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Understanding AIDS - The Surgeon General's pamphlet
A Message From The Surgeon General
This 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 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.
C. Everett Koop, M.D., Sc.D.
What AIDS Means To You
AIDS is one of the most serious health problems that has ever faced the
American 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
Your children need to know about AIDS. Discuss it with them as you would
any health concern.
How Do You Get AIDS?
There are two main ways you can get AIDS. First, you can become infected
by having sex -- oral, anal or vaginal -- with someone who is infected with
the AIDS virus.
Second, you can be infected by sharing drug needles and syringes with an
Babies of women who have been infected with the AIDS virus may be born
with the infection because it can be transmitted from the mother to the baby
before or during birth.
Can You Become Infected?
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, heterosexual, bisexual or homosexual.
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 sexual 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
you are at greater risk of getting AIDS.
You Won't Get AIDS From Insects -- Or A Kiss
No matter what you may have heard, the AIDS virus is hard to get and is
You won't just "catch" AIDS like a cold or flu because the virus is a
different type. The AIDS virus is transmitted through sexual intercourse, the
sharing of drug needles, or to babies of infected mothers before or during
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
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.
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.
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.
Not having sex.
Sex with one mutually faithful, uninfected partner.
Not shooting drugs.
What About Dating?
Dating 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
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
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.
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, 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.
What Is All The Talk About Condoms?
Not so very long ago, condoms (rubbers or prophylactics) were things we
didn't talk about very much.
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 drug store, 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.
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.
What Does Someone With AIDS Look Like?
It is very important that everyone understands that a person can be
infected with the AIDS virus without showing any symptoms at all.
It is possible to be infected for years, feel fine, look fine and have no
way of knowing you are infected unless you have a test for the AIDS virus.
During this period, however, people infected with the AIDS virus can pass
the virus to sexual partners, to people with whom drug needles are shared, and
to children before or during birth. That is one of the most disturbing things
Once symptoms do appear, they are similar to the symptoms of some other
diseases. As the disease progresses, they become more serious. That is because
the AIDS virus keeps your body's natural defenses from operating correctly.
If you are concerned whether you might be infected, consider your own
behavior and its effects on others. If you feel you need to be tested for the
AIDS virus, talk to a doctor or an AIDS counselor for more information.
Is There A Cure For AIDS?
There is presently no cure for AIDS.
Medicines such as AZT have prolonged the lives of some people with AIDS.
There is hope that additional treatments will be found.
There is also no vaccine to prevent uninfected people from getting the
infection. Researchers believe it may take years for an effective, safe
vaccine to be found.
The most effective way to prevent AIDS is avoiding exposure to the virus,
which you can control by your own behavior.
Should You Get An AIDS Test?
You have probably heard about the "AIDS Test." The test doesn't actually
tell you if you have AIDS. It shows if you have been infected with the virus.
It looks for changes in blood that occur after you have been infected.
The Public Health Service recommends you be confidentially counseled and
tested if you have had any sexually transmitted disease or shared needles; if
you are a man who has had sex with another man; or if you have had sex with a
prostitute, male or female. You should be tested if you have had sex with
anyone who has done any of these things.
If you are a woman who has been engaging in risky behavior and you plan to
have a baby or are not using birth control, you should be tested.
Your doctor may advise you to be counseled and tested if you are a
hemophiliac, or have received a blood transfusion between 1978 and 1985.
If you test positive, and find you have been infected with the AIDS virus,
you must take steps to protect your partner.
People who have always practiced safe behavior do not need to be tested.
There's been a great deal in the press about problems with the test. It is
very reliable if it is done by a good laboratory and the results are checked
by a physician or counselor.
If you have engaged in risky behavior, speak frankly to a doctor who
understands the AIDS problem, or to an AIDS counselor.
For more information, call your local public health agency. They're listed
in the government section of your phone book. Or, call your local AIDS
hotline. If you can't find the number, call 1-800-342-AIDS.
The Problem Of Drugs And AIDS
Today, in some cities, the sharing of drug needles and syringes by those
who shoot drugs is the fastest growing way that the virus is being spread.
No one should shoot drugs. It can result in addiction, poor health, family
disruption, emotional disturbances and death. Many drug users are addicted and
need to enter a drug treatment program as quickly as possible.
In the meantime, these people must avoid AIDS by not sharing any of the
equipment used to prepare and inject illegal drugs.
Sharing drug needles, even once, is an extremely easy way to be infected
with the AIDS virus. Blood from an infected person can be trapped in the
needle or syringe, and then injected directly into the bloodstream of the next
person who uses the needle.
Other kinds of drugs, including alcohol, can also cause problems. Under
their influence, your judgment becomes impaired. You could be exposed to the
AIDS virus while doing things you wouldn't otherwise do.
Teenagers are at an age when trying different things is especially
inviting. They must understand how serious the drug problem is and how to
Drugs are also one of the main ways in which prostitutes become infected.
They may share needles themselves or have sex with people who do. They then
can pass the AIDS virus to others.
For information about drug abuse treatment programs, contact your
physician, local public health agency or community AIDS or drug assistance
AIDS And Babies
An infected woman can give the AIDS virus to her baby before it is born,
or during birth. If a woman is infected, her child has about one chance in two
of being born with the virus.
If you are considering having a baby, and think you might have been at
risk of being infected with the AIDS virus, even if it was years ago, you
should receive counseling and be tested before you get pregnant.
You must have a long talk with the person with whom you're planning to
have a child. Even if you have known this person for a long time, there's no
way to be sure he or she hasn't been infected in the past, possibly without
realizing it. That person needs to think hard and decide if an AIDS test might
be a good idea. So should you.
Talking With Kids About AIDS
Children hear about AIDS, just as we all do. But they don't understand it,
so they become frightened. They are worried they or their friends might get
sick and die.
Children need to be told they can't get AIDS from everyday contact in the
classroom, cafeteria or bathrooms. They don't have to worry about getting AIDS
even if one of their schoolmates is infected.
Basic health education should be started as early as possible, in keeping
with parental and community standards. Local schools have the responsibility
to see that their students know the facts about AIDS. It is very important
that middle school students -- those entering their teens --learn to protect
themselves from the AIDS virus.
Children must also be taught values and responsibility, as well as skills
to help them resist peer pressure that might lead to risky behavior. These
skills can be reinforced by religious and community groups. However, final
responsibility rests with the parents. As a parent, you should read and
discuss this brochure with your children.
Helping A Person With AIDS
If you are one of the growing number of people who know someone who is
infected, you need to have a special understanding of the problem.
No one will require more support and more love than your friend with AIDS.
Feel free to offer what you can, without fear of becoming infected.
Don't worry about getting AIDS from everyday contact with a person with
AIDS. You need to take precautions such as wearing rubber gloves only when
blood is present.
If you don't know anyone with AIDS, but you'd still like to offer a
helping hand, become a volunteer. You can be sure your help will be
appreciated by a person with AIDS.
This might mean dropping by the supermarket to pick up groceries, sitting
with the person a while, or just being there to talk. You may even want to
enroll in a support group for caregivers. These are available around the
country. If you are interested, contact any local AIDS-related organization.
Above all, keep an upbeat attitude. It will help you and everyone face the
disease more comfortably.
Do You Know Enough To Talk About AIDS? Try This Quiz
It's important for each of us to share what we know about AIDS with family
members and others we love. Knowledge and understanding are the best weapons
we have against the disease. Check the boxes. Answers below.
1. If you are not in a "high risk group," you still need to be concerned
True or False
2. The AIDS virus is not spread through: A. insect bites. B. casual
contact. C. sharing drug needles. D. sexual intercourse.
3. Condoms are an effective, but not foolproof, way to prevent the spread
of the AIDS virus.
True or False
4. You can't tell by looking that someone has the AIDS virus.
True or False
5. If you think you've been exposed to the AIDS virus, you should get an
True or False
6. People who provide help for someone with AIDS are not personally at
risk for getting the disease.
True or False
1. True. It is risky behavior that puts you at risk for AIDS, regardless
of any "group" you belong to.
2. A & B. The AIDS virus is not spread by insects, kissing, tears or
3. True. However, the most effective preventive measure against AIDS is
not having sex or shooting drugs.
4. True. You cannot tell by looking if someone is infected. The virus by
itself is completely invisible. Symptoms may first appear years after
you have been infected.
5. True. You should be counseled about getting an AIDS test if you have
been engaging in risky behavior or think you have been exposed to the
virus. There is no reason to be tested if you don't engage in this
6. True. You won't get AIDS by helping someone who has the disease.
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
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.
HHS publication number (CDC)HHS-88-8404. Reproduction of the contents of
this brochure is encouraged.
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