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Approximately 107 million English-language versions of a brochure, "Understanding AIDS," will be distributed to every home and residential post office box by the U.S. Postal Service between May 26 and June 30, 1988. A Spanish-language version will be distributed in Puerto Rico and will also be available upon request after May 26, 1988. This national mailing marks the first time the federal government has attempted to contact virtually every resident, directly by mail, regarding a major public health problem. The brochure is reproduced in its entirety beginning on page 262.

The brochure was prepared by CDC in consultation with the Surgeon General and a wide spectrum of public health officials, medical experts, advertising consultants, and members of the general public. Every effort was made to make the presentation simple, direct, and understandable to the widest possible audience. The purpose of the mailer is to provide understandable information and to encourage safe behaviors that can prevent HIV infection. The mailing has three objectives:

• To make it clear how AIDS is and is not transmitted. People can protect themselves without having unnecessary fears.

• To make it clear that behaviors, not identification with "risk groups," put people at risk. As the brochure states, "who you are has nothing to do with whether you are in danger of being infected with the AIDS virus. What matters is what you do."

• To stimulate informed discussions about AIDS within families, between sexual partners, and at all levels of society by presenting the facts and showing people how AIDS relates to their own lives.

CDC has established a major effort to ensure that as many people as possible read and discuss this mailing. Major steps, including contacts with state health departments and manufacturers of AIDS testing kits, have been taken to handle the increased requests for information and testing that this brochure may generate. CDC will add up to 1,000 operators to the National AIDS Information Line (hotline) (1-800-342-AIDS) to handle the 1.5 million new calls anticipated during the mailing period. At present, the hotline is handling 120,000 calls per month as a result of the "America Responds to AIDS" public information campaign.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES/PUBLIC HEALTH SERVICE

U.S. DEPOSITORY MAY 19 1980

AIDS Continued

Hotline callers wishing to talk with a counselor or requesting information about local counseling and testing will be referred to local hotline numbers or, if none exist, will be served by counselors who staff the National AIDS Information Line. More than 300 Spanish-speaking operators will be available to answer a toll-free hotline (1-800-344-SIDA) to take orders for Spanish-language copies of the brochure. Requests for copies of the brochure in English or Spanish will be filled by the CDC National AIDS Clearinghouse.

To measure the impact of this brochure, CDC will use data gathered through the AIDS Knowledge and Attitudes supplement of the National Health Interview Survey (NHIS). This survey is conducted through interviews with a probability sample of American households by the Bureau of the Census for the National Center for Health Statistics. CDC will also monitor other indicators that may reflect public response to the brochure, such as calls to the national hotline and AIDS clearinghouse, requests for information to health-care providers, and media presentations of AIDS information.

In spite of all these efforts, there are things the brochure will not do. It will not reach people who cannot read or who read only languages other than English or Spanish. It may not reach the homeless or drug abusers, who need intensive outreach efforts. CDC is working with state and local health departments to target ongoing educational efforts for the hard-to-reach. One million advance copies of the brochure are being sent to doctors, nurses, dentists, pharmacists, hospitals, and public health officials so that they can be prepared to answer questions from their patients and clients.

T

Understanding
AIDS

A Message From The Surgeon General

his brochure has been sent to you by the Government of the

United States. In preparing it, we have consulted with the top
health experts in the country.

I feel it is important that you have the best information now

available for fighting the AIDS virus, a health problem that the
President has called "Public Enemy Number One."

Stopping AIDS is up to you, your family and your

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loved ones.

Some of the issues involved in this brochure may not be

things you are used to discussing openly. I can easily understand that. But now you must
discuss them. We all must know about AIDS. Read this brochure and talk about it with
those you love. Get involved. Many schools, churches, synagogues,

and community groups offer AIDS education activities.

I encourage you to practice responsible

behavior based on understanding and strong personal
values. This is what you can do to stop AIDS.

Chery

C. Everett Koop, M.D., Sc.D.

Surgeon General

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IDS is one of the most serious health

public. It is important that we all, regardless of who we are, understand this disease.

AIDS stands for acquired immunodeficiency syndrome. It is a disease caused by the Human Immunodeficiency Virus, HIV-the AIDS virus.

The AIDS virus may live in the human body for years before actual symptoms appear. It primarily affects you by making you unable to fight other diseases. These other diseases can kill you.

Many people feel that only certain "high risk groups" of people are infected by the AIDS

virus. This is untrue. Who you are has nothing to do with whether you are in danger of being infected with the AIDS virus. What matters is what you do. People are worried about getting AIDS. Some should be worried and need to take some serious precautions. But many are not in danger of contracting AIDS.

The purpose of this brochure is to tell you how you can, and just as important, how you can't become infected with the AIDS virus.

Your children need to know about AIDS. Discuss it with them as you would any health

concern.

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Yes, if you engage in risky behavior.

The male homosexual population was the first in this country to feel the effects of the disease. But in spite of what you may have heard, the number of heterosexual cases is growing.

People who have died of AIDS in the U.S. have been male and female, rich and poor, white, Black, Hispanic, Asian and American Indian.

How Do You

Get AIDS From Sex?

The AIDS virus can be spread by sexual intercourse whether you are male or female, heterosex

ual, bisexual or homosexual.

"Obviously women can get AIDS. I'm here to witness to that. AIDS is not a 'we,' 'they' disease, it's an 'us' disease."

- Carole has AIDS

This happens because a person infected with the AIDS virus may have the virus in semen or vaginal fluids. The virus can enter the body through the vagina, penis, rectum or mouth. Anal intercourse, with or without a condom, is risky. The rectum is easily injured during anal intercourse.

Remember, AIDS is sexually transmitted, and the AIDS virus is not the only infection that is passed through intimate sexual contact.

Other sexually transmitted diseases, such as gonorrhea, syphilis, herpes and chlamydia, can also be contracted through oral, anal and vaginal intercourse. If you are infected with one of these diseases and engage in risky behavior (see page 3), you are at greater risk of getting AIDS.

AMERICA RESPONDS TO AIDS

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You won't get the AIDS virus through everyday contact with the people around you in school, in the workplace, at parties, child care centers, or stores. You won't get it by swimming in a pool, even if someone in the pool is infected with the AIDS virus. Students attending school with someone infected with the AIDS virus are not in danger from casual contact.

You won't get AIDS from a mosquito bite. The AIDS virus is not transmitted through a mosquito's salivary glands like other diseases such as malaria or yellow fever. You won't get it from bed bugs, lice, flies or other insects, either.

You won't get AIDS from saliva, sweat, tears, urine or a bowel movement.

You won't get AIDS from a kiss.

You won't get AIDS from clothes, a telephone, or from a toilet seat. It can't be passed by using a glass or eating utensils that someone else has used. You won't get the virus by being on a bus, train or crowded elevator with a person who is infected with the virus, or who has AIDS.

The Difference Between Giving And Receiving Blood

1. Giving blood. You are not now, nor have you ever been in danger of getting AIDS from giving blood at a blood bank. The needles that are used for blood donations are brand-new. Once they are used, they are destroyed. There is no way you can come into contact with the AIDS virus by donating blood.

2. Receiving blood. The risk of getting AIDS from a blood transfusion has been greatly reduced. In the interest of making the blood supply as safe as possible, donors are screened for risk factors and donated blood is tested for the AIDS antibody. Call your local blood bank if you have questions.

What Behavior Puts You At Risk?

You are at risk of being infected with the AIDS virus if you have sex with someone who is infected, or if you share drug needles and syringes with someone who is infected.

Since you can't be sure who is infected, your chances of coming into contact with the virus increase with the number of sex partners you have. Any exchange of infected blood, semen or vaginal fluids can spread the virus and place you at great risk.

The following behaviors are risky when performed with an infected person. You can't tell by looking if a person is infected.

RISKY BEHAVIOR

Sharing drug needles and syringes. Anal sex, with or without a condom.

Vaginal or oral sex with someone who shoots drugs or engages in anal sex. Sex with someone you don't know well (a pickup or prostitute) or with someone you know has several sex partners. Unprotected sex (without a condom) with an infected person.

SAFE BEHAVIOR

Not having sex.

Sex with one mutually faithful, uninfected partner. Not shooting drugs.

AMERICA RESPONDS TO AIDS

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D

ating and getting to know other people is a normal part of life. Dating doesn't mean the same thing as having sex. Sexual intercourse as a part of dating can be risky. One of the risks is AIDS.

How can you tell if someone you're dating or would like to date has been exposed to the AIDS virus? The bad news is, you can't. But the good news is, as long as sexual activity and sharing drug needles are avoided, it doesn't matter.

You are going to have to be careful about the person you become sexually involved with, making your own decision based on your own best judgment. That can be difficult.

Has this person had any sexually transmitted diseases? How many people have they been to bed with? Have they experimented with drugs? All these are

sensitive, but important, questions. But you have a personal responsibility to ask.

Think of it this way. If you know someone well enough to have sex, then you should be able to talk about AIDS. If someone is unwilling to talk, you shouldn't have sex.

"Talk to your teenagers about AIDS. It is
primarily a sexually transmitted disease.
So if you're going to talk about AIDS,
there's no way you can avoid talking
about sex.

-Sally Jue
AIDS Counselor

Do Married
People Get
AIDS?

Married people who are uninfected, faithful and don't shoot drugs are not at risk. But if they engage in risky behavior (see page 3), they can become infected with the AIDS virus and infect their partners. If you feel your spouse may be putting you at risk, talk to him or her. It's your life.

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What Is All The Talk About Condoms?

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Now, they're discussed on the evening news and on the front page of your newspaper, and displayed out in the open in your local drugstore, grocery, and convenience store.

For those who are sexually active and not limiting their sexual activity to one partner, condoms have been shown to help prevent the spread of sexually transmitted diseases. That is why the use of condoms is recommended to help reduce the spread of AIDS.

Condoms are the best preventive measure against AIDS besides not having sex and practicing safe behavior (see page 3).

But condoms are far from being foolproof. You have to use them properly. And you have to use them every time you have sex, from start to finish. If you use a condom, you should remember these guidelines:

(1) Use condoms made of latex rubber. Latex serves as a barrier to the virus. "Lambskin"

or "natural membrane" condoms are not as good because of the pores in the material. Look for the word "latex" on the package.

(2) A condom with a spermicide may provide additional protection. Spermicides have been shown in laboratory tests to kill the virus. Use the spermicide in the tip and outside the condom.

(3) Condom use is safer with a lubricant. Check the list of ingredients on the back of the lubricant package to make sure the lubricant is water-based. Do not use petroleum-based jelly, cold cream, baby oil or cooking shortening. These can weaken the condom and cause it to break.

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AMERICA RESPONDS TO AIDS

"Condoms can be most effective when they are used correctly, and there is a right way and a wrong way to use one. Always use a latex condom."

Drew Sisselman
AIDS Volunteer

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