America Living With AIDS

coordinated systems of care, and public and private financing strategies to
pay for care.
DEVELOPING PREVENTION
MIESSAGES
Frank Talk About Sex and Drugs
Most of the disagreement about HIV
prevention is not over goals, but over
methods to achieve goals and over
who should decide which methods
ought to be used. As noted above,
there are a number of simple, readily
available technologies that will contribute significantly to reduction in
the spread of HIV infection. Yet AIDS
education and prevention efforts continue to be stymied by an unwillingness to talk frankly about sexual and
drug use behaviors that risk the spread
of HIV. Constraints on discussions of
sex, whether imposed by law, political
considerations, issues of morality, language, or culture, have been a substantial barrier to the creation and implementation of effective HIV prevention
programs. There is a cruel irony at
work here, for reticence about discussing sex has become an obstacle to
the implementation of lifesaving prevention programs. This withholding
of potentially lifesaving information
raises serious ethical problems.
In the early years of the AIDS epidemic messages concerning HIV were
couched in euphemisms. There were
warnings about the danger posed by
the "exchange of bodily fluids" when
the phrase eluded public understanding. Generic, incomplete, and
ambiguous messages such as this fos
tered misunderstandings
about the actual dimensions of risk and the ways
to avoid the threat posed situation i
by HIV disease. the islar
Research in many areas a high inc
of health education has there exiý
shown that to encourage about b
behavior change, preven- Ignorant
tion messages must be levels o
transmitted in a language emph
and manner that can be transpo
understood by the people funeral pt
to whom they are direct- for burials
ed. Those who design to be at
and implement education
and prevention programs
must be able to use urgent to
unvarnished language educatic
and communications that island to ai
are both meaningful and attitudes o
acceptable to the particu- suffered b
lar community or group to bec
being addressed. Where environn
the communications are tar- at
geted to a specific group, the
potential offensiveness to LUIS
others to whom the message No
is not directed should not
and need not be a barrier.
Congress should remove the
government restrictions that have been
imposed on the use of funds for certain
kinds of HIV education, services, and
research.
In addition to crafting clear and
explicit messages that are relevant to
those at risk, a greater realism is needed in approaches to altering sexual
behavior and drug use. For example,
although teenagers are encouraged to
delay sexual intercourse until marriage
or at least until adulthood, a majority