Countries unite to fight spread of AIDS. Education is key to control, officials say

From the United States to Western Europe to Africa, many nations are actively taking steps to slow the spread of the disease AIDS. The pace of education and information has quickened since the first of the year, as the world heeds warnings, like those of US Surgeon General C.Everett Koop, of the potential seriousness of the problem.

Despite the progress recorded in education and prevention in various parts of the world, many problems remain, including the vital task of changing sexual or drug behavior so the disease does not strike heterosexuals as heavily as it has homosexuals, providing proper privacy to potential AIDS victims, and finding sufficient staff, facilities, and funds to deal with the many ramifications of the problem.

Overall, however, there has been much progress: ``More and more countries now are recognizing the problem and doing something about it,'' says Dr. Pramilla Senanayike, medical director of the International Planned Parenthood Federation in London.

Until recently most African nations were reluctant to admit they had a problem. Now many are asking for help. Since January the World Health Organization has begun education and control programs in 10 African nations, says Manuel Carballo, a scientist with WHO's special program on AIDS, in Geneva.

Almost every day there are new data as health officials seek to inform the public and change behavior, and as scientists strive to produce the medical means of prevention and cure.

Last month Dr. Koop said that stopping the transmission of the disease was essential, otherwise 100 million people worldwide might succumb to it by century's end. The disease, formally called acquired immune deficiency syndrome, is not now considered medically curable.

Today's new information is a report by the US Centers for Disease Control, which says that 12,000 Americans may be at risk of AIDS because of pre-1985 blood transfusions. The report is expected to recommend what the American Red Cross did yesterday: that Americans consider taking tests for AIDS if they received blood transfusions and are concerned that they may have been exposed to the virus.

Yesterday a French researcher became the first person known to have given human beings, including himself, an experimental vaccine, part of the effort by the international medical community to produce a preventive. And the day before, the US government produced a plan for a nationwide education campaign, a plan immediately criticized by some as inadequate.

The United States and several European nations have ``very quickly and very effectively'' developed good education programs using mass media, Dr. Carballo says. ``And we're beginning to see this in developing countries.''

In recent weeks in Britain every household has been mailed educational information about AIDS and the primary ways it is transmitted, namely, through sexual intercourse and the use of contaminated needles by intravenous drug users. Surveys indicate most people read the material.

In the US a recent information campaign has been highly successful in increasing public knowledge among adults about the disease. Sherry Adams, a health consultant who has analyzed past polls on Americans' knowledge of AIDS, says that with one exception the results of recent polls are ``very encouraging.'' Americans now understand how the disease is spread, and unfounded fears are fading. The exception: Many still think it can be contracted by donating blood.

The next requirement, which finds the US and European nations ahead of Africa, is to change the behavior that can lead to the spread of AIDS. Koop and others have called on Americans to be monogamous in their sexual relationships as the best way of being free of AIDS. The second-best solution, he has said in a controversial message, is to use condoms. Advertisements for condoms as a disease preventive are soon to be shown on several dozen US television stations.

Some changes in behavior have already occurred. Although thorough studies have yet to be done, many young Americans are believed to have replaced the casual sex of recent years with a reinstitution of commitment and having fewer sexual encounters. Many homosexuals have ceased promiscuity, and homosexual communities in San Francisco and New York have set a standard for heterosexuals in banding together to assist those afflicted with the disease.

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