that teens understand the values inherent in sexual maturity.

Since pre-marital chastity and monogamous marriage are recognized as key elements in decreasing the number of AIDS victims, it is crucial that educators and parents become aware of good sex education programmes that could be widened to approach the AIDS problem from an appropriate ethical perspective.

To be continued.

Next month: a closer look at the Teen Aid and Love and Live programmes.