HEALTH

Spreading the news about AIDS

JOHN BARBER March 23 1987
HEALTH

Spreading the news about AIDS

JOHN BARBER March 23 1987

Spreading the news about AIDS

HEALTH

At first, the television advertisement produced by the Danish National Board of Health is confusing. A capital letter I, alone onscreen, gradually droops and collapses to the strains of a Viennese waltz. But the message becomes clearer when a condom is fitted over the letter and it recovers its vigor. Then the animated character is joined by three other letters to become part of a familiar acronym for a deadly, incurable disease—AIDS, for Acquired Immune Deficiency Syndrome. In a similar advertisement on Norwegian TV, the I in AIDS makes advances on its neighboring A but is rebuffed until it, too, dons protection.

There is little chance of such frank images appearing on Canadian television. Last week in Ottawa, a committee representing 20 private Canadian TV stations turned down three out of four decidedly tamer anti-AIDS ads prepared by the Canadian Public Health Association (CPHA). “Sex with different partners is risky,” says the urgent message in the three rejected commercials created by the countrywide organization of health professionals. “You’ve got to avoid it or use a condom for protection.” But, declared Patricia Beatty, a spokesman for the Telecaster Committee of Canada, a group which screens commercials for the private stations,“our perception is that that means it is okay to sleep around. In other words, they are promoting promiscuity.” By contrast the Canadian Broadcasting Corporation has accepted the CPHA ads and will run the 30-second commercials—including those dealing with condom use—in evening prime time.

The reactions of Canadian broadcasters and the Scandinavian approach to anti-AIDS campaigns illustrate the variety of responses that the spread of the disease has sparked. Indeed, its threat has prompted many convenience stores to begin selling condoms and convinced provincial government officials to add information about AIDS

to sex-education courses. The Danes, for one, plan to back up their TV campaign with realistic videos that will show schoolchildren aged 12 and older how to use condoms.

But at the other extreme, some impoverished countries in Central Africa

have only recently even acknowledged the existence of a severe AIDS problem in their midst. As many as five million people have been infected with the virus in the region between Zaïre and Zambia-half the total number of AIDS carriers in the world. Still, in the absence of signs of a speedy discovery of an AIDS cure, many governments are falling back on education as the best means of stopping AIDS. To that end, federal Health Minister Jake Epp endorsed the CPHA public awareness program last week and declared, “We have the power to control and prevent the spread of AIDS by the decisions each and every one of us makes about our behavior and particularly our sexual behavior.”

In some countries, including Japan and Belgium, education * campaigns have been accompanied by harsh legislation intended to isolate AIDS patients and control their sex lives. But all those measures have provoked considerable controversy, much of it based on arguments of morality. Epp became embroiled when he introduced the

$3.7-million CPHA campaign last week. A devout Mennonite who takes a conservative stand on most family issues, Epp defended the three controversial commercials as “proper and decent.” In one ad, a young man joining a group of friends in a restaurant warns view-

ers that AIDS can be contracted through casual sex without condoms— as does another ad featuring a woman completing a gymnasium workout. The fourth, which the committee approved, extols monogamy and does not mention condoms.

The broadcasters’ committee did not share Epp’s assessment and its ban in turn provoked strong reactions from CPHA officials and AIDS researchers. Said CPHA spokesman Robert Burr: “If we were setting out to promote casual sex, the last thing we would talk about is a deadly disease.” Added Toronto epidemiologist Randall Coates: “The committee’s decision is inhumane. It’s an ostrich approach.”

Condoms, which are a form of birth control as well as a barrier against sexually transmitted disease, are at the centre of the controversy over the CPHA ads. And now the prophylactics are available in corner stores. In British Columbia last month, the Burnaby, B.C.-based 7-Eleven chain of convenience stores began a trial program of

selling condoms alongside candy bars and take-out coffee. The company is considering stocking the contraceptives in all 470 stores across Canada. And in Quebec 335 convenience stores in the province’s Boni-Soir chain began selling condoms last month.

Meanwhile, public health officials who are acutely aware of AIDS’ rapid spread are adding their support to increasingly urgent demands for awareness programs about the disease. The number of AIDS patients is doubling yearly in many countries and in Canada alone there have been 944 reported cases of the disease (including 778 homosexuals) during the past seven years; half the total are already dead. Based on U.S. analyses, Dr. Alastair Clayton, head of the Laboratory Centre for Disease Control in Ottawa, said that by 1991, 3,350 Canadians will likely have died from the disease.

Indeed, U.S. Surgeon General C. Everett Koop said that by that date 179,000 Americans will already have died from AIDS—with 54,000 victims succumbing in 1991 alone. Until recently most scientists said they believed that less than 10 per cent of those infected with the virus would progress from simply carrying the disease to developing full-blown AIDS symptoms. But new findings from long-term studies conducted in San Francisco indicate that the number of victims succumbing to the disease will be much higher. Said Clayton: “Sooner or later someone who is infected is going to get the overt disease.”

That revised prediction provided a grim backround as representatives of five western countries gathered in Ottawa last week to discuss AIDS education programs. All agreed on the need for frank publicity campaigns. Said William Bowtell, a member of the Australian National Advisory Com-

mittee on AIDS: “Most people want frank, unbiased information. They are quite capable of making their own moral judgments and interpretations on the basis of that information.” For his part, Bernard Merkel of the British government’s AIDS Unit declared, “If you don’t educate people now, the number of victims will just escalate out of sight.”

In January Britain launched a $40million campaign, which has been praised by other countries. Officials mailed AiDS-information leaflets to 23 million British households—and received only 200 complaints about their contents in reply. The government is also preparing one million booklets for teachers and youth workers. But most of its anti-AIDS budget is devoted to a hard-hitting television, radio and print advertising campaign that uses the slogan, “Don’t die of ignorance.”

Some of the British TV ads convey the unambiguous antisex message that the Telecaster Committee said was missing from their Canadian equivalents. One states: “Sleep with as few people as possible. Use a condom or make your partner use one.” But some are also far more explicit than the Canadian ads. One print ad shows a young person wearing a Tshirt decorated with the slogan, “Sex and Drugs and Rock V Roll.” The accompanying message reads, “At least rock ’n’ roll can’t give you AIDS.” It goes on to explain that men carry the AIDS virus in their sperm and women carry it in their vaginal fluid.

In Canada, the new federally funded advertising campaign is one of few government initiatives to counter AIDS. In British Columbia, Premier William Vander Zalm declared last January, “There is only one way to avoid AIDS and that is, don’t have sex.” A longtime opponent of sex education, Vander Zalm has maintained that young people should be taught to refrain from sex just as they are taught not to drink and drive. But despite his strong personal views, the provincial education ministry plans to create a provincewide sex-education program that will include information about AIDS.

By contrast, Saskatchewan government officials have not yet determined the format of an AIDS information program for schools. But Ontario, which with Quebec and British Columbia has most of the reported AIDS cases in Canada, will make an AIDS program mandatory for students in Grades 7 through 13 this September. In Quebec, high-school students currently receive information about AIDS during a five-hour social-education program each year.

But in the United States, President Ronald Reagan’s administration has resisted calls for a national anti-AIDS campaign. Still, U.S. Surgeon General Koop has emerged as the country’s champion of AIDS awareness. Criticized by liberals for his opposition to abortion, Koop has dismayed many of his conservative supporters with a crusade over the past year to spread information on ways to avoid AIDS. Says Koop:

“You can’t teach young people about AIDS until you’ve taught them something about their own sexuality.”

Several other countries are considering far more drastic steps, adopting the theory that isolating AIDS patients will control the spread of the disease more effectively than education campaigns. The Japanese government is readying laws that would require doctors to report the names of all AIDS patients and empower health authorities to monitor their sexual activity. That legislation was drafted in February after two 20-year-old Japanese women—one a prostitute and the other pregnant—contracted AIDS. Said government spokesman Hoei Ohama: “If we respect the human rights of one person [with AIDS], we are depriving 99 others of the right to live.”

Japan has only a rudimentary antiAIDS education campaign under way, and its contents are colored by a wide-

spread distrust of foreigners. One of the few government pamphlets discussing AIDS shows a frowning, sweating Statue of Liberty clutching a book titled AIDS and towering ominously over a trembling Mount Fuji. The AIDS-infected prostitute from the port city of Kobe said that she had had hundreds of customers, but the Japanese press attributed her disease to a Greek sailor she lived with for one year.

Still, the Japanese government has rejected a proposal to have foreigners

entering the country carry certificates showing that they were AIDS-free. But in western Europe and the United States, conservative groups have called for similar controls. And earlier this month Belgium became the first European country to institute such controls. The government now demands that Third World students must pass AIDS tests before they receive scholarships allowing them to study in Belgium. Currently, there are about 1,500 Third World students in Belgium, most of them from the heavily AIDS-stricken nations of Zaïre and Rwanda—both former Belgian colonies. Declared government spokesman Paul Van Stallen: “We think we should protect our own people. We should not pay others to come here and be a danger.” For their part, spokesmen for the Africans say that they are being singled out for racial reasons. Declared Mushobekwa

Kalimba wa Katana, Zaire’s ambassador to Belgium: “The aim is to protect the Belgian population, so only a general test of foreigners would be morally acceptable.”

And in the West German state of Bavaria, Premier Franz-Josef Strauss proposed AIDS blood tests last month for civil service applicants, convicts, prostitutes—and non-European Community foreigners applying for residence. The citizens of neighboring Austria fell into the last category and that country’s press launched an attack on the decree and its author. In response, Strauss has delayed passage of the controversial legislation until the German government unveils its own AIDS control measures.

But it may already be too late to stanch the spread of AIDS through some African states through education campaigns. In many countries the disease is still largely confined to homosexuals and drug addicts, but AIDS is rampant among the heterosexual populations of Central and East African states, where the emaciating disease is known locally as “slim.” As a result, experts suggest that in some countries as many as 100 million Africans may be infected by 1991. In Kenya, rumors that Britain planned to introduce immigration restrictions sparked antiBritish charges of racism in the Kenyan press. And many African students staged protests in Belgium when the government announced it would deport carriers of the AIDS virus. But while Kenyan officials insist that their country has adopted some of the strictest AIDS con-

trols in Central Africa, some surveys indicate that at least 60 per cent of the country’s prostitutes are infected.

And even in developed countries, AIDS awareness programs are only the best available holding action—a finger held in the dike until researchers discover a cure for the disease. Still, the tactic has already proven its value within the homosexual communities of New York City and San Francisco, where vigorous campaigns promoting “safe sex” have begun to slow AIDS transmission. As a result, Epp and other supporters of information campaigns about AIDS say that, with good luck and more frank advice, the disease will not have a chance to wreak havoc among young heterosexuals.

JOHN BARBER with NORA UNDERWOOD in Ottawa, PHILLIP WINSLOW in London, PETER LEWIS in Brussels and PETER McGill in Tokyo