I was inspired to highlight this significant event when I read Joe’s timelines (thanks Joe!) posted in May. I work in Health Promotion and am really interested in how community attitudes shape our approach to health.
Understanding AIDS, June 1988.
Approximately 107 million English-language versions of the brochure, Understanding AIDS, were distributed to every home and residential post office box in the U.S. between May 26 and June 30, 1988 and a Spanish-language version was distributed in Puerto Rico during that period too. This was the first time the U.S. federal government attempted to contact virtually every resident, directly by mail, regarding a major public health problem. Pre-internet, pre smartphone, this was a major undertaking by any government. Not the least significant aspect of this was the subject matter itself.
The brochure was prepared by CDC in consultation with the Surgeon General (C. Everett Koop) and a wide spectrum of public health officials, medical experts, advertising consultants, and members of the general public. They made the effort to make the presentation simple, direct, and understandable to the widest possible audience. They wanted to provide understandable information and to encourage safe behaviors that can prevent HIV infection. They also wanted to make sure that the information was in a format acceptable to as many different groups as possible. The first draft of the brochure referred to different risk groups, but after consultation, they changed this to refer to behaviours. Not everyone in a risk group engages in risky behaviour – and people engage in risky behaviour even when they’re not in a risk group. The brochure did its best to make sure that anyone at risk could identify their risky behaviours and not ignore the warning because they didn’t identify with a risk group.
Dr. Koop said he realized later that the Reagan administration had been slow to address the disease because the election had brought to power people who were antithetical to gay people, then thought to be its only victims. As the epidemic worsened, reaching drug addicts infected with contaminated needles and hemophiliacs who had received a contaminated blood-clotting factor, Reagan, in 1986, asked Dr. Koop to prepare a special report. Dr. Koop proceeded cautiously, knowing the report would be unpopular with many in the administration, with conservatives in Congress and with church groups opposed to homosexuality. He wrote 17 drafts.
There has never been a formal review of the effect of this historic document/action.However, it’s estimated that 87 million people read at least some of the brochure. 85% of them approved of the government spending $25.5 million on it and 84% were glad to get it. 2% of people were offended by it and 1020 complaints were received.
There is a lot of information about HIV/AIDS available now and we now know that risk of transmission is reduced considerably if we don’t engage in risky behaviour. As yet, there is no cure, but it’s no longer a certain death sentence and someone infected with HIV has an excellent chance of living a relatively normal life if it’s managed correctly.
But the 1980’s and 90’s were before the research and before the more widespread understanding of the condition, and people still saw AIDS as a ‘gay’ disease. It would be some years before widespread understanding that it’s risky behaviour that spreads a disease like AIDS – not a particular group of people. The “Understanding AIDS” brochure went a long way toward bringing this understanding to the general public.
Understanding AIDS The Surgeon General
“Understanding AIDS” – the national AIDS mailer David Davis Phd.
C. Everett Koop’s legacy may be this trailblazing, seven-paid AIDS pamphlet Josh Voorhees
Perspectives in Disease Prevention and Health Promotion Understanding AIDS: An Information Brochure Being Mailed To All U.S. Households CDC
AIDS in 1988 Robert C. Gallo and Luc Montagnier
This was really interesting. I was too young at that time (or at least my parents must have thought so) to really have a grasp on that situation. I didn’t even realize the government sent brochures until reading something about it in DGC. I do remember the “it’s a gay people disease” attitude and what a disservice that attitude did for straight people. Because of that stupid attitude, people in my small town acted like it couldn’t possibly happen HERE because of course there were no gay people in Small Town, USA. Sex ed and safe sex were joked about when I was a kid (by the kids anyway…which was unfortunate really).
Anyway, thanks for writing this.
(Importing this comment from the Livejournal mirror)
Thanks for sharing this.
I still see comments from people online, sometimes, especially with articles abounding on SSM, that reference HIV/AIDS as gay-only. I can’t completely convey how frustrated and depressed that makes me.
I’m always amazed that C. Everett Koop was able to not only get this done but to have it make clear that risk groups and risky behavior are not the same thing.
I remember around 2000 hearing the term MSM being used a lot by HIV and AIDS advocates. I asked what it stood for and they said “men having sex with men.” They had to coin a term for it that wasn’t “gay” because too many guys who were having sex with men felt they were immune because they weren’t “gay” i.e. didn’t identify as gay. That’s how deep in denial people can get. WOW, eh?
This was really interesting. Thank you for posting it.
Not too long ago I came across a guy in his late teens/early twenties saying that as a young gay man he is realizing how little his generation knows about AIDS and that because it isn’t an instant death sentence he thinks it isn’t taken as seriously as it should. As someone who is old enough to remember when they discovered AIDS, this scares me. I hate to think that people will needlessly get sick because they didn’t take it seriously enough to protect themselves.