increased awareness about STD's and HIV. But, generally, I would say there is still a common belief that this is something that "won't happen to me," but I think this is part of growing up.

We all think "that will not happen to me," whether it is AIDS or being killed in a drunk-driving accident or whatever, "it won't happen to me," and that is certainly what I believed.

Senator KOHL. In my opening statement, I talked about the mistakes that people made when I was young, the mistakes were never fatal as they can be now with respect to AIDS, drugs and drinking and driving while you are drunk and all of those things. The point was when you are 14 or 16 or 17, you are not in a position to make those kinds of responsible decisions, because you do not see life as being mortal, and I think you touched on that. So, what do you do about trying to help young people who are 13 and 15 and, in many cases, just simply unable, understandably unable to make those kinds of life and death decisions with respect to their actions? What does society do about responding to that human thing which is not changeable? You cannot expect a 13- or a 14-year-old to make those kinds of responsible decisions. What would you suggest?

Mr. KAMENS. True, you cannot, but I think we can begin to talk about self-esteem and self-respect and where that comes from. I believe that self-respect and self-esteem come from acting on decisions and experience. Young people making a decision, acting on it and seeing the results. Seeing that it was a responsible decision, the results were worthwhile, they can walk away from it feeling good about what they decided and who they are. I do not think it is an overnight process. It is part of growing up.

Senator KOHL. I was getting at something a little different. If a society like ours presents those options to young people as we are today, to some extent is it not almost inevitable that we are going to have the kinds of unhappy results that we do have?

Mr. KAMENS. I think to some extent we are going to see STD's and pregnancy and drunk-driving accidents. I cannot see that, you know, in the future, but I have found that through just greater awareness and talking about the issues, becoming comfortable with them, and addressing these things that we are not addressing is a start. I do not have the answers for that, but I do get letters after I speak with kids who say, "Thank you, David. You know, you opened my eyes to my behavior, I'm going to go out and do some of the work that you're doing. Thank you," and this is what makes it worthwhile for me. I think they feel the results. They can relate to what I am saying and where I was and where I am coming from and hopefully they will go out and continue some of the same work.

Senator KOHL. Thank you, Mr. Chairman.

Chairman GLENN. Thank you very much. David, yours is a very powerful message. I hardly know what to ask you. What reaction do you get from the community? You said you sometimes encounter resistance in the community.

Mr. KAMENS. Like I said, just 4 weeks ago I stood up in front of 150 parents in Arlington County and they were angry. They were one of the most misinformed groups I had ever spoken to. One

sible decision-making skills and you're not just saying no." I said, well, that is not realistic, that is not realistic for me to say that. I said I am sexually active, I have done drugs, I have done all these things that are forbidden and are not going to talk about.

So, I understand where they are coming from, but I would say that from my peers, I get wonderful support and am met with wonderful compassion. I mean compassion and education is what we have, along with funds and scientific research. What I can do is educate and I can use the compassion that is there to help myself and help other people understand what this is about.

On a whole, yes, I have met some opposition, but I think it is derived from ignorance and misunderstanding. I have not met that much anger, it was only just a little while ago when I met with the parents.

Chairman GLENN. I think it would be nice if we lived in such a perfect society where you could say no and that was it and the problem solved itself. But the statistics I read into the record out of the GAO report were to me just sort of mind-boggling. I am not easily shocked any more, I will tell you that, but this thing was a real shock. I think the reason this hits me particularly this morning is that you are from Yorktown. We lived over there back in my days in the space program and my son was in the very first class that ever went to the new building at Yorktown.

Mr. KAMENS. I know that, sir.

Chairman GLENN. So, I am sitting here obviously this morning thinking what if.

Mr. KAMENS. When I was working with these parents before I spoke, they showed an educational video and this was through the Department of Health, and it was full of stats. It was about 4 years old. It had four profiles of people living with HIV and they all said, "Don't do drugs, don't have sex, this is going to happen to you, I'm going to die, it's a death sentence." It was very negative and that is what the parents wanted. They really wanted to show their kids this video.

One of the first things I said is, I am put off by this video, this is not what kids want to hear, this is what they turn off, this is what I now turn off and have turned off. I think we need to give information that is very sensitive to young people today and specific to different populations. I do not mean categorizing it, you know: the gay youth and the Latino community and the Asian community, but I do think we need to be sensitive, I really do. Like I said, we need to talk about sexuality and not give sex negative messages. I think this is really important. We are giving sex negative messages and I know kids who see these sex negative messages go, "Oh, that's bad, well, I have to try it," you know.

Chairman GLENN. You have spoken on college campuses. Do you get a different response on college campuses than working with your high school peers?

Mr. KAMENS. The younger the students are and the younger the people I work with, the more frank they are, the more interested they are. They have not been as inundated with information or see the headlines and they are more willing to listen. By the time they get to college, they do not turn me off and they are very active in participating in the dialogue, but I think they feel like they know

it all and this will not happen to them. They are already 25 and 26 years old sometimes and believe if they have made it to that point, it cannot happen, it will not happen.

Chairman GLENN. Thank you. We are going to have to move along. Your testimony has been fascinating. I wish you well.

The next witness is Ms. Wanda Wigfall-Williams, Center for Population Options, Washington, DC., and she will have a couple of other people she will also introduce for us.

Ms. Wigfall-Williams?

TESTIMONY OF WANDA WIGFALL-WILLIAMS, DIRECTOR, NATIONAL INITIATIVE ON AIDS AND HIV PREVENTION AMONG ADOLESCENTS, CENTER FOR POPULATION OPTIONS, WASHINGTON, DC,1 ACCOMPANIED BY BRIAN BESS, PEER EDUCATOR, WASHINGTON, DC, AND RAHIM JONES, PEER EDUCATOR, WASHINGTON, DC

MS. WIGFALL-WILLIAMS. Thank you, Mr. Chairman.

I am Wanda Wigfall-Williams, Director of the National Initiative on AIDS and HIV Prevention Among Adolescents for the Center for Population Options. This national initiative is funded, in part, by the CDC.

The AIDS and drug epidemics are gaining ground. Approximately 20 percent of reported AIDS cases are of people in their twenties. The long incubation period-up to 10 years—for the virus indicates that many of these people were probably infected with HIV during their teen years.

Although adolescents make up less than 1 percent of the total number of reported AIDS cases, the Centers for Disease Control reported a dramatic 42 percent increase in the number of adolescents diagnosed with AIDS between July 1988 and August 1989. Tragically, these statistics refer only to young people who have developed AIDS, not the unknown numbers of teens who are seropositive and asymptomatic.

Risk-taking behaviors, such as experimenting with drugs and engaging in unprotected intercourse, can result in deadly consequences. The need for HIV prevention and AIDS education is great. In our Nation's Capital, 1 in 300 adolescents tested positive for HIV-this was at Children's Hospital in 1988.

Chairman GLENN. What was that? Give that again, please.

Ms. WIGFALL-WILLIAMS. One in 300 adolescents tested positive for HIV. Yet, focus groups with area teenagers conducted by the Center for Population Options found that, while teenagers are aware of HIV and AIDS, many do not perceive themselves at risk of being infected.

It is difficult to protect the extent to which adolescents engage in activities that place them at risk for infection with HIV, as well as other sexually transmitted diseases. However, teen pregnancy rates can serve as one measure of sexual activity-one of the highest risk behaviors. Approximately 1 million teenage women become pregnant each year.

Parents, teachers, religious leaders, policy makers, health educators and youth have a responsibility to address this epidemic. CPO has developed a comprehensive program focusing on reproductive health, health promotion and "life planning" for adolescents.

In order to reach young people with motivating messages, practical information and accessible services, CPO approaches young people from a diversity of concerns and perspectives with realitybased, simple messages. We work through national, State and community based organizations to reach the largest numbers of youth, particularly those at greatest risk; we encourage multi-dimensional programs which provide formal and informal information and comprehensive health services; we create new programs, if needed, and evaluate existing ones to ensure that effective models are available to youth-serving professionals; and we assist opinion makers to reinforce messages and policy makers to support programs which prevent infection with HIV.

Peer education is one powerful approach to education for adolescents. Numerous studies have demonstrated that teens are more likely to ask their friends than an adult for information on a variety of topics, including health and sexuality. Often, peers are not only the main source of information for each other, they are the most influential in their ability to shape others' behavior. The peer group is a primary reference for values and behaviors.

In a focus group study conducted by CPO, inner-city adolescents said they would most likely listen to and believe what a person their age infected with HIV said about AIDS, rather than what an older person or a famous person said about AIDS or the virus. Further, an unpublished survey on condom use among adolescents found that teens' perceptions of other teens' condom use behaviors was the best indicator for determining their own condom use. In other words, if they thought that their peers thought using a condom was cool, they too would probably consider using a condom. Recognizing the power that teens have over one another, and that this power can be used to influence teens' behavior in a positive way, CPO developed Teens for AIDS Prevention, otherwise known as TAP, to educate adolescents about AIDS and HIV prevention. The TAP program provides 25 hours of skill-building training for a small group of peer leaders.

Once the TAP members complete the training, they create and implement activities in their school and community that focus on reducing misinformation, explaining consequences of and alternatives to risky behaviors, and increasing sensitivity to HIV infection and AIDS, including personal vulnerability, and ways to protect one's self from HIV infection.

It takes time to increase knowledge and change behaviors. Research indicates that simple, straightforward and reality-based HIV prevention messages delivered consistently by numerous sources, including peer educators, have a positive effect on changing knowledge, attitudes and behavioral intent.

Today, I am accompanied by Brian Bess and Rahim Jones from Ballou High School, located in Washington, D.C. As a result of

1 See p. 129 for a letter by the American Medical Association.

their involvement in the TAP program in their school, they have written a rap about HIV prevention and AIDS and they will perform it for you now.

Chairman GLENN. Good, we appreciate that. Where do you want to go, gentlemen? Come on up here, if you would like. Come up in this area right in here, so everybody can see you. If you could just stand at the side, then the audience can see you; present it to them and I will watch from the back. That is great.

[The following rap song was performed:] Acquired Immuno Deficiency Syndrome, I'll tell you straight up people it hits home.

It hits you hard and soon you know you're done for.

No rejoicing or praying you know the score.

I mean you can have AIDS you say you doubt it,

You or you with AIDS think about it.

I wanna milk this subject like I would a cow,

No ignorance needed just listen now.

Can you catch the disease by just shaking hands, from toilet seats, from meats, from touching, no you can't.

You should know shooting up would do you harm,
Injecting dope and disease right up in your arm,
I mean I pack me a rubber like it's a lucky charm,
So put you sex in check or else Joe your gone.
Because it can't be contained it'll spread around,

You're the problem won't solve 'em let me break it down.
Human Immunodeficiency virus,

You have to take high like Osiris.

C.P.O. and we will educate thee,

On the do's and don'ts of A-I-D-S, I want to express,

The negative trip that's coming from the rest.

Who thinks a subject like AIDS is just a gay click,

You're disillusioned, you're being stereotypic.

The needle drug users, the over abusers,

Are subject to AIDS and the accusers.

Male or female, gay or straight,

The AIDS virus doesn't discriminate.

Quote unquote D.D.P. for a while,

You just can't trust a big butt and a smile.

Not to be contacted from a kiss or cold sore,

Not to be given through the sweat of your pores,
Now that you know the information the score,

And if you wish it, I'll tell you more,

You see black, Latin Americans, white caucasians,

With the daily barbers, no discrimination,

A baby from when soon to come to an end,

You want to know why? Well, let me tell you, my friend.
Mothers abuse them, fathers just reuse them,

Shooting I.V. drugs, because it soothes them.

Everybody bopples, even to music,

But when the virus pops up, they start accusing.

But how about the baby who did no wrong,

Not the one you give the rattle, but the death song,