Ask the Scholar
Document scope · 1 page
Scholar
Ask about this object, its catalog metadata, its source description, or the page inventory.
For page-specific OCR and visual context, open one of the page chats.
Scholar Source Context
Document identity
localId
323152873
label
National Coalition on AIDS 3/29/90 [OA 6854] [1]
core
doc
dtoType
document
citationUrl
pageCount
1
Source metadata
id
323152873
contentType
document
title
National Coalition on AIDS 3/29/90 [OA 6854] [1]
citationUrl
identifierLocal
13710-009
collections
Records of the White House Office of Speechwriting (George H. W. Bush Administration)
Speech Backup Chronological Files
imageCount
1
hasImages
yes
source
import
hasTranscription
no
Source extras
naId
323152873
levelOfDescription
fileUnit
recordType
description
ocrSource
nara-archive
Single page context
seq
1
pageIndex
0
type
document
mediaId
5b679120e53a663b
ocrText
Originally Processed With FOIA(s):
FOIA Number:
Systematically Processed; 1998-0091-F
1998-0091-F
FOIA
MARKER
This is not a textual record. This is used as an
administrative marker by the George Bush Presidential
Library Staff.
Record Group/Collection:
George H.W. Bush Presidential Records
Collection/Office of Origin:
Speechwriting, White House Office of
Series:
Speech File Backup Files
Subseries:
Chron File, 1989-1993
OA/ID Number:
13710
Folder ID Number:
13710-009
Folder Title:
National Coalition on AID 3/29/90 [OA 6854] [1]
Stack:
Row:
Section:
Shelf:
Position:
THE WHITE HOUSE
WASHINGTON
DATE: 4-7-90
FROM THE PRESIDENT
all
To:
Dave Demarest
2 Things:
1. Your letter to Ed on AIDS speech was
excellent. I hope this is going on all
across the old U.S. of A.
2. Please give special thanks to
writer of Lyndon Johnson speech.
The LBJ people were really
touched. Gret sensitivity in there.
gb
CC: Sununu
Fitzwater
THE WHITE HOUSE
WASHINGTON
April 2, 1990
To the Editors:
The Washington Post billed the address as "long-awaited" --
the President's "first major speech on the AIDS epidemic." But
for readers of the Washington Post -- here in the area where the
speech was given -- the waiting isn't over yet.
Because if your readers wanted to know what was actually in
that "major speech,' they would need to buy the Los Angeles Times
or New York Times, where front-page accounts carried extensive
excerpts from the address. Or, they could have watched the
address live on CNN.
The Post's page four treatment of the speech summarized the
content of the speech in three sentences. One sentence of the
actual speech made it into the article in the sixth paragraph.
In contrast, the article gave ample space to six critics:
two hecklers, two AIDS activists, a businessman, and a Democratic
Congressman. The fact that the speech was interrupted eight
times for applause, and that the President was given a standing
ovation at the end of the speech, wasn't mentioned at all.
Your story reminded me of the heckler who interrupted the
speech to complain that the President hadn't yet uttered the "A"
word (AIDS). I suppose some people just don't want to listen.
At that point in the speech, the President had already used the
word "AIDS" 22 times.
The citizens of the Nation's capital care deeply about this
issue. To its credit, the Post did share with its readers an
important line from the President's speech on AIDS. If anyone
would like to read the other 134 lines of the President's
remarks, I'd be happy to send them a copy.
Sincerely
David
Assistant to the President
for Communications
The Editors
The Washington Post
15th Street, NW
Washington, DC
DRAFT
April 2, 1990
To the Editors:
The Washington Post billed the address as "long-awaited" --
the President's "first major speech on the AIDS epidemic.'
But for readers of the Washington Post -- here in the area
where the speech was given -- the waiting isn't over yet.
Because if your readers wanted to know what was actually in
that "major speech,' they would need to buy the Los Angeles Times
or New York Times, where front-page accounts carried extensive
excerpts from the address and made it the "Quotation of the Day."
The Post buried the story next to a furniture ad on an
inside page. You included just one quote from the speech itself
-- but found room for six quotes from those who criticized it.
Quick to point out that the President was interrupted twice by
hecklers -- you left out that he was interrupted eight times by
applause -- and closed to a standing ovation.
In fact, the President vowed to "fight like hell" to stop
the spread of AIDS, to stop the awful discrimination against
those who are HIV-positive, to use treatment and research to
"beat this virus" and find a cure -- and asked Congress for a
$500 million increase in the government's AIDS budget.
Your pre-packaged coverage is like the heckler who
interrupted the speech to complain that the President hadn't yet
uttered the word "AIDS." But people, like newspapers, hear what
they want to hear. At that point in the speech, the President
had already used the word "AIDS" no less than 22 times.
Washington is one of the cities most devastated by this
crisis. I don't expect everyone to agree with all of the
President's policies, but you owe readers enough information
about what the President is doing -- and saying -- to let them
make up their own minds.
Sincerely,
David Demarest
Assistant to the President
for Communications
The Editors
The Washington Post
15th Street, NW
Washington, DC
A4 FRIDAY, MARCH 30, 1990
THE WASHINGT
"But that is exactly what the pres-
President Calls for End
ident proposed in his budget for the
coming year. He removed all the
money to pay for AZT and preven-
To AIDS Discrimination
tative treatments for opportunistic
infection for low-income persons
not yet eligible for Medicaid. More-
over, he cut all of the money for
Strongest Statement Yet Is Criticized as Timid
service demonstration projects used
to support home and community-
based patient care."
By Malcolm Gladwell
ease, despite the large increase in
"I'm glad he's taking the first
Washington Post Staff Writer
AIDS cases expected this year.
step-kinder and gentler rhetoric,"
One corporate leader, who ad-
said Rep. Henry A. Waxman (D-
In his first major speech on the
dressed the conference immediately
Calif.), chairman of Energy and
AIDS epidemic, President Bush
before Bush, charged that the pres-
Commerce subcommittee on health.
yesterday called for an end to dis-
ident had taken money away from
"But it's all lip service if he doesn't
crimination against those infected
programs to treat people with AIDS
follow up his promises with pro-
with the virus and praised his ad-
in order to support research aimed at
grams. We can keep people from
ministration's efforts to combat the
preventing future infections.
dying if we provide preventative
disease.
"It is not acceptable to pit those
drugs. We can keep people from
Bush's long-awaited remarks
who may be spared from AIDS in
getting Infected if we provide
were the strongest public commit-
the future against those who are
education.
But we can't do any
ment ever given by the White
already infected," said Robert Haas,
of this without paying for it, and the
House to fighting the epidemic. But
chairman of Levi-Straus and Co.
Bush budget doesn't do that."
many AIDS activists, including two
hecklers, criticized the content of
Bush's address as too timid a re-
sponse to the severity of the AIDS
crisis. The hecklers disrupted the
speech with shouts of "Too little,
too late" and "Why did it take you
14 months to say this?"
"He has shown sensitivity and con-
cern that we have yet to witness
from the office," said Jean McGuire,
executive director of the AIDS Ac-
tion Council. "But a decade of neglect
requires more aggressive leadership
than we have seen today."
"This speech would have been
truly significant if it had been de-
livered six years ago," said Larry
Kessler, a member of the National
Commission on AIDS.
Bush's remarks were delivered
to the National Leadership Commis-
sion on AIDS, a private-sector
group established three years ago
to respond to the epidemic. Before
a crowd of 500, the president cited
the "unprecedented" $3.5 billion
budgeted for fighting AIDS this
year, praised the "American pio-
neers" at the National Institutes of
Health researching the disease and
urged Congress to pass the Amer-
icans with Disabilities Act, which
includes a prohibition on discrim-
ination against people with AIDS.
"In this nation, in this decade,
there is only one way to deal with
an individual who is sick," Bush said.
"With dignity, compassion, care,
confidentiality and without discrim-
ination."
But many AIDS activists were
disappointed that the president did
not address the 3-year-old U.S. pol-
icy of preventing people infected
with the AIDS virus from immigrat-
ing to the United States, an issue
that has prompted some activists to
call for a boycott of the internation-
al AIDS conference in San Francis-
co in June.
Bush also pledged no new funds
for fighting and treating the dis-
the News
civedy,
breezy,
Cye New York Cimes
periods of rain. High 45. Tonight, some
Fit to:Print"
rain and fog. Low 42 Tomorrow,
cloudy, damp. High 49. Yesterday,
high 50, low 37. Details, page A18.
XIX
No. 48,190
Copyright © 1000 The New York Times
NEW YORK, FRIDAY, MARCH 30, 1990
50 cents beyond 75 miles from New York City, except on Long Island
40 CENTS
se
y,
es
y
Bush, in First Address on AIDS,
0
Backs a Bill to Protect Its Victims
t
d
e
n
S
1
Quotation of the Day
'We don't spurn the accident
victim who didn't wear a seat
belt. We don't reject the cancer
patient who didn't quit smoking
cigarettes. We try to love them
and care for them and comfort
them. We do not fire them. We
don't evict them. We don't can-
cel their insurance."
- President Bush,
talking about AIDS.
[A1:3.]
Reuters
President Bush appealing for compassion for AIDS sufferers.
By PHILIP J. HILTS
Special to The New York Times
ALEXANDRIA, Va., March 29 - In
them. We do not fire them. We don't
his first address on AIDS since he took
evict them. We don't cancel their Insur-
e
office, President Bush appealed today
ance."
for compassion toward people infected
Several leaders of AIDS organiza-
with the AIDS virus and expressed sup-
tions said they were encouraged that
port for a bill that would outlaw dis-
Mr. Bush had addressed the subject
crimination against people with AIDS
but complained that he had not com-
and other diseases.
mented on some central issues. They
He said friends had died of AIDS and
cited immigration rules limiting the
added, "There is only one way to deal
travel of people with AIDS who want to
with an individual who is sick: with
attend conferences in the United
dignity, compassion, care, confidential-
States, and a bill sponsored by Senator
ity and without discrimination."
Edward M. Kennedy, Democrat of
Speaking at a conference sponsored
Massachusetts, that would deliver $600
by the National Leadership Coalition
million in Federal disaster relief to
on AIDS, which includes executives of
cities hit hard by AIDS.
large companies, the President said:
"We don't spurn the accident victim
Instead, the President gave his per-
sonal support to legislation that would
who didn't wear a seat belt. We don't
=
prevent discrimination against dis-
reject the cancer patient who didn't
).
abled people, including those Infected
.e
quit smoking cigarettes. We try to love
them and care for them and comfort
Continued on Page A14, Column 2
Bush Supports Bill to Outlaw Bias in AIDS Cases
Continued From Page Al
conference. "Every American must
policy groups, said Mr. Bush's speech
learn what AIDS is and what AIDS is
"was long on compassion, but short on
not. And they must learn now."
commitments."
with the AIDS virus, chiefly in regard
His speech drew protesters outside
the room where he spoke, and five peo-
Mr. Bush said his Administration
to employment or access to public
buildings and services. The Bush Ad-
ple were arrested. Two who did get in
and the Reagan Administration had
ministration has already supported the
broke into his speech four times, shout-
begun clinical trials for AIDS drugs
measure in Congress, where it has
ing that his remarks should have come
and expanded the availability of drugs.
14 months ago at the start of his Presi-
His budget for the fiscal year 1991
passed the Senate and two of four com-
dency. They were escorted from the
seeks $1.7 billion for AIDS research,
mittees in the House.
room and ejected from the Gateway
treatment and education, up from $1.6
In his speech Mr. Bush said the Gov-
Marriott Hotel, where the conference
billion for the current year.
ernment was "on a wartime footing"
was held.
at the National Institutes of Health and
the Centers for Disease Control, which
Praise and Criticism
conduct research on AIDS and the
Immediately before Mr. Bush spoke,
human immunodeficiency virus, or
Robert D. Haas, chairman of Levi
H.I.V., which causes it. "We are slash-
Strauss & Company, received a stand-
ing red tape," he said. "Accelerating
ing ovation after a speech in which he
schedules. Boosting research."
praised the President's decision to ad-
Some Personal Experience
dress the conference as "an event of
He spoke of his personal experience
symbolic and historic importance," but
with the disease, "Like many of you,
went on to say that "even if the private
Barbara and I have had friends who
sector helps create 'a thousand points
have died of AIDS," he said. "Our love
of light' across the land, it will be of no
for them when they were sick and when
avail if there is darkness in the White
they died was just as great and just as
House."
intense as for anyone lost to heart dis-
He said Mr. Bush had removed from
ease or cancer or accidents.
his budget crucial money for AIDS
"When our own daughter was dying
drugs and all of the money for demon-
of leukemia, we asked the doctor the
stration projects on home and com-
same question every H.I.V. family
munity care.
must ask - why - why this was hap-
Mr. Haas also criticized the Presi-
pening to our beautiful little girl. And
dent's strategy in the war on drugs as it
the doctor said: 'You have to realize
applies to the effort to control AIDS.
that every well person is a miracle. It
Experts on the disease say there is an
takes billions of cells to make a well
epidemic of AIDS among drug abusers,
person. And all it takes is one cell to be
and in some cities a majority of drug
bad to destroy a whole person.'
users are infected with the AIDS virus.
"Our goal is to turn irrational fear
Jean McGuire, director of the AIDS
into rational facts," Mr. Bush told the
Action Council, a coalition of AIDS
Bush Calls for Compassion,
and Cure, for AIDS Victims
By MARLENE CIMONS
anyone lost to heart disease or
TIMES STAFF WRITER
cancer or accidents."
And he likened the heartbreak of
WASHINGTON - President
babies infected with AIDS to the
Bush Thursday called on Ameri-
leukemia death of his own daugh-
cans to demonstrate compassion
ter, Robin, in 1953, two months
for people with AIDS and urged the
before her fourth birthday.
House to approve legislation that
"We asked the doctor the same
would protect them from discrimi-
question every HIV family must
nation.
ask: Why? Why this was happen-
"For those who are living with
ing to our beautiful little girl?" he
HIV [human immunodeficiency vi-
said at a meeting of the National
rus] and AIDS, our response is
Business Leadership Conference
clear," he said in his first major
on AIDS.
speech on AIDS. "They deserve
Bush's comments were praised
our compassion. They deserve our
by Dr. June Osborn, chairman of
care. And they deserve more than
the National Commission on AIDS,
a chance-they deserve a cure."
who said: "We've been desperately
In a speech that was unusually
needing this leadership from the
personal for Bush, he said that he
top. The most critical area has been
and his wife, Barbara, "have had
the need to get Americans to be
friends who have died of AIDS. Our
more compassionate and under-
love for them when they were sick
standing."
and when they died was just as
However, Jean McGuire, execu-
great and just as intense as for
Please see BUSH, A24
BUSH: Compassion and Anti-Bias Law for AIDS Victims Urged
Continued from A1
that they be effectively applied and
of the National Gay and Lesbian
caid funding. The White House has
tive director of the AIDS Action
implemented."
Task Force, held a sign that read:
requested $1.6 billion for research,
Council, called Bush's speech "long
Bush, appearing before an audi-
"Talk is cheap. AIDS funding is
prevention and non-Medicaid
on compassion but short on com-
ence of business and health execu-
not," and stood up to say: "Mr.
care-an amount that has been
mitment."
tives and officers of AIDS organi-
President, you don't understand.
criticized as inadequate by a range
McGuire complained that Bush
zations, heavily stressed the
We need funding."
of AIDS organizations.
had failed to address a U.S. immi-
compassion theme.
At the disruption, Bush departed
Rep. Henry A. Waxman (D-Los
gration policy that bars people
"Once disease strikes, we don't
from his prepared remarks and
Angeles), chairman of the House
with AIDS from entering the coun-
blame those who are suffering," he
said, to applause: "I can understand
Energy and Commerce subcom-
try, and said: "We have become an
said. "We don't spurn the accident
the concern that these people feel,
mittee on health, said he is glad
embarrassment to the global com-
victim who didn't wear a seat belt.
and I hope that, if we do nothing
Bush is "taking the first step-
munity."
We don't reject the cancer patient
else by coming here, I can help
kinder and gentler rhetoric." But,
The immigration restriction
who didn't quit smoking. We try to
them understand that, not only do
Waxman added: "It's all lip service
threatens to cripple a major global
love them and care for them and
you care, but we care, too."
if he doesn't follow up his promises
conference on AIDS scheduled for
comfort them. We do not fire them,
Bush described his Administra-
with programs."
June in San Francisco. Although
or evict them or cancel their insur-
tion's stance on AIDS as "a war-
Sen. Edward M. Kennedy (D-
AIDS-afflicted visitors can receive
ance."
time footing," adding: "We're go-
Mass.), chairman of the Senate
waivers to enter, the documents
He strongly endorsed House
ing to continue to fight like hell.
Labor and Human Resources Com-
become part of an individual's
passage of the Americans with
But we're also going to fight for
mittee and the author of a $600-
record and are considered unac-
Disabilities Act, which prohibits
hope. America has a unique capaci-
million emergency disaster relief
ceptable by many scientific and
discrimination in the private sector
ty for beating the odds-and as-
AIDS bill, called Bush's speech "an
AIDS organizations.
against the disabled, including
tounding the world."
encouraging start, far beyond the
As a result, many participants
those with HIV infection or fully
He said that his Administration
commitment the Reagan Adminis-
are expected to boycott the annual
developed AIDS. The Senate has
has asked Congress for almost $3.5
tration was willing to make." He
International Conference of AIDS,
already approved the measure.
billion for AIDS, including Medi-
urged Bush to support his measure.
considered the most important
"We're in a fight against a dis-
AIDS meeting of the year.
ease-not a fight against people,"
Presidential spokesman Marlin
Bush said. "And we will not-and
Fitzwater told reporters that im-
we must not in America-tolerate
migration rules are enacted by
discrimination."
Congress, "so we don't have a lot of
He was interrupted several
political recourse except to try to
times by two hecklers. One un-
make them work."
identified man shouted: "Why did
He added: "We do share the
it take you 14 months to say this?"
concerns of the AIDS organizations
Urvashi Vaid, executive director
EDITORIALS/COLUMNISTS
AIDS
Mr. Bush Talks About AIDS -- "President Bush's address to the National
Leadership Coalition on AIDS recently was called a 'historic and symbolic
event' by another speaker. Bush's appearance was historic, in a sense,
because he did something that his predecessor, the only other president in
office during the epidemic, did not do. He spoke out publicly and
forcefully on behalf of AIDS sufferers, asking that they be treated
compassionately and protected from discrimination. It was symbolic,
because the President can set the tone for the country
A critic said
Bush's appearance was 'long on compassion and short on commitments.'
True enough. The President has yet to come to grips with the terrible
financial toll on the health-care system in those areas with the most AIDS
cases. Perhaps he will also come to see the need for federal funds for
demonstration projects on home and community care for AIDS patients,
which will save money in the long run. But no one should forget the
compassion. It is a welcome change at the White House."
(Hartford Courant, 4/9)
Bush's Message On AIDS -- " The press and entertainment media have
taken up the cause of AIDS like few other diseases in history. Major
newspapers print lengthy reports on the subject, far out of proportion to
the disease's impact. Some of the 'gay press' has revealed the overall
objective of this focus on AIDS, and it is more than compassion for the
sick. It has to do, some say, with a radical political agenda that will use
'compassion' for AIDS 'victims' as a means of wearing down the public's
resistance to what used to be known as immoral behavior
The kindest,
though perhaps not gentlest, conduct for Bush would be to exercise his
compassion for those with AIDS by not only caring for the sick, but by
using his office to encourage the overwhelming majority of people who get
AIDS because of their behavior not to engage in the risky activities that
put them in jeopardy."
(Cal Thomas, Washington Times, 4/9)
President Must Match Deeds To Words -- "There you go again, George.
Throwing around the C-words. Caring, Compassion. And now,
Confidentiality
Fourteen months after taking office, George Bush
finally made his first policy speech on AIDS. In it, he urged that people
with AIDS be not only protected from discrimination but protected with
confidentiality. That is, of course, unless they're planning to visit the
good ole USA
It is time to start throwing the C-words around again,
George, and this time we're talking Courage. The President must go
back to Congress, demanding the restrictions on AIDS-infected travelers
be removed. The responsibility for safeguarding the public health will
return to the Public Health Service, where it should have remained all
along. It will not be a popular request, and at least one senator [Sen.
Helms] is guaranteed to kick, scream and threaten. It would be easier,
perhaps, for the President not to get involved. But people with AIDS --
indeed, all Americans -- are owed a bit more than caring, compassion and
confidentiality. They're owed political courage, as well."
(Margaret Doris, Boston Herald, 4/5)
-more-
Wednesday, April 11, 1990 -- C-2
Compassion Not Enough For Activists -- "The President turned his
kinder/gentler attention to AIDS [recently], and got a kick in the teeth
for his trouble. In his first major AIDS policy address, Bush did
everything short of leading a safe-sex sing-along to demonstrate his
concern
Following [his] obeisance came tribute of a more tangible kind
the announcement of yet another increase in AIDS funding, bringing
the grand total to a staggering $1.7 billion for the current fiscal year
[AIDS activists] demand that the middle class subsidize degeneracy, with
mass distribution of prophylactics, literature describing gay sex acts in
the most explicit terms and clean hypodermic needles. The taxpayers
currently cover 40 percent of the costs of AIDS medical care, and
indirectly subsidize the rest through higher insurance premiums
The
President is correct: We don't ask how someone contracted a terminal
disease, as the basis for determining if they merit our support. At the
same time, we don't say to smokers: Hey, relax, light up a Camel. We
don't inform motorists: If seat belts interfere with your lifestyle, not to
worry, we'll just spend a few hundred million more to find new treatments
for head injuries. We don't put privacy ahead of public health
considerations in our efforts to halt the spread of a venereal disease.
Each concession to the AIDS establishment only whets its appetite,
prompting new, more outrageous demands."
(Don Felder, Boston Herald, 4/5)
A Belated Speech On AIDS -- "Talk is cheap.' That's what a protester's
sign said at the speech President Bush gave on AIDS last week. The
speech was indeed eloquent. But Bush's declaration of war on AIDS is
long overdue
People who suffer from AIDS are often evicted and fired
and shunned by their families and friends. A president's call for
compassion can focus a nation's attention. But this was the President's
first speech on AIDS, and he has been in office 14 months. That's 14
months of headlines: artists, playwrights, addicts, babies, rich and poor,
famous and unknown -- suffering terribly and dying of AIDS in a national
plague. Where has he been?
Does [the President's] speech mean Bush
will assume a commanding role in the fight against a vicious disease?
Belinda Mason, a person with AIDS appointed by Bush to the National
AIDS Commission, met with the President before his speech. She said he
'seemed surprised that people with AIDS and the country expected
leadership, and was skeptical it would make a difference.' Mason asks an
important question: 'Does he really not know how powerful he is?"
([Hackensack] Record, 4/1)
Bush Backs AIDS Bill -- "President Bush commendably has thrown his
support behind legislation to outlaw discrimination against people with AIDS
and other diseases. Some of Bush's critics noted that compassion is
cheap; commitment is costly. That's so, but Bush's predecessor, Ronald
Reagan, hardly ever uttered a peep about the disease. The chairman of
Levi Strauss & Co., Robert Haas, whose company has become a national
model for compassionate treatment of employees with AIDS, justly criticized
Bush for spending too little of the federal drug budget on prevention and
treatment and too much on law enforcement. And Haas, who addressed a
national conference on AIDS just before the President, correctly noted that
'even if the private sector helps create a thousand points of light across
the land, it will be of no avail if there is darkness at the White House.'
Nevertheless, Bush, who quietly acknowledged that even presidents have
friends who have died of AIDS, has made a good beginning in calling for
compassion. Now he needs to back it up with sensible spending policies."
(Seattle Post Intelligencer, 3/31)
-more-
Wednesday, April 11, 1990 -- C-3
The AIDS Cure: Prevention -- "President Bush surely spoke for all
Americans of good will when he said people infected with AIDS should be
treated with compassion. But it was very unbecoming that a mob
demonstrated outside the hall where he spoke, making sneering demands
upon the President as though he were responsible for AIDS. As millions
of dollars are spent on AIDS research and treatment, there is already a
sure 'cure' for those who don't yet have AIDS. It's prevention. Most
AIDS cases result from homosexual promiscuity, multiple heterosexual
liaisons, shared contaminated illegal drug needles -- and the most tragic
cases of all, little babies who get AIDS from infected mothers. Since we
know what to do to avoid AIDS, the fatal disease should be promptly
eliminated. To heckle public officials for not giving more money to fight
AIDS when some still defend and engage in the things that spread it, and
will not give moral support to prevention, is unjust, foolish -- and for
some may prove fatal."
(Chattanooga News-Free Press, 3/30)
The AIDS Message Bush Must Give -- " An expanded level of funding
would recognize a fact that is sometimes forgotten at a time of confusing
statistics: The epidemic is not over. A leveling out of new case loads in
some areas only presages what will be record numbers of living AIDS
patients in already-impacted urban areas, while in some states, such as
California, the majority of new cases will occur outside impacted areas such
as Los Angeles and San Francisco. Statistics have proven unreliable as
well as confusing. There is evidence that doctors are careless about
reporting AIDS cases. One thing remains clear, however: An already
burdened health-care system faces an increasing load of HIV-related cases
for many years to come. The Kennedy-Hatch legislation recognizes the
reality of the cost. The President should do no less.'
(Los Angeles Times, 3/28)
-end of News Summary-
News Summary
OFFICE OF THE PRESS SECRETARY
THE WHITE HOUSE
WASHINGTON
FRIDAY, MARCH 30, 1990 -- 6 a.m. EST EDITION
TODAY'S HEADLINES
INTERNATIONAL NEWS
Iraq Said To Build Launchers For Its 400-Mile Missiles -- Iraq has
constructed for the first time launchers for missiles within range of Tel
Aviv and Damascus, according to classified American intelligence reports.
While the weapons could be used for offensive purposes, American
intelligence experts believe that the missiles are intended in part to
discourage any possible Israeli attack on Iraqi nuclear or chemical weapon
installations.
(New York Times)
NATIONAL NEWS
Housing Investigation -- The Department of Housing and Urban
Development's inspector general is investigating three no-bid contracts
awarded by a new government agency at the center of a power struggle
involving Secretary Kemp's top aides, a department source said Thursday
night.
(AP)
S&L Director/Senate -- President Bush's nominee for top savings and loan
regulator appears headed for defeat in the Senate Banking Committee, the
committee chairman said Thursday evening.
NETWORK NEWS (Thursday evening)
AIDS SPEECH -- President Bush urged
INTERNATIONAL NEWS
A-1
Americans to open their hearts to
victims of AIDS and to end irrational
NATIONAL NEWS
A-10
fears of the deadly disease.
NETWORK NEWS
B-1
CHILD CARE -- The House defeated a
Republican child care plan and approved
EDITORIALS
C-1
a more expensive Democratic plan.
FOREIGN MEDIA
C-3
CLEAN AIR An amendment by Sen. Byrd
was defeated 50 to 49.
This Summary is prepared Monday through Friday by the White House News Summary Staff.
For complete stories or information, please call 456-2950.
INTERNATIONAL NEWS
ESTONIA'S NEW LEGISLATURE SWINGS INTO ACTION
MOSCOW -- Estonia's new nationalist parliament took a
non-confrontational step toward independence, unlike Lithuania, and
elected communist Arnold Ruutel to continue as president of the republic.
Estonia has pledged not to follow the route taken by Lithuania
But Tass sauid Thursday that para-military defense units were being
formed across Estonia to protect the borders of a "future independent
republic."
(Gerald Nadler, UPI)
BUSH HEEDS VISITORS TO MOSCOW
President Bush decided to take a low-key approach to the
confrontation between Lithuania and Soviet President Gorbachev this week
after receiving private reports from Americans visiting Moscow that
Gorbachev is under intense pressure to take a hard line toward the
secessionist republic, Administration officials said Thursday.
The messages were from Sen. Kennedy, who met with Gorbachev on
Monday, and William Crowe, who visited with other senior Soviet officials
in Moscow, the U.S. officials said
Kennedy reported directly to Bush at the White House Thursday and
said in a subsequent interview that Gorbachev complained that "his efforts
at perestroika are being undermined" by Western criticism of his actions
toward Lithuania
Kennedy added, "My own sense is that Gorbachev understands that
Lithuania is going to be independent at some time. But it is going to be
on his terms." In the meantime, said Kennedy, "There is a strong
compelling sense within the Soviet Union for a crackdown on Lithuania from
all quarters."
Administration officials said Bush also was influenced by cables
received from Crowe after his meeting with Soviet officials. Crowe
cautioned that the Soviets were deeply concerned about the Lithuanian
independence drive and that the Baltic republic was "something that would
not be let go," said an official familiar with the message
"We would not be discussing Lithuanian independence if it were not
for glasnost and perestroika. There is a greater goal, and it is to make
sure the process survives," said an informed Administration official
"We don't want to say anything that would give Landsbergis more
confidence," said another official who is familiar with the high-level
deliberations at the White House.
(David Hoffman & Don Oberdorfer, Washington Post, A1)
Lithuania: Bush Waits
President Bush -- hanging tough against critics -- still hopes for a
peaceful end to the Lithuanian freedom crisis.
With few options to act open to him, Bush has been forced to walk a
thin line between supporting Lithuanian freedom fighters and not
jeopardizing arms negotiations with the Soviets
"The wise course is to stone-wall," says Adam Garfinkle of the
Foreign Policy Research Institute. "If the President is smart, he'll let the
clamor to do something roll off his back.'
Analysts say the President's high public approval ratings allow him
the luxury of holding off. Leaders in trouble with the public, they note,
usually feel compelled to act quickly. (Richard Benedetto, USA Today, 4A)
-more-
Friday, March 30, 1990 -- A-2
Bush Won't Reach Out And Touch Gorbachev
President Bush has ruled out direct talks with President Gorbachev
on the Lithuanian independence crisis, the White House said Thursday.
White House spokesman Fitzwater said, "We would not want to take
moves that disrupted that diplomatic effort, and the President simply feels
this is not the time to make a direct contact to Chairman Gorbachev for
those reasons."
Some saw Bush's reluctance to phone Gorbachev, despite their
evolving friendship, as sending a critical message to the Kremlin leader.
Senior Administration officials, however, said the two sides are
contacting each other through diplomatic channels. One top official said
the leaders are talking to each other through his office.
Meanwhile, Bush phoned Prime Minister Thatcher late Wednesday to
discuss the tensions in Lithuania and the Western reaction.
(Paul Bedard, Washington Times, A5)
USA's Lithuanians Want Stronger Stand
CHICAGO -- There's only one topic of conversation these days in
Chicago's Lithuanian community: Why is the White House so reluctant to
recognize the Baltic state's move to independence?
People here of Lithuanian descent -- about 200,000 live in Chicago --
are angered at President Bush's low-key approach to the situation.
"Mr. President is more worried about Gorbachev than Lithuania," said
Aldon Slonskis
"He's afraid to lose his friend."
Added Janina Petrusis: "Maybe Mr. President is worried about war
or something. And Lithuania is such a litte country he doesn't care."
Lithuanians plan to rally in downtown Chicago today to show support
for their homeland's effort to break free from Soviet domination.
(Kevin Johnson, USA Today, 4A)
REFERENDUM POSSIBLE, LITHUANIANS INDICATE
Separatist Leader Softens Opposition To Vote
VILNIUS -- The Lithuanian leadership indicated today it would
consider holding a referendum on independence, if only to "bring an
additional ace" to any future negotiations with the Kremlin.
A decision to hold a referendum in the republic is likely to be seen in
Moscow as a key concession by the Lithuanians
Until now, President
Landsbergis has adamantly opposed holding a referendum, insisting that
the parliament's March 11 declaration of independence made Lithuania a
sovereign state.
But Algirdas Brazauskas, the Lithuanian Communist Party chief and a
deputy prime minister, said that in talks on March 13, President
Gorbachev was insistent that the republic hold a referendum before Moscow
even considered direct talks on independence
"This perhaps could strengthen the self-determination of our
nation, Brazauskas said. Asked about the possibility of a referendum,
Landsbergis appeared to soften his own position, saying, "There are no
questions that cannot be discusses, except the question of Lithuanian
independence. The problem of a referendum could also be discussed."
(David Remnick, Washington Post, A19)
-more-
Friday, March 30, 1990 -- A-3
KREMLIN OFFERS CONDITIONAL AMNESTY FOR LITHUANIAN DESERTERS
MOSCOW -- The Kremlin offered conditional amnesty to Lithuanian
deserters Thursday after the breakaway republic backed down on creating
its own border force
The amnesty offer was reported by Tass, which said any Lithuanian
deserter who gave up and promised to continue his military service would
not be prosecuted.
"It is stressed, however, that people who continue to break the law
of the USSR on general military service will be sought out, detained and
face criminal punishments in accordance with the relevant legislation," it
added
[Meanwhile], Lithuania appealed to U.S. senators and congressmen to
pressure the Bush Administration for recognition, saying this would not
only aid democracy in Eastern Europe but prevent Gorbachev from making
a "gross mistake."
(Susan Cornwell, Reuter)
FRANCE'S DUMAS TO URGE SOVIET NEGOTIATIONS WITH LITHUANIA
PARIS -- French Foreign Minister Roland Dumas said he would urge
the Soviet Union to open negotiations with the rebel Baltic republic of
Lithuania
when
he
met Soviet Foreign Minister Shevardnadze Friday.
"Lithuania's right to sovereignty is indisputable, and we hope to see
talks begin as soon as possible with the Soviet Union in order to find the
best way of expressing this right, Dumas told France's Europe 1 radio
station shortly before boarding a plane for Moscow.
(Reuter)
NUNN CRITICIZES CHENEY OVER DEFENSE PLANNING
Soviet Cuts Being Ignored, Senator Says
Sen. Nunn Thursday sharply criticized Secretary Cheney for failing
to take full account of a diminished Soviet military threat, which Nunn said
warrants new cuts in U.S. defense spending and force deployment
overseas.
Nunn, in a lengthy speech on the Senate floor, challenged Cheney's
assessment that the Soviet Union could potentially reverse course and
rebuild military forces, noting that a stream of expert witnesses told the
committee this year that the loss of Soviet military power is probably
irreversible.
"The testimony strongly indicates that Director Webster's assessment
is closer to the mark" than Cheney's, Nunn said
But Nunn complained that the Administration's military budget
proposal for fiscal year 1991 and a classified assessment of the
international military threat completed by the Pentagon a few weeks ago
"did not include as part of
[their] calculations the recent disintegration"
of the Warsaw Pact or the military benefits of a likely future treaty
sharply reducing Soviet conventional forces.
Pentagon spokesman Pete Williams left open the possibility that
Cheney might seek to amend his proposal later this year "as events
change."
(R. Jeffrey Smith, Washington Post, A10)
-more-
Friday, March 30, 1990 -- A-4
NUNN, MILITARY DISCUSS TERRORISM THREAT
The chairman of the Senate Armed Services Committee said Thursday
he has met with U.S. military leaders over concerns that Soviet dissidents
might spark a nuclear crisis involving the U.S.
Sen. Nunn
called for the Soviet government to join with the U.S. in
separate but parallel "top to bottom" reviews of nuclear-weapons control
and fail-safe procedures.
In a speech on the Senate floor, Nunn said he met with Gen. Colin
Powell
and the service chiefs on this issue. He said he looked forward
to working with Secretary Cheney and Gen. Powell "as we pursue this
matter further."
"The Senate Armed Services Committee plans to review this area in
the months ahead,' he said.
(Peter Almond, Washington Times, A4)
U.S. INTELLIGENCE AGENCIES REPORTEDLY
STEPPING UP SOVIET OPERATIONS
Attracted by espionage opportunities offered by the opening of Soviet
society and fearful that the Soviet Union may be moving into a period of
chaos, the U.S. intelligence community is reportedly pushing to step up
its intelligence-gathering operations in the Soviet Union.
Despite the immense improvement in U.S.-Soviet relations, the
proposed expansion of espionage operations has aroused little opposition
within policy circles, according to a senior U.S. specialist on Soviet
affairs.
But a proposal to increase intelligence operations in some of the newly
independent countries of Eastern Europe is causing more concern
Some senior CIA officials involved in both clandestine operations and
analysis continues to be deeply skeptical about Gorbachev's chances of
survival about his motives, and about his country's future
And
they
are markedly less convinced than some of their political masters that
Gorbachev has converted in some fashion to democratic ideals
Supporters of the idea of stepping up operations in Eastern European
countries
argue that the KGB will be doing the same
Opponents of stepping up U.S. espionage in Eastern Europe are
reportedly unhappy at the direction of the operations and their capacity
to backfire. One source conversant with the debate said that intelligence
professionals want to penetrate not only the military and police, but also
the new political parties taking shape in the region. The potential for a
blunder -- and for embarrassing a new ally like President Havel -- is too
great to justify the risks, this source maintains.
(Paul Quinn-Judge, Boston Globe)
NATO BEGINS TALKS ON REDUCING SHORT-RANGE FORCES
NATO has quietly begun preparations for unprecedented arms talks
leading to a sharp reduction in short-range nuclear missiles, including the
controversial Lance weapon, Bush Administration officials and Western
diplomats disclosed Thursday.
The plans reflect tacit recognition that negotiations on politically
sensitive SNF will begin far sooner than envisioned last May
They also appear to further reduce the already slim chances that
NATO will field a modernized version of the aging Lance missile
"It's prudent to be dealing with all these issues," said a State
Department official, confirming that discussions about such negotiations
have picked up in the past month (Warren Strobel, Washington Times, A9)
-more-
Friday, March 30, 1990 -- A-5
W. GERMAN CHANCELLOR CALLS ON POLES
TO ADMIT HARM DONE TO GERMANS
CAMBRIDGE -- Chancellor Kohl on Thursday called on Poland to
acknowledge that it inflicted "an injustice" on innocent Germans who came
under Polish rule after World War II.
Kohl quickly added that there was no obligation to apologize to his
country, saying, "We Germans are not entitled to such words, and even
less must we try to balance accounts in one way or another."
But he indicated such a gesture would be appreciated in his speech
at a dinner with Prime Minister Thatcher.
(AP)
GAO SAYS 1986 LAW LED TO HIRING DISCRIMINATION
AGAINST HISPANICS, ETHNICS
The GAO rekindled a heated congressional debate over illegal
immigration by reporting Thursday that a landmark 1986 law designed to
stop the flow of illegal immigrants has caused "widespread" hiring
discrimination against Hispanics, Asian-Americans and other ethnic
minorities.
One of the key provisions of the Immigration Reform and Control Act
made employers subject to fines and potential criminal sentences if they
were found to have hired illegal aliens. In order to avoid those penalties,
an estimated 19 percent of 9,400 employers surveyed by GAO had engaged
in discriminatory hiring practices, including refusing to hire any job
applicants who had a "foreign appearance or accent" or in some cases not
hiring anyone who was not a U.S. citizen, the GAO report stated.
A group of Hispanic and Asian members of Congress who had voted
for the 1986 law said the GAO findings confirmed their worst fears about
the provision. They vowed to mount an immediate effort to rescind the
employer-sanctions provision. But Immigration and Naturalization
Commissioner Gene McNary flatly rejected such a move and said the
government should instead "explore" an improved verification system for
workers, including a universal worker-identification card.
(Michael Isikoff, Washington Post, A11)
OAS MAY SEEK $139 MILLION FOR CONTRAS
Funds Would Be Used To Resettle
8,000 Guerrillas, 12,000 Dependents
The Organization of American States has estimated it will need almost
$139 million to pay for its share of the costs of resettling 8,000 contra
guerrillas and their 12,000 dependents from exile camps in Honduras to
their homes in neighboring Nicaragua.
The preliminary estimate was given to the Bush Administration this
week
The presidents called for the OAS and the U.N. jointly to run the
International Commission for Support and Verification to facilitate the
voluntary demobilization, repatriation and reintegration of the contra
resistance to Nicaragua's Sandinista government
Funding for the U.S. and OAS programs is expected to come
primarily from the U.S
U.N. officials have not yet estimated their
share of the costs.
(John Goshko, Washington Post, A18)
-more-
Friday, March 30, 1990 -- A-6
CONTRAS BEGIN RETURNING TO NICARAGUA
TEGUCIGALPA -- Several Nicaraguan rebels in Honduras have already
begun returning to their homeland, moving before official arrangements are
made for their repatriation, officials said.
"We are aware that there has been some filtration of some members of
the Nicaraguan resistance," U.S. Ambassador Crescencio Arcos said
Thursday
"It is said they are starting to return to those security zones," Arcos
said
A contra spokesman in Honduras said some contras at Yamales, near
the Nicaraguan border, have been returning voluntarily to Nicaragua with
their families since the [election]. He said their return was not arranged
by the contra leadership.
(Vilma Rosales, UPI)
SANDINISTAS COULD REMAIN AT TOP OF ARMY
MANAGUA -- President-elect Chamorro may offer Defense Minister
Humberto Ortega, brother of President Daniel Ortega, the post of army
chief of staff if he resigns his Sandinista party posts, a Chamorro
spokesman said.
"If Humberto Ortega resigns from his party posts, he would have the
option of being chief of staff or any other post in the military structure,"
Luis Sanchez, a member of Chamorro's transition team and spokesman for
her UNO coalition, said Thursday.
"But the president-elect has the final decision," he said.
(Douglas Tweedale, UPI)
LATIN AMERICAN ENVOYS WORRIED
BY WORSENING U.S.-CUBA RELATIONS
MEXICO CITY -- Foreign Ministers from seven Latin American nations
said Thursday they were concerned that worsening relations between Cuba
and the U.S. had put the entire region at risk.
Growing tension between the two countries "not only affect relations
and peace between Cuba and the U.S. -- countries that we have positive
relations with -- but they also could have damaging effects in the
Caribbean and in hemispheric relations," Venezuelan Foreign Minister
Reynaldao Figueredo said
Julio Londono, Colombia's foreign minister, said the situation between
the two ideologically-opposed countries was "critical" and would be
carefully examined during the two-day ministerial meeting.
(Reuter)
U.S. REJECTS CUBAN CLAIMS TV MARTI VIOLATES INTERNATIONAL LAW
U.N. -- The U.S. Thursday rejected Cuba's claims that test
broadcasts to Cuba by the U.S.-funded station TV Marti violated
international law and said they posed no threat to the island's sovereignty.
"The test broadcasts have been carried out in a manner consistent
with the conventions of the International Telecommunications Union and the
International Frequency Regulation Board," the U.S. U.N. mission said in
a press statement.
(Reuter)
-more-
Friday, March 30, 1990 -- A-7
DIFFICULTIES SEEN FOR U.S.-MEXICAN FREE TRADE AGREEMENT
AUSTIN, Tex. -- President Bush is committed to obtaining a
U.S.-Mexico free-trade agreement but it will not come easily, a U.S.
Commerce official said Thursday.
"It's something that everybody realizes is not going to be without
great difficulty," Deputy Undersecretary of Commerce Robert Wallace said
during a seminar on trade and investment held during the opening session
of a two-day J.S.-Mexican border governors' conference.
Wallace said that "President Bush is firmly on record as favoring a
North American free-trade area." But he said it took at least four tries
before such an agreement was negotiated with Canada and an accord with
Mexico is clearly not expected anytime soon.
(Reuter)
OPENING OF MEXICO TO INVESTMENT BY FOREIGNERS
HAILED AT CONFERENCE
AUSTIN, Tex. -- The opening of Mexico to foreign investment has
come about quickly and on a large scale -- but is being eclipsed by
developments in Eastern Europe, speakers at the Border Governor's
Conference said Thursday.
"We're living in a unique place at a unique time in history," said
Donald Hagans, chairman of the Texas-Mexico Authority
"The only
thing that worries me is that it's not known around the world."
Participants at a discussion of trade and investment opportunities
spoke glowingly of Mexico's ability to charge ahead with significant
changes in deregulation, privatization and opening the country to foreign
investors
Oscar de Leon Montemayor, a representative of the Mexican
government from Tamaulipas, said that his country's trade barriers fell
before the Berlin Wall was being torn down
The difficulty now, he
said, is that there is still a need to send goods abroad but most Mexican
producers do not know how to exportMaggie Rivers, Dallas Morning News)
HONDURAS TO GET $147 MILLION IN U.S. ECONOMIC AID
TEGUCIGALPA -- Honduras will receive $147 million in U.S. economic
aid to address problems in its balance of payments and to buy corn and
wheat, a presidential spokesman said Thursday.
"The most important of the agreements signed is for a donation of
economic aid worth $120 million to support Honduras' balance of payments,"
spokesman Nahun Valladares said.
(UPI)
IRAQ SAID TO BUILD LAUNCHERS FOR ITS 400-MILE MISSILES
Iraq has constructed for the first time launchers for missiles within
range of Tel Aviv and Damascus, according to classified American
intelligence reports. While the weapons could be used for offensive
purposes, American intelligence experts believe that the missiles are
intended in part to discourage any possible Israeli attack in Iraqi nuclear
or chemical weapon installations
The construction of the missile launchers in Western Iraq, which has
provoked concern among senior Administration officials, was described in a
classified CIA report prepared early this month
"By building fixed launchers, they want everyone to know that the
launchers are there," said a senior Administration official.
(Michael Gordon, New York Times, A6)
-more-
Friday, March 30, 1990 -- A-8
U.S. INDICTS FIVE IN IRAQI SMUGGLING PLOT
Four Iraqis and the export manager of a London-based front company
were accused in a federal indictment unsealed in San Diego Thursday of
conspiring to smuggle 40 nuclear warhead detonation capacitators into Iraq
from the United States.
The devices were shipped from Los Angles to London last week, but
officials said they were in "government custody" all the way
The 38-page indictment recounts a plot by the government of Iraq to
obtain the
capacitators from a California company
The Iraqi News Agency quoted a Foreign Ministry spokesman as
denouncing the arrests as part of an anti-Iraqi campaign on the part of
the British government, news media, and "Zionists."
(George Lardner, Washington Post, A6)
REPORT: BROTHER OF IRANIAN PRESIDENT
WAS IN LEBANON FOR HOSTAGES
BEIRUT -- The brother of Iranian President Rafsanjani secretly
visited Lebanon a few days ago in an effort to negotiate the release of 18
Western hostages, the daily Ad-Diyara newspaper reported Thursday.
The newspaper, which has close links with the Syrians, said Mahmoud
Rafsanjani held clandestine talks with leaders of the Iranian-inspired
Hezbollah group, the organization believed to be holding the foreign
captives.
(UPI)
CORRESPONDENTS DINNER/PRESIDENT
President Bush joked to an audience of radio and television
correspondents Thursday night that he got even with the Iranians for a
phony phone call from President Rafsanjani.
"Your broadcasts hit me pretty hard a while back about a guy
claiming to be Rafsanjani -- a little confusion with the phone call," Bush
told the broadcasters.
"Today I got him back. Called him up and asked if he had Prince
Abdul in a can," said Bush to laughter from the crowd of more than
2,000. "But then I forgot how to say, "Let him out,' in Farsi."
(AP)
CHINA'S CHIEF JUSTICE DEFENDS COURTS
AGAINST FOREIGN 'SLANDER'
BEIJING -- China's chief justice, in language reminiscent of the
radical Maoist past, lashed out Thursday at "class enemies" and foreign
critics of the country's legal system, declaring that "Western hegemonists"
had "viciously slandered" Chinese courts.
Ren Jianxin, president of the Supreme People's Court, scoffed at
allegations by Western governments and human-rights organizations that
China had engaged in secret interrogations, trials, sentencing and other
civil-rights abuses and labeled such charges "deliberate fabrications and
absolutely groundless."
In his speech Thursday, Ren acknowledged total party control over
the judicial system and instructed courts to maintain their role as
instruments of the "people's democratic dictatorship."
"The rhetoric makes it sound like they've gone back to the Cultural
Revolution, but they can't go all the way back," said one Western legal
expert here of Ren's remarks. (Daniel Southerland, Washington Post, A20)
-more-
Friday, March 30, 1990 -- A-9
TOKYO STOCKS PLUNGE MORE THAN 3 PERCENT, DOLLAR CLIMBS
TOKYO -- The dollar ended a roller-coaster session firmer while stock
prices plunged more than 3 percent on the Tokyo Stock Exchange
Friday
"Spirits are very low with no bottom immediately in sight," said a
trader at a Japanese brokerage.
(Susan Moran, Reuter)
EDITOR'S NOTES: "Iraq's Ability To Build Bomb Becomes An Issue," by
John Fialka, appears in The Wall Street Journal, page A18.
"Syrians Fire On Shi'ite Leader," by Farouk Nassar, appears in The
Washington Times, page A1.
"Emergency Food Reaches Ethiopian Drought Victims," by Caryle Murphy,
appears in The Washington Post, page A1.
###
NATIONAL NEWS
HOUSING INVESTIGATION
The Department of Housing and Urban Development's inspector
general is investigating three no-bid contracts awarded by a new
government agency at the center of a power struggle involving Secretary
Kemp's top aides,a department source said Thursday night.
Inspector General Paul Adams, in a preliminary report to Kemp, said
the contracts may have been issued in violation of government procedures,
according to the sources, who spoke on condition of anonymity.
The source said Kemp raised the issue during a lengthy meeting
Thursday with Mary Bush, his hand-picked choice to lead the new Federal
Housing Finance Board
That meeting was arranged soon after a behind-the-scenes effort by
Kemp aides to gain control over the agency became public
Joseph Slyle, a spokesman for the housing board, confirmed that
Adams had visited the agency earlier this week and taken several contract
files. He said Mary Bush had asked the board's inspector general to look
into the contracts after department officials raised questions about them
last week.
(AP)
S&L DIRECTOR/SENATE
President Bush's nominee for top savings and loan regulator appears
headed for defeat in the Senate Banking Committee, the committee chairman
said Thursday evening
Sen. Riegle, after caucusing with Democrats on his committee for
several hours and consulting the senior Republican, Sen. Garn, said in a
Senate speech he did not believe Ryan would win the committee's
endorsement.
"My sense of the canvass of the votes would be -- and it's not
complete, I have not talked with every member directly -- but I think
that, based on the vote count that I have, that there are not the votes to
confirm this nomination," Riegle said.
Riegle scheduled a vote Friday.
(AP)
BUSH IN AIDS VICTIMS PLEA
President Bush Thursday appealed for compassion for AIDS victims,
declaring they should not be fired, evicted, denied health insurance or
blamed for their disease.
"We're in a fight against a disease, not a fight against people,¹ Bush
said in unusually personal remarks that represented a dramatic reversal in
tone from the Reagan Administration. "We won't tolerate discrimination."
"We don't spurn the accident victim who didn't wear a seat belt,"
Bush said. "We don't reject the cancer patient who didn't quit smoking.
We try to love them and care for them and comfort them. We do not fire
them, or evict them or cancel their insurance."
In his first major speech on the AIDS crisis, Bush revealed that he
watched friends die of AIDS and said, "There is only one way to deal with
an individual who is sick. With dignity, compassion, care, confidentiality
and without discrimination." (Maureen Santini, New York Daily News, 2)
-more-
Friday, March 30, 1990 -- A-11
President Calls For End To AIDS Discrimination
In his first major speech on the AIDS epidemic, President Bush
Thursday called for an end to discrimination against those infected with
the virus and praised his Administration's efforts to combat the disease.
Bush's long-awaited remarks represented the strongest public
commitment ever given by the White House to fighting the epidemic. But
many AIDS activists, including two hecklers, criticized the content of
Bush's address as too timid a response to the severity of the AIDS crisis.
The hecklers disrupted the speech with shouts of "Too little, too late" and
"Why did it take you 14 months to say this?"
"He has shown sensitivity and concern that we have yet to witness
from the office," said Jean McQuire, executive director of the AIDS Action
Council. "But a decade of neglect requires more aggressive leadership
than we have seen today.'
Bush's remarks were delivered to the National Leadership Commission
on AIDS
Before a crowd of 500, the President cited the
"unprecedented" $3.5 billion budgeted for fighting AIDS this year, praised
the "American pioneers" at the National Institutes of Health researching
the disease and urged Congress to pass the Americans with Disabilities Act
which includes a prohibition on discrimination against people with AIDS.
(Malcolm Gladwell, Washington Post, A4)
Bush Calls For Compassion, And Cure, For AIDS Victims
President Bush Thursday called on Americans to demonstrate
compassion for people with AIDS and urged the House to approve
legislation that would protect them from discrimination.
In a speech that was unusually personal for Bush, he said that he
and his wife, Barbara, "have had friends who have died from AIDS. Our
love for them when they were sick and when they died was just as great
and just as intense as for anyone lost to heart disease or cancer or
accidents."
Bush's comments were praised by Dr. June Osborn, chairman of the
National Commission on AIDS, who said: "We've been desperately needing
this leadership from the top. The most critical area has been the need to
get Americans to be more compassionate and understanding."
However, Jean McGuire, executive director of the AIDS Action
Council, called Bush's speech "long on compassion but short on
commitment."
(Marjorie Cimons, Los Angeles Times, A1)
Bush Says U.S. At War With AIDS
ARLINGTON, Va. -- In his first major address on AIDS, President
Bush on Thursday pledged a compassionate response to AIDS patients and
called on Congress to enact a landmark anti-discrimination bill.
Speaking to the National Business Leadership Conference on AIDS,
Bush declared that the country is on a "wartime footing" in the fight
against the epidemic
"We're in a fight against a disease, not a fight against people," Bush
told about 500 business and health executives. "And we won't tolerate
discrimination."
Although the President called for passage of the Americans with
Disabilities Act, Bush was criticized by AIDS activists for not specifically
naming ways his Administration could fight the epidemic.
(Catalina Camia, Dallas Morning News)
-more-
Friday, March 30, 1990 -- A-12
Bush Urges House To Pass Anti-Discrimination Bill In First AIDS Speech
ARLINGTON, Va. -- In his first policy speech on the nation's
nine-year-old AIDS epidemic, President Bush called on the House Thursday
to pass a long-pending proposal to ban discrimination against people
infected with the AIDS virus.
"We will not and we must not in America tolerate discrimination,"
Bush told the National Leadership Coalition on AIDS, a business group.
"In this nation, there is only one way to deal with an individual who
is sick; with dignity, compassion, care, confidentiality and without
discrimination," he said, drawing applause from the 400 corporate leaders
who had been invited.
(Richard Knox, Boston Globe)
AIDS Activists Laud Tone, Blast Content Of Bush Speech
SAN FRANCISCO -- AIDS activists reacted warmly Thursday to the
compassionate tone of President Bush's first major speech on AIDS, but
said he needed to back up the kind words with stronger action and more
money.
"I was certainly pleased by his expression of compassion and
sensitivity, which I felt was sincere," said Mervyn Silverman
San
Francisco's former health director. "However, more important was what
wasn't said. He didn't talk about increased funding for care."
Activists faulted Bush for sidestepping any discussion of immigration
policies that restrict entry to the country by people who test HIV-positive.
"It's one thing for Bush to support protection from discrimination
for people with AIDS; we commend him for that," said Eric Rofes,
executive director of the Shanti Project, and AIDS services organization in
San Francisco. "But it is a contradiction to continue to support a system
that discriminates against HIV-positive people in travel."
(Brian Rooney, UPI)
CDC FINDS NO LINKAGE OF AGENT ORANGE, CANCER
But Lymphoma Rate Is Higher Among Vets
Vietnam veterans have a 50 percent higher risk than other men in
their age group of developing non-Hodgkin's lymphoma, a rare cancer of
the immune-system, but the increased risk does not appear to be related
to Agent Orange exposure, according to a government report released
Thursday.
The five-year study by the federal Centers for Disease Control is the
final study in a decade of congressionally mandated research on the toxic
herbicide
Shortly after the CDC study was released, Secretary Derwinski
announced that he was ordering disability payments to an estimated 1,6000
to 1,800 Vietnam veterans believed to have contracted non-Hodgkin's
lymphoma.
The action was approved by President Bush Thursday
morning.
"Remember, this is a kinder, gentler Administration," Derwinski said.
"So our assumptions are more liberal."
(Susan Okie & Bill McAllister, Washington Post, A3)
-more-
Friday, March 30, 1990 -- A-13
Vets Win Ruling On Defoliant
A ruling that Vietnam veterans with a rare cancer are entitled to
disability payments may be the first step to linking Agent Orange to other
diseases.
"It's a start, but we're going to continue fighting," says John Kahler
of Michigan's Vietnam Veterans of America.
Secretary Derwinski, after consulting with President Bush, gave
Vietnam vets "the benefit of the doubt" Thursday, ordering $20 million a
year in payments to 1,800 vets with non-Hodgkin's lymphoma
Derwinski says he hopes the ruling will help "mend the divisiveness
and controversy" on the Agent Orange issue
But vets were disappointed a CDC study said there's "no evidence"
Agent Orange
caused the cancer.
(Judy Keen, USA Today, 1A)
VETO GAUNTLET THROWN BY BUSH
Despite his repeated pledges of cooperation with Congress, President
Bush issued an unusual blanket veto threat Thursday to congressional
Democratic leaders who fiddle with his legislative programs.
"Sometimes you have to draw the line," said Presidential spokesman
Fitzwater.
The White House leveled its veto threat as Congress was considering
four legislative packages that Bush has complained are being ravaged by
Democratic changes.
Calling the new veto strategy a "positive approach to the legislative
process," Fitzwater said, "The veto threat in this strategy is a way of
achieving that compromise and achieving a legislative package."
(Paul Bedard, Washington Times, A1)
$30 BILLION CHILD-CARE BILL PASSES HOUSE; VETO THREATENED
The House Thursday ignored threats of a White House veto and
approved child-care legislation costing nearly $30 billion that would create
new school programs for "latchkey" children, set up a system of vouchers
for parents and provide income tax credits for low-income families.
The bill now goes to a conference committee with the Senate, which
passed a similar bill even less to the liking of the Bush Administration.
The
Senate bill has a much more modest tax credit plan and would
require the states to follow federal standards for day-care centers
Marian Wright Edelman, president of the Children's Defense Fund and
a primary force behind the child-care legislation, said the House vote
takes the nation a "significant step closer to providing the relief families
so urgently need."
(Frank Swoboda, Washington Post, A1)
Democrats Tempt Veto With Ambitious Child Care Plan
House Democrats are tempting a Presidential veto by rejecting the
White House version of a child-care bill in favor of their own more costly
and ambitious plan
"Rather than waving his veto pen, our President should match his
warm words with good deeds and agree to sign our child-care bill," Rep.
Gephardt said after the vote
"I think President Bush, as he examines the bill, will find a lot more
to be comfortable with than not," said a sponsor, Rep. Downey.
(William Welch, AP)
-more-
Friday, March 30, 1990 -- A-14
House Passes Landmark Child-Care Bill; Deal With Senate Expected Soon
The House Thursday night passed a $27 billion child-care package
that supporters labeled the most significant social legislation since
President Johnson's Great Society measures 25 years ago
The measure was supported by 218 Democrats and 47 Republicans
Rep. Gingrich said Bush will veto the legislation. Democrats
seemed eager to challenge the President to reject the popular legislation
and make it a burden for the Republicans in the coming elections.
"This is a great victory for America's families, for America's
children," said Speaker Foley after the vote
"Rep. Downey issued a challenge to Bush, saying, "Obviously the
kids won today, and we've provided a little electricity for the 'thousand
points of light."
(Michael Frisby, Boston Globe)
AID REJECTED FOR MINERS HURT BY ACID RAIN CURB
Senate Vote Is A Rare Rebuff For Byrd
After intense, last-minute pressure from Senate leaders and the Bush
Administration, the Senate narrowly rejected an amendment to the clean air
bill that would have established a $500 million relief program for coal
miners in Appalachia and the Midwest who lose their jobs because of acid
rain controls.
The 50 to 49 vote was a rare defeat for Sen. Byrd
who engaged in
an impassioned campaign to give the miners special benefits that would
have amounted to three times the level of normal unemployment
compensation
Defeat of the amendment removes the last major obstacle to passage of
the compromise clean air bill
The Senate is scheduled to vote on the
bill at 8 p.m. Tuesday.
(Michael Weisskopf, Washington Post, A1)
Senate Apparently Prepared To Pass Clean Air Bill By Rejecting
Amendment
In a dramatic vote that appears to clear the way for Senate passage
of the clean air bill, the Senate rejected Thursday by the narrowest of
margins an amendment that would have provided $500 million to coal miners
who lost jobs as a result of controls on acid rain.
The proposal by Sen. Byrd lost, 50 to 49, after several senators
switched their votes, and President Bush called nine senators to warn
them he would veto the entire clean air bill if the amendment passed.
"They peeled off three of my votes," Byrd said, referring to the
White House
Chief of Staff Sununu told Sen. Biden that the President would
"absolutely" veto the bill if the Byrd amendment was passed, Biden said.
Biden said that after talking to Sununu, he decided to vote against the
amendment because "I wasn't prepared to take a chance that the White
House wasn't telling the truth" about the veto threat.
(Michael Kranish, Boston Globe)
-more-
Friday, March 30, 1990 -- A-15
SENATE APPROVES SHIFT TO CLEANER AIR FUELS
The U.S. Senate Thursday adopted an amendment to the proposed
new Clean Air Act that will require the widespread use of cleaner-burning
reformulated gasoline, despite threats that it will lead to a veto by
President Bush.
Backed by a coalition of farm state senators, led by Sen. Dole, and
environmentalists, the Senate rejected 69 to 30 an attempt to block the
amendment, which is seen as a boon for corn growing farmers.
The amendment requires that reformulated gasoline be sold starting in
1992 in the nine major metropolitan areas with the worst pollution
problems
Oil state senators warned that the proposal would cost refiners up to
$50 billion to comply with and would force motorists to pay an extra 20 or
30 cents a gallon. "It is clearly a 'buy more corn' bill," protested Sen.
Breaux. "It is clearly a deal breaker."
(Robert Kearns, Reuter)
PANEL VOTES TO INDEX CROP SUBSIDY RATES
A House panel voted Thursday to "index" crop subsidy rates --
which could boost the cost of the farm program by 10 percent -- but tried
to direct the benefits to family-sized farms.
Deputy Agriculture Undersecretary John Campbell warned "huge"
changes would have to be made in other parts of the farm program if it
was going to meet budget limits.
There were no indications the House Budget Committee would order
the Agriculture Committee to reduce farm spending by $900 million below
this year's level, estimated at $10.2 billion.
(Charles Abbott, UPI)
NASA SATELLITES FIND NO SIGN OF 'GREENHOUSE' WARMING
Satellites taking the most precise global temperature measurements
ever have found no evidence of global warming from the "greenhouse
effect" during the last decade, according to NASA.
The data, collected from 1979 through 1988 by the TIROS-N series of
weather satellites, proved that the Earth's temperature can be measured
accurately by instruments probing the atmosphere from space, two
scientists say in a paper to be published today in Science
"We found that the Earth's atmosphere goes through fairly large
year-to-year changes in temperature and over that 10-year period we saw
no long-term warming or cooling trend," said Roy Spencer of the Marshall
Space Flight Center in Huntsville, Ala., study co-author.
But co-author John Christy, a climate research scientist at the
University of Alabama, cautioned against misues of the findings. "About
the long-term global warming it does not say anything," he said.
(Ronald Taylor, Washington Times, A1)
-more-
Friday, March 30, 1990 -- A-16
LIQUIDATION OF EASTERN PROPOSED
Creditors Tell Judge Airline Should Close
After a year of supporting Frank Lorenzo's efforts to rebuild Eastern
Airlines, the airline's creditors have told a federal bankruptcy judge they
want to shut down the company and sell its planes, routes and leases.
Eastern's unsecured creditors met with U.S. Bankruptcy Judge
Burton Lifland Wednesday afternoon in a closed-door session and said they
will oppose using the proceeds of asset sales to keep the airline operating.
Eastern attorney Bruce Zirinsky said Thursday he believes the
creditors' stance is a negotiating position. He said he is confident that
the airline and its creditors will be able to work out an agreement that
avoids liquidation
If Eastern were liquidated, the Transportation Department might take
the position that the route authority it had previously granted to Eastern
would revert to the public domain and could not be sold.
(Martha Hamilton, Washington Post, A1)
NEA ON THE OFFENSE
Chairman Assails Arts Agency Critics
Bolstered by President Bush's statement of support last week,
National Endowment for the Arts Chairman Frohnmayer went on the
offensive again Thursday, rebutting criticisms of his agency before
friendly audiences on the Hill and at the National Press Club.
Frohnmayer said in a luncheon speech at the press club that in
order to fund [international artistic projects] adequately as well as support
struggling artistic organizations, the endowment would require an increase
in budget from the current $170 million to $300 million.
"The arts teach self-respect," Frohnmayer told the Senate
subcommittee that will write reauthorization legislation for the agency.
"They teach empowerment, that every person has worth
The arts
teach family values, which is why I think it's so ironic that some of the
attackers of the endowment would strongly promote family values.
Later at the press club, Frohnmayer assailed his agency's critics,
including the conservative American Family Association.
(Elizabeth Kastor, Washington Post, B1)
EDITOR'S NOTE: "Business Leaders Call For More U.S. AIDS Funds," by
Victor Zonana, appears in The Los Angeles Times page A24.
-End of A-Section-
NETWORK NEWS
AIDS ADDRESS
ABC's Peter Jennings: President Bush has made a major speech on the
subject of AIDS. Ronald Reagan never made one, SO many Americans
who wanted to hear from the White House on the subject of such
importance have had to wait a long time. President Bush said today
that America will wage a wartime effort to find a cure, and the
discrimination against people with AIDS will not be tolerated. This is
a fight against disease, he said, not against people. To all
concerned, it was an eloquent speech; to many affected, it was still
short on substance.
ABC's Brit Hume:
(Protesters, chanting: "Eight thousand dead from AIDS, where was
George?")
Even before the President arrived, it was clear that the AIDS
activists gathered outside would not be satisfied -- not with the
Administration's 18% overall increase in spending on AIDS and not
with the President's speech. It was a highly personal address in
which Mr. Bush grew emotional after recalling the death of his own
infant daughter from leukemia and the death of a friend from AIDS.
(President: "There is only one way to deal with an individual who is
sick: with dignity, with compassion, care and confidentiality, and
without discrimination.")
The President was interrupted several times by applause, but also by
this:
(Heckler: "Watching the situation for 14 months, you haven't said
the A-word yet. Say the A-word, Mr. President.")
(President: "And I hope, if we do nothing else by coming here, I
can help them understand that not only do you care, but we care
too.")
Earlier the President met in the Oval Office with members of the
government's AIDS commission, including Bush appointee Dr. David
Rogers.
(Still photo of President meeting with AIDS commission.)
Later Rogers applauded the speech but was blunt about one point:
money
(Rogers: "I would say it's not enough."
Administration officials don't claim that what they've budgeted to fight
AIDS next year is enough, but they do say an 18% increase is a lot.
After all, some Administration priorities, including education, are
getting almost no increase at all.
(ABC-Lead)
NBC's Tom Brokaw: President Bush today urged Americans to open their
hearts to victims of AIDS and to end irrational fears of the deadly
diseases. It was the President's first major speech on the subject
and some in the audience criticized it as being too little, too late.
Bush wants to spend $3.5 billion to fight AIDS and he pleaded for
other help for AIDS patients.
(President: "There is only one way to deal with an individual who is
sick: with dignity, with compassion, care and confidentiality, and
without discrimination.")
(NBC-10)
-more-
Friday, March 30, 1990 -- B-2
CBS's Dan Rather: President Bush delivered his first major speech on
AIDS today. He called for compassion, education and no
discrimination against people infected by the AIDS virus. Mr. Bush
presented no new policy initiatives.
(TV coverage of President giving the address.)
AIDS activists, including some who heckled the speech, said the
federal government still has not committed enough resources and
complained that U.S. immigration laws discriminate against people with
AIDS.
(CBS-13)
AIDS/URBAN HOSPITALS
NBC's Robert Bazell highlights the worsening health care crisis in big city
hospitals by profiling one hospital in New York City. AIDS patients
are swamping the hospital, placing added stress on staff and making
access to health care for other medical problems more difficult to
attain.
(NBC-11)
CHILD CARE
Rather: The House is voting tonight for long-stalled legislation on day
care for America's children. It's a version that President Bush has
threatened to veto. This follows months of partisan political
wrangling and campaign promises to do something about the day care
nightmare faced by millions of working American parents.
CBS's Bob Schieffer reports on the $27 billion Democratic plan. It is
a complicated and very expensive solution to what has become a
simple but growing problem in modern America. Schieffer describes
the provisions of the bill. All sides have agreed for years that
something had to be done, but even today what to do left Congress
mired in battles over turf, ideology and cost.
(Rep. Frenzel: "What a weird, tortured way of taking care of
children by giving them an I.O.U. for nearly $30 billion.")
(Rep. Frost: "Unfortunately the world of June Cleaver and Margaret
Anderson no longer exists.")
(Rep. Gunderson: "There are 41 pages of federal standards
")
Republicans said Democratic efforts to set up quality and safety
standards for day care would result in a huge new federal
bureaucracy and they belittled Democratic misgivings about using
federal money to pay for day care centers run by churches.
(Rep. Weber: "They want the government, in essence, to set up the
child care system in this country and more or less dictate to parents
what options are going to be available to them.")
The legislation does clear the way to use some federal subsidies for
church-related day care. But still to be worked out are major
differences with a bill passed by the Senate last summer. And after
that comes the big question: Will the President veto the whole thing,
saying it's too expensive? As yet, no one knows the answer to that.
(CBS-Lead)
Brokaw: Despite a veto threat by President Bush, the House tonight
defeated a Republican child care bill and approved a more expensive
Democratic plan. Whatever the final outcome, however, the way
Americans take care of their children now will change.
-more-
Friday, March 30, 1990 -- B-3
NBC's Andrea Mitchell reports action in Congress will result in
Americans getting more government help for their children's care.
Mitchell describes the Democratic plan. But all of this would cost a
lot of money: $27 billion over five years. Republicans oppose adding
benefits for middle-class families, saying that adds to the deficit.
(Rep. Frenzel: "What a weird, tortured way of taking care of
children by giving them an I.O.U. for nearly $30 billion.")
(Rep. Downey: "You wash your hands of the middle class. We do
not. We recognize the five to ten million children who will need
after-school care and we care for them.")
Despite objections from those who want a strict separation of church
and state, both Democrats and Republicans agree that parents can
use vouchers for church-sponsored child care. President Bush is
threatening a veto, saying the proposal costs too much. Democrats
are betting that when it gets to his desk, the President won't want to
kill such a popular program.
(NBC-8)
CLEAN AIR/SENATE
Brokaw: There was a key test in the Senate today on legislation to clean
this country's air. An amendment by Sen. Byrd calling for hundreds
of millions in aid for coal miners who might lose their jobs because of
tougher pollution controls. After five hours of intense debate the
amendment was defeated 50-49. The White House was pleased, saying
it would have set a bad precedent.
(NBC-7)
Jennings: The last major challenge to Senate passage of the Clean Air Act
has been defeated. By a vote of only 50-49, the Senate today
rejected an amendment by West Virginia's Robert Byrd that would
have made available millions of dollars to coal miners and others who
he says may lose their jobs because of tougher clean air standards.
The Senate is expected to vote on the entire clean air bill next week.
(ABC-3)
Rather: Action in the U.S. Senate today on an amendment to the clean
air bill. By one vote President Bush got his way: the Senate
rejected an assistance plan for coal miners who might lose their jobs
because of anti-pollution rules.
(CBS-2)
GLOBAL WARMING STUDY
Rather: NASA scientists threw some cold water tonight on the theory that
the earth is undergoing a potentially catastrophic warming trend
triggered by air pollution. NASA says temperature measurements
taken by satellites around the world show no global warming trend
took place during the last decade.
(CBS-15)
Brokaw: For all of the alarm about global warming there's a new study
out tonight questioning whether in fact it is happening. The study
reported in the Journal of Science reviewed ten years of data from
weather satellites. While the scientists said it will be at least another
decade before they can be certain, they found no long-term warming
or cooling trend -- a conclusion that is certain to trigger even more
scientific debate on whether temperatures are in fact on the rise.
(NBC-6)
-more-
Friday, March 30, 1990 -- B-4
IRAQ/NUCLEAR TRIGGERS
Jennings: Indictments unsealed in San Diego today make it clear that
U.S. agents were aware of every detail of the alleged plot to smuggle
nuclear triggers from the U.S. to Iraq. The indictments name five
individuals and two British companies. Two of the individuals were
arrested in London yesterday, the other three are believed to be in
Iraq. The Iraqi president has denied that his government was trying
to make nuclear weapons
ABC's Walter Rodgers reports Iraqi President Hussein tried to turn
the smuggling charges around by accusing the West of trying to stop
his march of progress. In Paris the Iraqi ambassador acknowledged
his country's nuclear program, but said it was strictly for peaceful
purposes. U.S. Customs officials say the British firm Euromac,
which negotiated the purchase of the nuclear weapons triggers, is a
front for the Iraqi government. The Iraqis agreed to pay $10,000 for
14 nuclear weapon triggers, but they promised U.S. Customs
undercover agents millions in additional business if the deal went
through.
(ABC-4)
NBC's Dennis Murphy reports three of the suspects arrested were brought
to a suburban London courthouse for a 15-minute appearance. One of
the three, a French woman, was released on bail, while two men, a
Lebanese and an Iraqi, were held in custody. The French woman and
the Lebanese man were also named in a U.S. indictment unsealed
today. They are accused by American and British authorities of
trying to buy and illegally ship to Iraq triggers for a nuclear bomb.
The British government ordered a second Iraqi, who was arrested, to
be deported to Iraq. During their surveillance of the 18-month sting
operation here and in the U.S., NBC's Brian Ross and Ira Silverman
found direct evidence of the Iraqi government's involvement. NBC
News learned in the course of its investigation that three nuclear
engineers from Iraq met in this London hotel with an American
undercover agent who was part of the sting operation. The Iraqis
wanted to buy nuclear detonators. They even invited the undercover
agent to visit Iraq to see the labs where their nuclear projects are
underway. President Hussein has made it clear that he wants Iraq to
be a Mideast superpower. He has rearmed to the teeth since the
Iran-Iraq war -- a war in which he used chemical weapons on
civilians.
(NBC-Lead, CBS-6))
CHINA/MIDEAST MISSILES
Brokaw: There are new reports that the Chinese now are back to
shipping short-range ballistic missiles to the Mideast. Here in
Washington a presidential spokesman said the Administration would
question the Chinese about that, adding that it wouldn't be happy if
those reports are true.
(NBC-2)
-more-
Friday, March 30, 1990 -- B-5
RABTA FIRE
CBS's David Martin reports it now appears the Rabta fire could have been
a staged event. After studying the latest satellite photos, some U.S.
intelligence analysts say the damage to the plant appears to have
been much less than originally thought. Some of the analysts even
suspect the fire was a trick, designed to make people think Qadaffy
had been knocked out the chemical weapons business. That would be
a big change from what the Bush administration was saying two weeks
ago. In early satellite photos the plant was obscured by smoke;
photos taken later showed virtually no change in the condition of the
plant from photos taken before the fire. At the time Libyan officials
said the plant had burned to the ground. U.S. intelligence has
ordered up a new set of satellite photos in order to reach a firm
conclusion of Qadaffy's chemical plant. But for the moment it appears
reports of its death were premature.
(CBS-7)
LIBYA/FIGHTER-BOMBER REFUELING
Brokaw: The Defense Department believes that Libya has developed the
ability to refuel its fighter-bombers in midflight. That would
significantly extend the range of Col. Qadaffy's ability to make
trouble in that part of the world.
(NBC-3)
LITHUANIA
Jennings: There are indications today that Moscow may be willing to bend
a little in Lithuania. The Soviet army has offered amnesty to
Lithuanian deserters who return to their units. At the same time,
defense officials have threatened to punish those who continue to
hide. Certainly at the moment Moscow thinks it has the upper hand
in Lithuania.
ABC's Jim Laurie reports Mikhail Gorbachev is seeking to make it
clear that Moscow is very much in charge, whatever Lithuanians might
say. Gorbachev also appears to be stalling for time until he
completes a new federal law setting rules under which a republic
might gain independence. That would set the stage for prolonged
negotiations on Moscow's terms. Gorbachev has also used the national
media to rally Soviet public opinion against the Lithuanians; even
Baltic neighbors acknowledge that has been effective. But some here
worry that Gorbachev's strategy may be undermined by the Soviet
military. A senior Western diplomat expressed concern today about
the army, which seems prepared to crush the Lithuanian rebels with
whatever it takes -- a view reinforced by Marshal Sergei
Akhromeyev. "The president has his own view," said Akhromeyev,
"but as a military man I would never complain about too much
toughness." Gorbachev loyalists emphasize he's very much in charge
of the army and a Lithuanian solution lies only in negotiation. But
they also say Gorbachev will negotiate only when he's good and
ready.
(ABC-9)
Rather: A spokesman said today that President Bush talked by telephone
with British Prime Minister Thatcher, who briefed him on her own
phone conversation with Mikhail Gorbachev about Lithuania. But the
spokesman said Mr. Bush has no plans to call Gorbachev himself.
U.S. officials say Mr. Bush is determined not to put pressure on the
Soviet leader.
-more-
Friday, March 30, 1990 -- B-6
Rather continues:
Lithuania was tense again today, but there was one conciliatory
gesture made by Soviet authorities. The Soviet defense ministry said
it will not punish Lithuanian desterters from the Red Army as long as
they return to their regular army units.
(CBS-5)
SOUTH AFRICA/BLACK-ON-BLACK VIOLENCE
Rather: South Africa's most powerful black leaders, Nelson Mandela and
Zulu chief Buthelezi, today agreed to meet for the first time next
week. They'll try to calm down their followers who've been waging
full-scale war in Natal province. Twenty-five people have been killed
in black-on-black violence in the last two days and two hundred
homes burned
(CBS-8, ABC-11)
MACAU/CHINESE REFUGEES
Rather: Scores of Chinese people were trampled today in a rush to get
out of their communist homeland. Tens of thousands of Chinese
swarmed into the Portuguese colony of Macau when they heard about
a limited amnesty for illegal aliens. Most were not eligible, but they
stormed the gates of a stadium, hoping against hope to register
anyway. About 70 were injured, some with broken bones.
(CBS-9, ABC-10)
AGENT ORANGE REPORT
ABC's George Strait reports on a government study on the effects of
Agent Orange on Vietnam vets. The report concluded that Vietnam
vets were 50% more likely to lymphoma, but that there was no
evidence that the lymphoma was caused by Agent Orange.
(Dr. William Roper, CDC: "This study, you can look carefully at the
issue of cancer in Vietnam veterans, we found no link to Agent
Orange.")
Because the study showed that Vietnam vets were at increased risk
for lymphoma, the Veterans Administration today said it would pay
compensation of more than $20 million to the almost 2,000 vets with
that cancer. But that leaves 34,000 other vets who claim they've
been harmed by Agent Orange and will not be compensated. There
are bills in Congress to provide that compensation, but none is
supported by the Administration. As far as it is concerned, the
fight about Agent Orange is over.
(ABC-2, NBC-4, CBS-3)
IDAHO/ABORTION
NBC's Roger O'Neil reports pro-choice advocates are calling for a boycott
of Idaho potatoes while pro-lifers are buying every potato on the
markets' shelves. Caught in the middle is Gov. Andrus, a long-time
opponent of abortion who is nonetheless admitting for the first time
today the bill passed by the legislature last week may be too
restrictive.
(Gov. Andrus: "A person, a woman who has suffered rape, incest,
the mother's life is in danger, might not even be able to receive an
abortion and basically that's what I'm agonizing over right now.")
The potato threats escalated today, with both sides claiming to use
the spuds to support their respective positions. The governor will
make his decision on whether or not to veto the abortion bill by
Saturday night.
(NBC-9)
-more-
Friday, March 30, 1990 -- B-7
IMMIGRATION LAW/DISCRIMINATION
ABC's Kathleen DeLaski reports a GAO study says that a four-year-old
illegal aliens law has resulted in almost 20% of employers
discriminating against legal residents because they appear foreign or
have only temporary resident cards. More than 3,500 companies have
been fined in the past two years. Critics say the law has done more
harm than good.
(Rep. Richardson: "Employer sanctions has not worked. We don't
even think it's been a deterrent to illegal immigration. It is clearly
discriminatory.")
But Sen. Simpson says without the crackdown on employers the
flood gates will open again.
(Sen. Simpson: "We will say to those in the less developed world,
'Come on and make the dangerous illegal journey to our country. But
if you make it U.S. employers can't hire you'.")
Those against employer sanctions have been waiting three years for
this study; now they say they have enough ammunition to attack the
immigration law they never liked.
(ABC-5)
HAZELWOOD
CBS's Connie Chung interviews and reports on Joseph Hazelwood.
Hazelwood denies he was ever drunk, before during or after the
accident. According to Exxon, Hazelwood was fired for drinking
alcohol in a bar before boarding the Exxon Valdez, but today
Hazelwood revealed that Exxon dismissed him without ever questioning
him about what happened the night of the grounding.
(CBS-4)
ENVIRONMENT/MIGRATORY BIRDS
ABC's Linda Patilla reports each year thousands of migrating birds die,
trapped in uncovered oil pits and tanks in the Southwest. With most
of the states unwilling to act, federal wildlife agents are cracking
down. They are preparing criminal charges against more than 30
companies. Faced with the threat of prosecution and bad publicity,
most of the major oil companies have begun placing screens on their
tanks and pits, but thousands of small, independent operators say
it's too costly and maintain the problem is exaggerated. Fish and
Wildlife agents hope that fines of up to $10,000 dollars will persuade
the oil industry that it is cheaper to protect the birds than let them
die.
(ABC-7)
BLOOD THINNER RECALL/FDA
Rather: The FDA has announced an emergency recall of two lots of a
generic version of what's supposed to be a blood-thinning drug. The
blood thinner made by Phamaceutical Basics, Inc. of Denver was
mislabeled and sold as an anti-depressant. The FDA says it ordered
a class one recall, signifying a life-threatening situation. (CBS-11)
-End of B-Section-
EDITORIALS/COLUMNISTS
CHILD CARE
D-Day For Day Care -- " The [Democratic] leadership's proposal offers
the most help directly to families. It speaks directly to the issues of
targeting state block-grant money into day care, expanding Head Start
programs to full-day, full-year programs, offering before- and after-school
care, funding referral services vital to all parents, and improving
day-care standards
The Stenholm-Shaw package is far less specific in
what states would do with federal funds. It would rely more heavily on
earned-income tax credits, which are necessary to help the working poor
but which wouldn't provide a direct funding source for day care
The
Senate already has passed a good bill. So the fate of day care rests with
the House. It has the chance to help families -- both those who need
subsidies and those who do not -- find good care for their children. It
has the chance to raise the quantity and quality of that care. The House
should do so in full, not with half measures."
(Miami Herald, 3/28)
An
'F'
For
ABC
"
Congress
seems to have a choice between a bad bill
[Stenholm-Shaw] and an abominable one [Democratic leadership]. Two
parents who both earn the minimum wage, work 40 hours a week and never
do overtime would not be poor enough to qualify for the full tax credits in
either bill. Parents who earn more than $5.04 an hour would be too
wealthy to qualify for any tax credit at all. In other words, the bill
discriminates against industrious people. Moreover, and worse still,
traditional families would be penalized by a system of taxation and rewards
that drives mothers into the labor market and forces them to surrender the
nurturing of their children to state institutions. If Mr. Bush and
Congress want to help real American families, they should trash both
'child-care' bills. The real economic problem for hard-working American
parents is the huge tax bill levied on their paychecks each week to
underwrite the welfare state. Working parents aren't children, and they
need a tax cut. They don't need another government program and they
certainly don't need this one. "
(Washington Times, 3/29)
Child Care: Don't Falter Now -- " It is vital that the House approve
the compromise measure [Democratic leadership bill]. Moreover, if
President Bush is serious about defending the family values he claimed to
champion during the 1988 campaign, he should withdraw his misguided
threat to veto Congress' cost-effective ideas for helping families secure
high-quality care for their children
The 101st Congress' child-care
drive will stall unless the House sends the bill where the real action will
be: to a House-Senate conference committee that must reshape federal
child-care policy
If the House joins the Senate in a workable
child-care compromise, Congress' resolve might prod the Bush
administration to drop its unwise veto threat. America's famílies have
waited too long, and the child-care effort has come too far, for Washington
to falter now. "
(Cleveland Plain Dealer, 3/21)
-more-
Friday, March 30, 1990 -- C-2
Congress Getting Close On Child Care --
"
The White House is pushing
a coalition of conservative Democrats and Republicans to back [the
Stenholm-Shaw plan]. The bill's primary failing is that it provides less
money than the House leadership's version, particularly money aimed,
crucially, at ensuring that low-income parents have access to quality child
care. Both House bills track Senate language that dangerously provides
for child-care vouchers that parents could spend as they please, including
for church-sponsored child care that includes religious instruction. The
implications for violation of the separation of church and state are clear;
the precedent, if accepted by the U.S. Supreme Court, could open the
way to charging taxpayers for the support of private religious elementary
and high schools
Unfortunately, the House seems ready to abandon an
important provision of the Senate's legislation. The ABC bill would push
states to establish minimum standards for day-care providers. The House
is yielding to hysterical claims that red tape would keep grandparents
from babysitting. Minimum standards should be fought for in conference
committee. A national day-care policy shouldn't be limited to issues of
availability and affordability. Parents also need to know that the places
where they leave their children are safe."
(Atlanta Constitution, 3/28)
Getting Child Care Out Of Infancy -- " The House [Democratic
leadership's] bill deserves support because its enactment would finally
move the country toward putting action behind all the platitudes about
quality child care
The Stenholm-Shaw bill is supported by the White
House, but the House bill is superior because it requires states to set
quality-of-care guidelines and because it provides millions of dollars for
before- and after-school 'latchkey' programs. Admittedly, the bill is not
the last word on child care. But at least the House is moving again on an
issue important to so many working families." (Los Angeles Times, 3/29)
Compromise On Child Care --
"
Child care is an issue that demands the
attention of Congress and the White House, and the House needs to break
the logjam blocking progress on this measure. Some House conservatives
complain that the measure, with its $27 billion, five-year price tag, is too
expensive, and there probably is sympathy for that view among White
House officials. The fact is, there is time for further compromise after
the House passes its bill and goes to conference with the Senate, which
approved a child-care measure last year. That's where the real child-care
bill will be produced. But only if the House manages to break its own
stalemate and produce a bill."
(Baltimore Sun, 3/29)
A Child Care Truce -- 11 The House needs to forge enough of a
compromise this week to get the bill into a conference committee with the
Senate, from where the bill must emerge in a form acceptable to President
Bush. That task will be easier if lawmakers stick to child care and ways
to deliver money directly to working parents who need it most. The best
way is to expand the child-care tax credit and make it refundable for
people with incomes so low they don't pay income taxes."
(Minneapolis Star Tribune, 3/21)
###
FOREIGN MEDIA REACTION
IRAQ/NUCLEAR TRIGGERS
"The common factor in all third world ballistic and nuclear missile
programs is that they rely on key foreign technologies: Only six
countries are believed to be capable of manufacturing nuclear triggers
Without a parallel ban on missile proliferation, the Nuclear Proliferation
Treaty is a wholly inadequate safeguard. The West has been far to
half-hearted about interdicting the transfer of the requisite
technologies
Brilliant detective work stopped Iraq in its tracks
yesterday, but the case exposes the imperative need for more systematic
pre-emptive action.'
(Times, Britain)
"The only way forward remains a difficult one: a Middle East peace
settlement in parallel with the most determined efforts to halt nuclear
proliferation. There must now, at the very least, be an outright ban on
all other technology exports which support the industrial machine of this
dangerously destabilizing regime."
(Guardian, Britain)
"We don't know whether it was an isolated operation, but the
smuggling attempt proves that Iraq is renewing its efforts to be a nuclear
power. And it does not take extrasensory perception to know against
whom Iraqi nuclear bombs would be directed. The 1981 raid against Iraqi
nuclear facilities gave Israel nine years of respite from the nuclear
nightmare. Now it is coming back. We may not be able to mount another
raid, but the Iraqi dictator and the rest of the world ought to be made
aware that Israel will not put up with nuclear arms in the region."
(Yediot Aharonot, Israel)
"The dreadful vision of nuclear weapons in the hands of a terrorist
regime is becoming increasingly more realistic. The confiscation at
Heathrow makes evident that, meanwhile, almost everything can be had for
money
The international community has little means besides appeals
and controls
However, efforts must be continued to exert political and
economic pressure to stop this dreadful development. The latest catch in
London should be warning enough for everyone."
(Neue Osnabruecker Zeitung, West Germany)
-End of News Summary-
please Bob- See ml re: this ,E.
March 30, 1990
INFORMATION
MEMORANDUM FOR DAVID DEMAREST
CHRISS WINSTON
FROM:
EDWARD McNALLY
SUBJECT:
ODD MAN OUT ON AIDS
The New York Times put AIDS on the front page, with a
photo, and quoted directly from the President's speech something
like eight times.
Ditto with the L.A. Times -- front page, approximately
seven or eight direct quotations.
But in the principle paper in the city where the speech
was delivered, the story was buried next to a furniture ad on
page 4. And after describing the address as "long-awaited
remarks" -- the President's "first major speech on the AIDS
epidemic" -- the article included exactly one Presidential quote,
a single sentence.
Rather than tell its readers what was in this "first
major speech" -- rather than tell its readers what the "long-
awaited remarks" were all about -- and letting them make up their
own minds about the President's message -- the article balanced
its one Presidential quote with five from Presidential opponents
-- two hecklers, one AIDS activist, a business critic, and a
Congressional opponent.
Fair coverage?
Maybe worth pointing out to someone now.
Certainly worth remembering the next time they
criticize the Administration for not demonstrating Presidential
leadership by failing to focus public attention on the important
issues of the day.
letter to ed. Dave
from
A4 FRIDAY, MARCH 30, 1990
THE WASHINGTON POST
President Calls for End
"But that is exactly what the pres-
ident proposed in his budget for the
coming year. He removed all the
Emerge
money to pay for AZT and preven-
To AIDS Discrimination
tative treatments for opportunistic
infection for low-income persons
FDA Reports
not yet eligible for Medicaid. More-
over, he cut all of the money for
The Food and Drug
Strongest Statement Yet Is Criticized as Timid
service demonstration projects used
tion yesterday announce
to support home and community-
gency recall of two lots
based patient care."
By Malcolm Gladwell
ease, despite the large increase in
depressant drug desipra
"I'm glad he's taking the first
Washington Post Staff Writer
AIDS cases expected this year.
by Pharmaceutical Basi
step-kinder and gentler rhetoric,"
One corporate leader, who ad-
cause some bottles may
said Rep. Henry A. Waxman (D-
In his first major speech on the
dressed the conference immediately
blood thinner also used a
Calif.), chairman of Energy and
AIDS epidemic, President Bush
before Bush, charged that the pres-
son that could cause
Commerce subcommittee on health.
yesterday called for an end to dis-
ident had taken money away from
"But it's all lip service if he doesn't
bleeding.
crimination against those infected
programs to treat people with AIDS
follow up his promises with pro-
The agency said people
with the virus and praised his ad-
in order to support research aimed at
grams. We can keep people from
to be taking desipramin
ministration's efforts to combat the
preventing future infections.
dying if we provide preventative
the Denver-based generi
disease:
"It is not acceptable to pit those
drugs. We can keep people from
should examine their ta
Bush's long-awaited remarks.
who may be spared from AIDS in
getting infected if we provide
correct drug is lavend
were the strongest public commit-
the future against those who are
education.
But we can't do any
marked with numbers.
ment ever given by the White
already infected," said Robert Haas,
of this without paying for it, and the
neous tablets are pink a
House to fighting the epidemic. But
chairman of Levi-Straus and Co.
Bush budget doesn't do that."
with the blood drug's
many AIDS activists, including two
hecklers, criticized the content of
Bush's address as too timid a re-
sponse to the severity of the AIDS
crisis. The hecklers disrupted the
FRI. 6-MIDNIGHT, SAT. 10-9, SUI
speech with shouts of "Too little,
too late" and "Why did it take you
14 months to say this?"
"He has shown sensitivity and con-
cern that we have yet to witness
from the office," said Jean McGuire,
executive director of the AIDS Ac-
tion Council. "But a decade of neglect
requires more aggressive leadership
than we have seen today.'
This speech would have been
truly significant if it had been de-
livered six years ago," said Larry
Kessler, a member of the National
Commission on AIDS.
Bush's remarks were delivered
to the National Leadership Commis-
SURVIVED
FRIDAY
6 PM-7 PM Take (
sion on AIDS, a private-sector
group established three years ago
7 PM-8 PM Take $100 off e
to respond to the epidemic. Before
a crowd of 500, the president cited
WEEKEND
8 PM-9 PM Buy a 5-piece d
dining room and get an EX'
the "unprecedented" $3.5 billion
budgeted for fighting AIDS this
and get the night stand FRE
year, praised the "American pio-
10 PM-11 PM Get $100 off an
neers" at the National Institutes of
11 PM-MIDNIGHT Take 20%
Health researching the disease and
urged Congress to pass the Amer-
chest, dining table, whatever sin
icans with Disabilities Act, which
an EXTRA 10% off everything i
includes a prohibition on discrim-
loveseat. Get $200 off if you bu
ination against people with AIDS.
"In this nation, in this decade,
room, or take $50 off any dinet
there is only one way to deal with
FRIDAY
Register to win a
stand FREE. Or buy a set of be
an individual who is sick," Bush said.
"With dignity, compassion, care,
FREE Sweatshirt!
Stratolounger® recliner at the
confidentiality and without discrim-
We'll have a drawing
sleep sofa. Add the matching
ination."
every hour, 6 pm-
midnight. No
EXTRA $100 off all 5-piece li
But many AIDS activists were
purchase necessary.
Prices start at $999. 5 PM-6 1
disappointed that the president did
not address the 3-year-old U.S. pol-
FREE, or buy a 6-piece dining
SATURDAY
icy of preventing people infected
with the AIDS virus from immigrat-
The first 100
an EXTRA 10% off in-stock 1
ing to the United States, an issue
shoppers will get a
custom-upholstered furniture.
that has prompted some activists to
FREE Sweatband!
choice with any purchase over $
call for a boycott of the internation-
No purchase necessary.
item in the store. Sofa, chair, dresser, Cl
al AIDS conference in San Francis-
CO in June.
1 PM-2 PM Get $100 off any sofa, sleep
Bush also pledged no new funds
any 4-piece bedroom. 3 PM-4 PM Get $
for fighting and treating the dis-
dinette. 4 PM-5 PM Get 20% in additio
$500. 5 PM-6 PM Your choice of any sp
ONLY-register for a $25 gift certificat
DIAMONDS
THESE ARE REAL SAVINGS
Are
3-30-90
Bush Calls for Compassion,
and Cure, for AIDS Victims
By MARLENE CIMONS
anyone lost to heart disease or
TIMES STAFF WRITER
cancer or accidents."
And he likened the heartbreak of
WASHINGTON - President
babies infected with AIDS to the
Bush Thursday called on Ameri-
leukemia death of his own daugh-
cans to demonstrate compassion
ter, Robin, in 1953, two months
for people with AIDS and urged the
before her fourth birthday.
House to approve legislation that
"We asked the doctor the same
would protect them from discrimi-
question every HIV family must
nation.
ask: Why? Why this was happen-
"For those who are living with
ing to our beautiful little girl?" he
HIV [human immunodeficiency vi-
said at a meeting of the National
rus] and AIDS, our response is
Business Leadership Conference
clear," he said in his first major
on AIDS.
speech on AIDS. "They deserve
Bush's comments were praised
our compassion. They deserve our
by Dr. June Osborn, chairman of
care. And they deserve more than
the National Commission on AIDS,
a chance-they deserve a cure."
who said: "We've been desperately
In a speech that was unusually
needing this leadership from the
personal for Bush, he said that he
top. The most critical area has been
and his wife, Barbara, "have had
the need to get Americans to be
friends who have died of AIDS. Our
more compassionate and under-
love for them when they were sick
standing."
and when they died was just as
However, Jean McGuire, execu-
great and just as intense as for
Please see BUSH, A24
BUSH: Compassion and Anti-Bias Law for AIDS Victims Urged
Continued from A1
that they be effectively applied and
of the National Gay and Lesbian
caid funding. The White House has
tive director of the AIDS Action
implemented."
Task Force, held a sign that read:
requested $1.6 billion for research,
Council, called Bush's speech "long
Bush, appearing before an audi-
"Talk is cheap. AIDS funding is
prevention and non-Medicaid
on compassion but short on com-
ence of business and health execu-
not," and stood up to say: "Mr.
care-an amount that has been
mitment."
tives and officers of AIDS organi-
President, you don't understand.
criticized as inadequate by a range
McGuire complained that Bush
zations, heavily stressed the
We need funding."
of AIDS organizations.
had failed to address a U.S. immi-
compassion theme.
At the disruption, Bush departed
Rep. Henry A. Waxman (D-Los
gration policy that bars people
"Once disease strikes, we don't
from his prepared remarks and
Angeles), chairman of the House
with AIDS from entering the coun-
blame those who are suffering," he
said, to applause: "I can understand
Energy and Commerce subcom-
try, and said: "We have become an
said. "We don't spurn the accident
the concern that these people feel,
mittee on health, said he is glad
embarrassment to the global com-
victim who didn't wear a seat belt.
and I hope that, if we do nothing
Bush is "taking the first step-
munity."
We don't reject the cancer patient
else by coming here, I can help
kinder and gentler rhetoric." But,
The immigration restriction
who didn't quit smoking. We try to
them understand that, not only do
Waxman added: "It's all lip service
threatens to cripple a major global
love them and care for them and
you care, but we care, too."
if he doesn't follow up his promises
conference on AIDS scheduled for
comfort them. We do not fire them,
Bush described his Administra-
with programs."
June in San Francisco. Although
or evict them or cancel their insur-
tion's stance on AIDS as "a war-
Sen. Edward M. Kennedy (D-
AIDS-afflicted visitors can receive
ance."
time footing," adding: "We're go-
Mass.), chairman of the Senate
waivers to enter, the documents
He strongly endorsed House
ing to continue to fight like hell.
Labor and Human Resources Com-
become part of an individual's
passage of the Americans with
But we're also going to fight for
mittee and the author of a $600-
record and are considered unac-
Disabilities Act, which prohibits
hope. America has a unique capaci-
million emergency disaster relief
ceptable by many scientific and
discrimination in the private sector
ty for beating the odds-and as-
AIDS bill, called Bush's speech "an
AIDS organizations.
against the disabled, including
tounding the world."
encouraging start, far beyond the
As a result, many participants
those with HIV infection or fully
He said that his Administration
commitment the Reagan Adminis-
are expected to boycott the annual
developed AIDS. The Senate has
has asked Congress for almost $3.5
tration was willing to make." He
International Conference of AIDS,
already approved the measure.
billion for AIDS, including Medi-
urged Bush to support his measure.
considered the most important
"We're in a fight against a dis-
AIDS meeting of the year.
ease-not a fight against people,"
Presidential spokesman Marlin
Bush said. "And we will not-and
Fitzwater told reporters that im-
we must not in America-tolerate
migration rules are enacted by
discrimination."
Congress, "so we don't have a lot of
He was interrupted several
political recourse except to try to
times by two hecklers. One un-
make them work."
identified man shouted: "Why did
He added: "We do share the
it take you 14 months to say this?"
concerns of the AIDS organizations
Urvashi Vaid, executive director
THE WHITE HOUSE
WASHINGTON
March 27, 1990
INFORMATION
MEMORANDUM FOR THE PRESIDENT
THROUGH:
CHRISS WINSTON CW
FROM:
EDWARD McNALLY ann
SUBJECT:
REMARKS: NAT'L. LEADERSHIP COALITION ON AIDS
I. SUMMARY
Attached are draft remarks for Thursday morning's
keynote address to the National Leadership Coalition on AIDS.
II. DISCUSSION
At 11:15 a.m. on Thursday, March 29, 1990, you are
scheduled to arrive onstage at the Crystal Gateway Marriott in
Crystal City to address approximately 400 CEO's and other key
executives. Approximately 40 percent of those attending
represent corporations that were pioneers in responding to the
AIDS crisis -- while about 60 percent come from interested
corporations that are not yet participating in programs designed
to cope with AIDS in the workplace.
While the tone of the address (14 minutes,
TelePrompTer) is very serious, sober, and straightforward, our
proposed draft contains very upbeat language about America's
ability to respond to this epidemic.
It is a very personal speech, aimed at sending a
powerful message about compassion, discrimination, and hope.
McNally/Simon
March 27, 1990
Draft Six (B:AIDS)
PRESIDENTIAL REMARKS: NATIONAL LEADERSHIP COALITION ON AIDS
CRYSTAL GATEWAY MARRIOTT
THURSDAY, MARCH 29, 1990, 11:15 A.M.
Thank you, Louis Sullivan. And thanks to Larry Williford of
Allstate and B.J. Stiles from the Coalition here. Dr. David
Rogers and Belinda Mason, my appointees to the AIDS Commission,
with whom I just met. My friend and physician, Dr. Burton Lee.
There could scarcely be a more important place for me to be
than here with you -- the men and women who guide American
business as it helps those people suffering with HIV and AIDS.
You make our hearts glad. And you make your country proud.
Other generations have faced life-threatening medical
crises, from polio to the plague. This virus is our challenge.
Not a challenge we sought. Not a challenge we chose. But today
our responsibility is clear: We must meet this challenge. We
must beat this virus. For whether talking about a nation or an
individual, character is measured not by our tragedies -- but by
our response to those tragedies. III
And for those who are living with HIV and AIDS, our response
is clear: They deserve our compassion. They deserve our care.
And they deserve more than a chance -- they deserve a cure. 111
America will accept nothing less. We are slashing red tape.
Accelerating schedules. Boosting research. And somewhere out
there, there's a Nobel prize -- and the gratitude of planet Earth
-- waiting for the man or woman who discovers the answer that's
eluded everyone else. 111
2
We pray that day will come soon. But until that day --
until this virus can be defeated by science -- there's a battle
to be waged by society. 111
Because in 1990, the most effective weapon in our arsenal
against AIDS is not just medication, 11 but also education. III
Our goal is to turn irrational fear into rational facts.
Because this isn't just a fight against disease. It's also
a fight against ignorance. A fight against discrimination. III
Today, HIV has joined cancer, heart disease, and accidents
as one of the deadly realities of our time.
of these, HIV is one of the most lethal, one of the most
frightening. But HIV is also one of the most preventable.
Every American must learn what AIDS is -- and what AIDS is
not. And they must learn now. You in this room already know
what so many Americans don't. So, together, let's shoot down
some myths. The HIV virus is not spread by handshakes or hugs.
You can't get it from food or drink. Coughing or sneezing. or
by sharing bathrooms or towels or conversation.
The transmission of HIV is as simple as it is deadly. In
most cases, it's determined not by what you are -- but by what
you do -- and by what you fail to do. III
Let me state it clearly: People are placed at risk not by
their demographics, but by their deeds. By their behavior. 111
And so it is our duty to make certain that every American
has the essential information needed to prevent the spread of HIV
and AIDS. Because while the ignorant may discriminate against
3
AIDS -- AIDS won't discriminate among the ignorant.
Like many of you, Barbara and I have had friends who have
died of AIDS. Our love for them when they were sick and when
they died was just as great and just as intense as for anyone we
have lost to heart disease or cancer or accidents.
Probably everyone here has read the heartbreaking stories
about AIDS babies and those infected by transfusions. When our
own daughter was dying of leukemia, Barbara asked the doctor the
same question every HIV family must ask -- why -- why this was
happening to our beautiful little girl. And the doctor said:
"You have to realize that every well person is a miracle. It
takes billions of cells to make a well person. And all it takes
is one cell to be bad to destroy a whole person. "
We will always remember the love and compassion with which
our friends and family responded. In this nation, in this
decade, there is only one way to deal with an individual who is
sick. With dignity. Compassion. Care. Confidentiality. And
without discrimination.
Once disease strikes -- we don't blame those who are
suffering. We don't spurn the accident victim who didn't wear a
seatbelt. We don't reject the cancer patient who didn't quit
smoking. We try to love them and care for them and comfort them.
We do not fire them, or evict them, or cancel their insurance.
People with AIDS are our colleagues and co-workers. Our
friends. Our families. THEY ARE US.
Today I call on the House of Representatives to get on with
4
the job of passing a law -- as embodied in the Americans with
Disabilities Act -- that prohibits discrimination against those
with HIV and AIDS. We're in a fight against a disease -- not a
fight against people. And we won't tolerate discrimination. III
The disease is attacking our most precious resource -- our
people, especially our young. The statistics are numbing. You
heard them this morning. But just look at the amazing quilts
hanging here today. They prove that no one is a statistic.
Every life has its own fabric. Its own colors. Its own purpose.
Its own soul. And like the quilts, no two are alike. III
When Barbara and I left Washington for Christmas, our last
stop was a clinic up at NIH. We were impressed by the determina-
tion of the people there -- the doctors, nurses, and health care
workers -- and especially the brave people who are living with
HIV. We learned a lot about caring. A lot about family. And a
lot about hope. We saw the face of humanity in the face of AIDS.
Recently, we received a letter from seven patients whom we
visited. They wrote: "Each of us looks for hope in very
personal ways. We seek comfort and warmth from those we love.
We seek new answers through participation in experimental drug
studies. We seek to enjoy the simplest of pleasures in everyday
life. To make peace with ourselves and with those who don't
understand us. We seek a voice, a compassionate voice, that can
address the concerns of hundreds of thousands of people."
Ladies and gentlemen, the voice they seek must be your
voice. The voice of every American. 111
5
Your employees will take their cues from you. You are in a
powerful, unique position to influence the response to HIV and
AIDS. When someone asks: "Who will volunteer to help care for
our co-workers with AIDS?" we should be the first to say: "We
will." Washing our hands of it won't help solve this problem.
But rolling up our sleeves will.
The roster of participants at this Conference is an honor
roll. Allstate sponsored a landmark conference on HIV and work.
Fortune magazine launched a survey on C.E.O.'s response to HIV.
General Motors pledged to conduct an education program. Others
are fighting the spread of HIV by fighting to keep schools and
workplaces drug-free. This is America responding to a crisis.
This is America at its best. III
This epidemic is having a major impact on our health care
system. It is altering spending patterns by our government. In
1982, we knew little about AIDS -- and spent only $8 million.
But this year I have asked Congress for almost $3.5 billion to
battle HIV. Money for basic research. For HIV treatment and
education. For protecting civil rights. III
America has the most sophisticated health care system in the
world. But it is not without its problems. We face many
challenges. Our system depends on private insurance and
individual payments, as well as government programs. AIDS
magnifies the challenges, including the challenge of expanding
access, bringing costs under control, and overcoming obstacles to
quality care. With these concerns in mind, I asked Dr. Louis
6
Sullivan to lead a Cabinet-level review of health care in the
1990's. And businesses like those you represent must play a
major role in helping improve our Nation's health care system.
The crisis is not over. We report tens of thousands of
new cases every year. And many predict we can expect to continue
to do so in this decade, and even into the next century.
And yet, as Barbara so often reminds me, "where there is
life there is hope." There are hopeful signs. To begin with, we
can be encouraged by the news that current projections of the
infection rate will not be as high as we thought just a year ago.
The use of new medicines such as A-Z-T means that more and
more people with HIV will be able to live and work because these
therapies offer the potential of making it a more manageable
disease. Keep them in your workforce -- as I know many of you
are already doing, as leaders in this effort. They can serve
many, many more productive years with no threat to you, your
other workers, or your companies. It will reduce costs for
everyone. And it's the right thing to do. III
The pace of progress is promising. The HIV virus has been
identified, isolated, and attacked with experimental treatments
in a span of less than 10 years. The normal, centuries-long
evolution of disease and treatment compressed into a decade.
And this race against time has produced an explosion in
knowledge and basic understanding about the nature of disease and
immunology. Like the unexpected technological boons from
Apollo's race to the moon, some physicians predict the race to
7
cure AIDS may even lead to a cure for cancer.
We're going to continue to fight like hell. But we're also
going to fight for hope. America has a unique capacity for
beating the odds -- and astounding the world. III
During my own childhood, the silent, whispered terror was a
mysterious killer called polio. Like HIV, the virus ignored
class distinctions and geographic boundaries. Monday would come,
and kids who'd been in school on Friday were simply never seen
again. Theaters were closed, summer camps, swimming pools.
As with AIDS, there was a lot of ignorance. Thousands of
stray cats and dogs put to death. Kids sleeping with camphor
inhalers. At least one town was fumigated with D.D.T.
There were terrifying outbreaks in the teens, in the
thirties, in the fifties. A cure was so far distant the experts
refused to speculate. 1111 And then, suddenly, it was over.
The dreaded iron lung, unused, cluttering hospital hallways.
Children again growing up in a world without fear. III
Many comparisons have been made to epidemics past. Cholera.
Small pox. Yellow fever. None of them perfect. So let me boil
down the lessons of polio to two:
There was a lot of ignorance -- let's learn from that. And
in the darkest of hours -- hope came unexpectedly, powerfully and
with finality. Let's work hard to see that day come to pass. III
Together, we will make a difference, for those with HIV and
AIDS -- and for all Americans.
Thank you. And may God bless the United States of America.
#
#
#
SIMPLY BARBARA BUSH
No Crying Aloud
do such a simple thing as blow her nose-George
"Robin was in remission but she had holes all
watched her condition deteriorate and he suffered.
through her tummy. Our uncle-doctor, whom we
"He was just killing himself, while I was very
love more than life, really thought we ought to let
strong," Barbara said.
her go. The doctors at Memorial really wanted to
"I remember asking the doctor why this was
operate-they knew so little about all that. I opted
happening to our little girl, this perfectly beautiful
to go with the doctors." And then, talking to me
of
creature," Barbara said. "And the doctor said, 'You
thirty-six years later at the White House, Barbara
have to realize that every well person is a miracle. It
started to cry. "She was very, very sick. She never
A/DS
takes billions of cells to make up a person. And all it
came out of the operation. But they asked me to do
takes is one cell to be bad to destroy a whole person.'
it. Although Johnny Walker [the uncle], to spare us,
So I came to see that the people who are sitting around
said you don't have to do that, I just felt they were
"Bardow
alive are the miracles."
killing themselves to save a child and we ought to
When Robin slept, Barbara walked the halls at
cooperate. I don't care what anybody says, where
Sloan-Kettering. She listened to the staff, talked to
there's life there's hope."
the children, met their parents, and shared some of
When George arrived, he knew Barbara had been
their sorrows. Or sometimes, from a forty-second-
right. When Robin died, they both were with her.
floor window, she'd just gaze at the Manhattan sky-
"You learn how people react-Barbara's strength,
line. Lud Ashley, their friend from Yale who was
and then I saw other families that reacted very dif-
living in New York at the time, knew to look for her
ferently," George told me in 1988 at Kennebunkport
there. "I never saw her cry. It was one of the won-
a few days before the Republican Convention. "We
ders," said Ashley, for whom there was never any
saw one group-their child had just died-and they
question that this was one of the really remarkable
were asked for permission to do an autopsy and they
women he was ever going to know.
turned on the nurses and doctors, saying, 'Haven't
Then one day in October, Robin started to hem-
you done enough?' They were so grief-stricken they
orrhage. George was on his way up from Texas, but
turned on the people who helped them the most.
Barbara was alone. Robin was such a frail little thing
Barbara's and my reaction was very different from
by then, her skin almost transparent over her wasted
that. I think we love everyone more because of
bones. The bleeding might be stopped but there could
Robin."
never be any lasting reprieve from the end that surely
The next day, George went back to the hospital
was coming. Barbara, who was twenty-eight at the
to thank everyone who had helped their child. What
time, stuck out her jaw and stood very firm.
he could not know, according to Ashley, was that
116
117
McNally/Simon
March 26, 1990
Draft Four (B:AIDS)
PRESIDENTIAL REMARKS: NATIONAL LEADERSHIP COALITION ON AIDS
CRYSTAL GATEWAY MARRIOTT
THURSDAY, MARCH 29, 1990, 11:15 A.M.
Thank you. And I want to thank Louis Sullivan. Larry
Williford of Allstate and B.J. Stiles from the Coalition here.
Dr. David Rogers and Belinda Mason, my appointees to the AIDS
Commission. My friend and physician, Dr. Burton Lee.
There could scarcely be a more important gathering, a more
important place for me to be than here with you -- the men and
women who guide American business as it helps those people
suffering with HIV and AIDS. There are many team players in this
struggle. Community service organizations. Religious leaders of
all persuasions. AIDS service organizations created by
volunteers, many of them also infected with HIV. Corporations
and private foundations that together have given over $100
million to support literally thousands of AIDS projects.
You make our hearts glad. And you make your country proud.
Other generations have faced life-threatening medical
crises, from polio to the plague. This virus is our challenge.
Not a challenge we sought. Not a challenge we chose. But today
our responsibility is clear: We must meet this challenge. We
must beat this virus. For whether talking about a nation or an
individual, character is measured not by our tragedies -- but by
how we respond to those tragedies. III
And for those who are living with HIV and AIDS, our response
is clear: They deserve our compassion. They deserve our care.
2
And they deserve more than a chance -- they deserve a cure. III
America will accept nothing less. We are slashing red tape.
Accelerating schedules. Boosting research. And somewhere out
there, there's a Nobel prize -- and the gratitude of planet Earth
-- waiting for the man or woman who peers into a microscope and
sees the answer that's eluded everyone else.
We pray that day will come soon. But until that day --
until this virus can be defeated by science -- there's a battle
to be waged by society. III
Because in 1990, the most effective weapon in our arsenal
against AIDS is not just medication, 11 but also education. III
We must increase our efforts to educate the public about
AIDS and how it is contracted. Our goal is to turn irrational
fear into rational facts.
Because this isn't just a fight against disease. It's also
a fight against ignorance. A fight against discrimination. III
Today, HIV has joined cancer, heart disease, and accidents
as one of the deadly realities of our time.
of these, HIV is one of the most lethal, one of the most
frightening. But HIV is also one of the most preventable.
Every American must learn what AIDS is -- and what AIDS is
not. And they must learn now. You in this room already know
what so many Americans don't. So, together, let's shoot down
some myths. The HIV virus is not spread by handshakes or hugs.
You can't get it from food or drink. Coughing or sneezing. Or
by sharing bathrooms or towels or conversation.
3
The transmission of AIDS is as simple as it is deadly. In
most cases, it's determined not by what you are -- but by what
you do -- and by what you fail to do. III
Let me state it clearly: People are placed at risk not by
their demographics, but by their deeds. By their behavior. III
And so it is our duty to make certain that every American
has the essential information needed to prevent the spread of HIV
and AIDS. Because while the ignorant may discriminate against
AIDS -- AIDS won't discriminate among the ignorant. III
Like many of you, Barbara and I have had friends who have
died of AIDS. Our love for them when they were sick and when
they died was just as great and just as intense as for anyone we
have lost to heart disease or cancer or accidents.
Probably everyone here has read the heartbreaking stories
about AIDS babies and those infected by transfusions. When our
own daughter was dying of leukemia, Barbara asked the doctor the
same question every HIV family must ask -- why -- why this was
happening to our beautiful little girl. And the doctor said:
"You have to realize that every well person is a miracle. It
takes billions of cells to make a well person. And all it takes
is one cell to be bad to destroy a whole person."
We will always remember the love and compassion with which
our friends and family responded. In this nation, in this
decade, there is only one way to deal with an individual who is
sick. With dignity. Compassion. Care. Confidentiality. And
without discrimination. III
4
Once disease strikes -- we don't blame those who are
suffering. We don't spurn the accident victim who didn't wear a
seatbelt. We don't reject the cancer patient who didn't quit
smoking. We try to love them and care for them and comfort them.
We do not fire them, or evict them, or cancel their insurance.
People with AIDS are no different than people with other
disabling and life-threatening diseases. They are our colleagues
and co-workers. Our friends. Our families. THEY ARE
US.
Today I call on the House of Representatives to get on with
the job of passing a law -- the Americans with Disabilities Act
-- that prohibits discrimination against those with HIV and AIDS.
We're in a fight against a disease -- not a fight against
people. III And we won't tolerate discrimination.
The disease is attacking our most precious resource -- our
people, our young. Unlike many of the diseases that cause
disability in our elderly, AIDS affects many Americans now in the
prime of life. The vast majority of Americans diagnosed with
AIDS since 1981 have been between the ages of 20 and 59. These
were the years they planned to work and create, and save for the
future. Now their struggle is to survive.
The statistics are numbing. You heard them this morning.
But just look at the amazing quilts which hang around us today.
They prove that no one is a statistic. Every life has its own
fabric. Its own colors. Its own purpose. Its own soul. And
like the quilts, no two are alike. III
These quilts commemorate the dead. But the most important
5
part of our learning is with the living. And I hope that you
will go out and visit the AIDS wards. Meet with the patients and
their families. See the face of humanity in the face of AIDS.
When Barbara and I left Washington for Christmas, our last
stop was a clinic at the National Institutes of Health. We were
impressed by the determination of the people there -- the
doctors, nurses, and health care workers -- and especially the
brave people who are living with HIV. We learned a lot about
caring. A lot about family. And a lot about hope.
Recently, we received a letter from seven patients whom we
visited. They wrote: "Each of us looks for hope in very
personal ways. We seek comfort and warmth from those we love.
We seek new answers through participation in experimental drug
studies. We seek to enjoy the simplest of pleasures in everyday
life. To make peace with ourselves and with those who don't
understand us. We seek a voice, a compassionate voice, that can
address the concerns of hundreds of thousands of people."
Ladies and gentlemen, the voice they seek must be your
voice. The voice of every American. III
Your employees will take their cues from you. You are in a
powerful, unique position to influence the response to HIV and
AIDS. When someone asks: "Who will volunteer to help care for
our co-workers with AIDS?" we should be the first to say, "We
will." Washing our hands of it won't help solve this problem.
But rolling up our sleeves will. III
The roster of participants at this Conference is an honor
6
roll. Allstate sponsored a landmark conference to help deal with
the impact of HIV at work. Fortune magazine launched a survey
that helped us understand the attitudes and actions of C.E.O.'s
in responding to HIV. General Motors asked an HIV expert to
brief its key officers -- and pledged to conduct an education
program for employees. Others are fighting the spread of HIV by
fighting to keep schools and workplaces drug-free. This is
America responding to a crisis. This is America at its best.
This epidemic is having a major impact on our health care
system. It is altering spending patterns by our government. In
1982, we knew little about AIDS -- and spent only $8 million. By
1990, that has grown to almost $3 billion.
And I have asked Congress for still more money -- almost
$3.5 billion in the next fiscal year. Money for basic research.
For HIV treatment and education. For protecting civil rights.
America has the most sophisticated health care system in the
world. But it's not enough. Our system depends on private
insurance and individual payments, as well as government
programs. AIDS magnifies the challenges, including the challenge
of providing fair access to care to all Americans, rich and poor.
In my State of the Union Address, I asked Dr. Louis Sullivan
to lead a Cabinet-level review of health care in the 1990's.
We don't know yet where this review will lead us. But we do
know that businesses like those you represent will be a big part
of the answer to improving health care and increasing access.
The epidemic is not over. We report tens of thousands of
7
new cases every year. And many predict we can expect to continue
to do so in this decade, and even into the next century.
And yet, as Barbara so often reminds me, "where there is
life there is hope." There are hopeful signs. To begin with, we
can be encouraged by the news that current projections of the
infection rate will not be as high as we thought just a year ago.
The use of new medicines such as A-Z-T means that more and
more people with HIV will be able to live and work because these
therapies offer the potential of making it a more manageable
disease. Keep them in your workforce -- as I know many of you
are already doing, as leaders in this effort. They can serve
many, many more productive years with no threat to you, your
other workers, or your companies. It will reduce costs for
everyone. And it's the right thing to do. 111
The pace of progress is promising. The HIV virus has been
identified, isolated, and attacked with experimental treatments
in a span of less than 10 years. The normal, centuries-long
evolution of disease and treatment compressed into a decade.
And this race against time has produced an explosion in
knowledge and basic understanding about the nature of disease and
immunology. Like the unexpected technological boons from
Apollo's race to the moon, some physicians predict the race to
cure AIDS may even lead to a cure for cancer.
We're going to continue to fight like hell. But we're also
going to fight for hope. America has a unique capacity for
beating the odds -- and astounding the world.
8
During my own childhood, the silent, whispered terror was a
mysterious killer called polio. Like HIV, the virus ignored
class distinctions and geographic boundaries. Monday would come,
and kids who'd been in school on Friday were simply never seen
again. Theaters were closed, summer camps, swimming pools.
As with AIDS, there was a lot of ignorance. Thousands of
stray cats and dogs put to death. Kids sleeping with camphor
inhalers. At least one town was fumigated with D.D.T.
There were terrifying outbreaks in the teens, in the
thirties, in the fifties. A cure was so far distant the experts
refused to speculate. One doctor observed: "We have learned
very little that is new about the disease, but much that is old
about ourselves."
And then, suddenly, it was over. It happened so fast. The
dreaded iron lung, unused, cluttering hospital hallways.
Children again growing up in a world without fear.
Many comparisons have been made to epidemics past. Cholera.
Small pox. Yellow fever. None of them perfect. So let me boil
down the lessons of polio to two:
There was a lot of ignorance -- let's learn from that. And
in the darkest of hours -- hope came unexpectedly, powerfully and
with finality. Let's work hard to see that day come to pass. III
Together, we will make a difference, for those with HIV and
AIDS -- and for all Americans.
Thank you. And may God bless the United States of America.
#
#
#
McNally/Simon
March 23, 1990
Draft Three (B:AIDS)
PRESIDENTIAL REMARKS: NATIONAL LEADERSHIP COALITION ON AIDS
CRYSTAL GATEWAY MARRIOTT
THURSDAY, MARCH 29, 1990, 11:15 A.M.
Thank you,
. [ACKNOWLEDGEMENTS]
There could scarcely be a more important gathering, a more
important place for me to be than here with you -- the men and
women who guide business and industry as they focus on the best
way to help our people suffering with HIV and AIDS.
There are many team players in this struggle. Community
service organizations. Religious leaders of all persuasions.
AIDS service organizations created by volunteers, many of them
also infected with HIV. And corporations and private foundations
that together have given over $100 million to support literally
thousands of AIDS projects.
You make our hearts glad. And you make your country proud.
Other generations have faced life-threatening medical
crises, from polio to the plague. This virus is our challenge.
Not a challenge we sought. Not a challenge we chose. But today
our choice is simple:
We will meet this challenge. We will beat this virus. For
whether talking about a nation or an individual, character is
measured not by our tragedies -- but by how we respond to those
tragedies. III
And for those who are living with HIV and AIDS, our response
is simple: They deserve our compassion. They deserve our care.
And they deserve more than a chance -- they deserve a cure. III
2
America will accept nothing less. We are slashing red tape.
Accelerating schedules. Boosting research. And somewhere out
there, there's a Nobel prize -- and the gratitude of the planet
Earth -- waiting for the man or woman who peers into a microscope
and sees the answer that's eluded everyone else.
We pray that day will come soon. But until that day --
until this virus can be defeated in our hospitals -- there's a
battle to be waged in our homes. III
Because in 1990, the single most effective weapon in our
arsenal against AIDS is not medication, 11 but education. 111
We must increase our efforts to educate the public about
AIDS and how it is contracted. Our goal is to turn irrational
fear into rational facts.
Because this isn't just a fight against disease. It's also
a fight against ignorance. A fight against discrimination. III
Almost three years ago, I described our struggle against the
HIV virus as a battle against a "new and mysterious disease."
Today, HIV is not so new and not so mysterious. Today, HIV
has joined cancer, heart disease, and accidents as one of the
deadly realities of our time.
of these, HIV is one of the most lethal, one of the most
frightening. But HIV is also one of the most preventable.
Every American must learn what AIDS is -- and what AIDS is
not. And they must learn now. So let's shoot down some myths.
The HIV virus is not spread by handshakes or hugs. You can't get
3
it from food or drink. Coughing or sneezing. Or by sharing
bathrooms or towels or conversation.
It's not like heart disease, where there's confusion over
ever-changing bits of advice on oat bran and olive oil, exercise
and eggs. The transmission of AIDS is as simple as it is deadly.
It's determined not by what you are -- but by what you do -- and
by what you fail to do. 111
Let me state it clearly: People are placed at risk not by
their demographics, but by their deeds. By their behavior. III
And so it is our duty to make certain that every American
has the essential information needed to prevent the spread of HIV
and AIDS. Because while the ignorant may discriminate against
AIDS -- AIDS won't discriminate among the ignorant. 111
Like many of you, Barbara and I have had friends who have
died of AIDS. Our love for them when they were sick and when
they died was just as great and just as intense as for anyone we
have lost to heart disease or cancer or accidents.
In this nation, in this decade, there is only one way to
deal with an individual who is sick. With dignity. Compassion.
Care. Confidentiality. And without discrimination. 111
Once disease strikes -- we don't blame those who are
suffering. We don't spurn the accident victim who didn't wear a
seatbelt. We don't reject the cancer patient who didn't quit
smoking. We try to love them and care for them and comfort them.
We do not fire them, or evict them, or cancel their insurance.
4
People with AIDS are no different than people with other
disabling and life-threatening diseases. They are our colleagues
and co-workers. Our friends. Our families. THEY
ARE
US.
And today I call on the House of Representatives to get on
with the job of passing a law -- the Americans with Disabilities
Act -- that prohibits discrimination against those with HIV and
AIDS.
This is a fight against a disease -- not a fight against
people. III And we won't tolerate discrimination. 1111
The disease is attacking our most precious resource -- our
people, our young. Unlike many of the diseases that cause
disability in our elderly, AIDS affects many Americans now in the
The vast majority
prime of life. Ninety-five percent of the 115,000 Americans with
AIDS are between the ages of 20 and 59. These were the years
they planned to work and create, and save for the future. Now
their struggle is to survive.
The statistics are numbing. You heard them this morning.
But just look at the amazing quilts which hang around us today.
They prove that no man is a statistic. Every life has its own
fabric. Its own colors. Its own purpose. Its own soul. And
like the quilts, no two are alike. III
These quilts commemorate the dead. But the most important
part of our learning is with the living. And I hope that you
will go out and visit the AIDS wards. Meet with the patients and
their families. See the face of humanity in the face of AIDS.
5
When Barbara and I left Washington for the Christmas
holidays, our last stop was a clinic at the National Institutes
of Health. We were impressed by the mettle and determination of
the people there -- the doctors, nurses, and health care workers
-- and especially the brave people who are living with HIV. We
learned a lot about courage. A lot about family. And a lot
about hope.
Recently, we received a letter from seven who we visited.
They wrote: "Each of us looks for hope in very personal ways.
We seek comfort and warmth from those we love. We seek new
answers through participation in experimental drug studies. We
seek to enjoy the simplest of pleasures in everyday life. We
seek to make peace with ourselves and with those who don't
understand us. We seek a voice, a compassionate voice, that can
address the concerns of hundreds of thousands of people."
Ladies and gentlemen, the voice they seek must be your
voice. The voice of every American. III
Your employees will take their cues from you. You are in a
powerful, unique position to influence the response to HIV and
AIDS. When someone asks: "Who will volunteer to help care for
our co-workers with AIDS?" you should be the first to say, "I
will." Washing your hands of it won't help solve this problem.
But rolling up your sleeves will. 111
The roster of participants at this Conference is an honor
roll. Allstate sponsored a landmark conference to help deal with
the impact of HIV at work. The magazine, Fortune, launched a
6
survey that helped us understand the attitudes and actions of
C.E.O.'s in responding to HIV. [An industrial giant] asked an
HIV expert to brief its key officers -- and pledged to conduct an
education program for employees. Others are fighting the spread
of HIV by fighting to keep schools and workplaces drug-free.
This is America responding to a crisis. This is America at its
best.
This epidemic is having a major impact on our health care
system. It is altering spending patterns by our government. In
1982, we knew little about AIDS -- and spent only $8 million. By
1990, that has grown to almost $3 billion -- more, even, than the
budget of the entire FBI -- and almost double what's spent for
the National Cancer Institute.
And I have asked Congress for still more money -- almost
$3.5 billion in the next fiscal year. Money for basic research.
For HIV treatment and education. For protecting civil rights.
America has the most sophisticated health care system in the
world. But it's not enough. Our system depends on private
insurance and individual payments, as well as government
programs. AIDS magnifies the challenges, including the challenge
of providing fair access to care to all Americans, rich and poor.
In my State of the Union Address, I asked Dr. Louis Sullivan
to lead a Cabinet-level review of health care in the 1990's.
We don't know yet where this review will lead us. But we do
know that businesses like those you represent will be a big part
of the answer to improving health care and increasing access.
7
The epidemic is not over. We report tens of thousands of
new cases every year. And many predict we can expect to continue
to do so in this decade, and even into the next century.
And yet, as in every generation, no crisis is without
hopeful signs. To begin with, we can be encouraged by the news
that current projections of the infection rate will not be as
high as we thought just a year ago.
The use of new medicines such as A-Z-T means that more and
more people with HIV will be able to live and work because these
therapies offer the potential of making it a more manageable
disease. Keep them in your workforce. They can serve many, many
more productive years with no threat to you, your other workers,
or your companies. It will reduce costs for everyone. And it's
the right thing to do. III
The pace of progress is promising. The HIV virus has been
identified, isolated, and attacked with experimental treatments
in a span of less than 10 years. The normal, centuries-long
evolution of disease and treatment compressed into a decade.
And this race against time has produced an explosion in
knowledge and basic understanding about the nature of disease and
immunology. Like the unexpected technological boons from
Apollo's race to the moon, some physicians predict the race to
lead to
cure AIDS may even produce a cure for cancer.
We're going to continue to fight like hell. But we're also
going to fight for hope. America has a unique capacity for
beating the odds -- and astounding the world.
8
During my own childhood, the silent, whispered terror was a
mysterious killer called polio. Like HIV, the virus ignored
class distinctions and geographic boundaries. Monday would come,
and kids who'd been in school on Friday were simply never seen
again. Theaters were closed, summer camps, swimming pools.
As with AIDS, there was a lot of ignorance. Thousands of
stray cats and dogs put to death. Kids sleeping with camphor
inhalers. At least one town was fumigated with D.D.T. -- doing
nothing to stop polio -- and unknowingly helping endanger the
American eagle.
There were terrifying outbreaks in the teens, in the
thirties, in the fifties. A cure was so far distant the experts
refused to speculate. One doctor observed: "We have learned
very little that is new about the disease, but much that is old
about ourselves."
And then, suddenly, it was over. It happened so fast. The
dreaded iron lung, unused, cluttering hospital hallways.
Children again growing up in a world without fear.
Many comparisons have been made to epidemics past. Cholera.
The Plague. Yellow fever. None of them perfect. So let me boil
down the lessons of polio to two:
There was a lot of ignorance -- let's learn from that. And
in the darkest of hours -- hope came unexpectedly, powerfully and
with finality. Let's work hard to see that day come to pass. III
Together, we will make a difference, for those with HIV and
AIDS -- and for all Americans.
Thank you. And may God bless the United States of America.
#
#
#
McNally/Simon
March 20, 1990
Draft Two (B:AIDS)
PRESIDENTIAL REMARKS: NATIONAL LEADERSHIP COALITION ON AIDS
CRYSTAL GATEWAY MARRIOTT
THURSDAY, MARCH 29, 1990, 11:15 A.M.
Thank you,
. [ACKNOWLEDGEMENTS]
There could scarcely be a more important gathering, a more
important place for me to be than here with you -- the men and
women who guide business and industry as they focus on the best
way to help our people suffering with HIV and AIDS.
Nat'l Leddership There are many team players in this struggle. The American
Coalition Red Cross and the United Way. Religious leaders of all
pomplet see
A105
persuasions. AIDS service organizations created by, volunteers,
many of them also infected with HIV. And corporations and
private foundations that together have given over $100 million to
support literally thousands of AIDS projects.
You make our hearts glad. And you make your country proud.
Other generations have faced life-threatening medical
crises, from polio to the Plague. This virus is our challenge.
Not a challenge we sought. Not a challenge we chose. But today
our choice is simple:
We will meet this challenge. We will beat this virus. For
whether talking about a nation or an individual, character is
measured not by our tragedies -- but by our response. \\\
And for those who are living with HIV and AIDS, our response
is simple: They deserve our compassion. They deserve our care.
And they deserve more than a chance -- they deserve a cure. \\\
America will accept nothing less. We are slashing red tape.
2
Accelerating schedules. Boosting research. And somewhere out
there, there's a Nobel prize -- and the gratitude of the planet
Earth -- waiting for the man or woman who peers into a microscope
and sees the answer that's eluded everyone else.
We pray that day will come soon. But until that day --
until this virus can be defeated in our hospitals -- there's a
battle to be waged in our homes.
Because in 1990, the single most effective weapon in our
arsenal against AIDS is not medication, 11 but education.
We must increase our efforts to educate the public about
AIDS and how it is contracted. Our goal is to turn irrational
fear into rational facts.
Because this isn't just a fight against disease. It's also
a fight against ignorance. A fight against discrimination.
speech
Almost three years ago, I described our struggle against the
6-1-87
HIV virus as a battle against a "new and mysterious disease."
see
Today, HIV is not so new and not so mysterious. Today, HIV
6th cause of , 1987: age
has
joined cancer, heart disease, and accidents as one of the
deadly realities of our time.
Of these, HIV is one of the most lethal, one of the most
for 436-8884
frightening. But HIV is also one of the most preventable.
Every American must learn what AIDS is -- and what AIDS is
not. And they must learn now. So let's shoot down some myths.
The HIV virus is not spread by handshakes or hugs. You can't get
it from food or drink. Coughing or sneezing. Or by sharing
bathrooms or towels or conversation.
3
It's not like heart disease, where there's confusion over
ever-changing bits of advice on oat bran and olive oil, exercise
and eggs. The transmission of AIDS is as simple as it is deadly.
It's determined not by what you are -- but by what you do -- and
by what you fail to do.
Let me state it clearly: People are placed at risk not by
their demographics, but by their deeds. By their behavior. \\\
And SO it is our duty to make certain that every American
has the essential information needed to prevent the spread of HIV
and AIDS. Because while the ignorant may discriminate against
AIDS -- AIDS won't discriminate among the ignorant.
Like many of you, Barbara and I have had friends who have
died of AIDS. Our love for them when they were sick and when
they died was just as great and just as intense as for anyone we
have lost to heart disease or cancer or accidents.
In this nation, in this decade, there is only one way to
deal with an individual who is sick. With dignity. Compassion.
Care. Confidentiality. And without discrimination.
Once disease strikes -- we don't blame those who are
suffering. We don't spurn the accident victim who didn't wear a
seatbelt. We don't reject the cancer patient who didn't quit
smoking. We try to love them and care for them and comfort them.
We do not fire them, or evict them, or cancel their insurance.
People with AIDS are no different than people with other
disabling and life-threatening diseases. They are our colleagues
and co-workers. Our friends. Our families. THEY ARE
US.
4
And today I call on the House of Representatives to get on
the Americans with Disabilities act
with the job of passing a law -- a good, fair, and effective law
that prohibits discrimination against those with HIV and AIDS.
This is a fight against a disease -- not a fight against
people. \\\ And we won't tolerate discrimination.
The disease is attacking our most precious resource -- our
people, our young. Unlike many of the diseases that cause
disability in our elderly, AIDS affects many Americans now in the
3/90
The vast majority
Surveillance
prime of life. Ninety five percent of the 115,000 Americans with
Report
AIDS are between the ages of 20 and 59. These were the years
CDcable 7
they planned to work and create, and save for the future. Now
their struggle is to survive.
429-0930 Stiles
The statistics are numbing. You heard them this morning.
But just look at the amazing quilts which hang around us today.
They prove that no man is a statistic. Every life has its own
fabric. Its own colors. Its own purpose. Its own soul. And
like the quilts, no two are alike.
see
When the AIDS Quilt was spread out over 14 acres behind the
fill
White House last fall, people out just to take a curious stroll
wash
Post
suddenly found themselves wiping away tears. I hope you have a
10/8/89
chance to display some of the panels at your businesses. And
I
10/7/89
hope we have a chance to display some at the White House.
The quilts commemorate the dead. But the most important
part of our learning is with the living. And I hope that you
will go out and visit the AIDS wards. Meet with the patients and
their families. See the face of humanity in the face of AIDS.
5
in
December
12/22/89
When Barbara and I left Washington for the holidays, our
last stop was a clinic at the National Institute of Health. We
schedule
were impressed by the mettle and determination of the people
there -- the doctors, nurses, and health care workers -- and
especially the brave people who are living with HIV. We learned
a lot about courage. A lot about family. And a lot about hope.
Recently, we received a letter from seven who we visited.
They wrote: "Each of us looks for hope in very personal ways.
see
letter
We seek comfort and warmth from those we love. We seek new
answers through participation in experimental drug studies. We
seek to enjoy the simplest of pleasures in everyday life. We
file
seek to make peace with ourselves and with those who don't
understand us. We seek a voice, a compassionate voice, that can
address the concerns of hundreds of thousands of people."
Ladies and gentlemen, the voice they seek must be your
voice. The voice of every American. III
Your employees will take their cues from you. You are in a
powerful, unique position to influence the response to HIV and
AIDS. When someone asks: "Who will volunteer to help care for
our co-workers with AIDS?" you should be the first to say, "I
will." Washing your hands of it won't help solve this problem.
But rolling up your sleeves will. III
pamphlet:
The roster of participants at this Conference is an honor
a private
to the challenges
sector Response
roll. Allstate sponsored a landmark conference to help deal with
of AIDS
the impact of HIV at work. A magazine launched a survey that
[FORTUNE]
see
helped us understand the attitudes and actions of C.E.O.'s in
file
6
responding to HIV. An industrial giant asked an HIV expert to
brief its key officers -- and pledged to conduct an education
program for employees. Others are fighting the spread of HIV by
fighting to keep schools and workplaces drug-free. This is
America responding to a crisis. This is America at its best.
This epidemic is having a major impact on our health care
PHS
system. It is altering spending patterns by our government. In
see file
Table
1982, we knew little about AIDS -- and spent only $8 million. By
90
has
Fiscal
1989, that had grown to almost $3 billion -- more, even, than the
FYGI 91
Budget
budget of the entire FBI -- and double what's spent for the
P. A-225
almost
National Cancer Institute.
P. A-204
And I have asked Congress for still more money -- almost
Budget FY 91
$3.5 billion in the next fiscal year. Money for basic research.
p.79
P.
For HIV treatment and education. For protecting civil rights.
America has the most sophisticated health care system in the
world. But it's not enough. Our system depends on private
insurance and individual payments, as well as government
programs. AIDS magnifies the challenges, including the challenge
of providing fair access to care to all Americans, rich and poor.
1-31-90
In my State of the Union Address, I asked Dr. Louis Sullivan
speech
to lead a Cabinet-level review of health care in the 1990's.
We don't know yet where this review will lead us. But we do
know that businesses like those you represent will be a big part
of the answer to improving health care and increasing access.
The epidemic is not over. We report tens of thousands of
see seewr 2-23-90
new cases every year. And many predict we can expect to continue
from CDC
table 2
7
to do SO in this decade, and even into the next century.
And yet, as in every generation, no crisis is without
hopeful signs. To begin with, we can be encouraged by the news
CDC
that current projections of the infection rate will not be as
MMWR
2-23-90
high as we thought just a year ago.
Nickson
The use of new medicines such as A-Z-T means that more and
more people with HIV will be able to live and work because these
therapies offer the potential of making it a more manageable
disease. Keep them in your workforce. They can serve many, many
more productive years with no threat to you, your other workers,
or your companies. It will reduce costs for everyone. And it's
the right thing to do.
fact PHS sheet
The pace of progress is promising. The HIV virus has been
identified, isolated, and attacked with experimental treatments
see
file
in a span of less than 10 years. The normal, centuries-long
evolution of disease and treatment compressed into a decade.
And this race against time has produced an explosion in
knowledge and basic understanding about the nature of disease and
immunology. Like the unexpected technological boons from
Dr.
Apollo's race to the moon, some physicians predict the race to
Favci
lead to
cure AIDS may even produce a cure for cancer.
496-2263
We're going to continue to fight like hell. But we're also
going to fight for hope. America has a unique capacity for
beating the odds -- and astounding the world.
During my own childhood, the silent, whispered terror was a
mysterious killer called polio. Like HIV, the virus ignored
8
class distinctions and geographic boundaries. Monday would come,
and kids who'd been in school on Friday were simply never seen
again. Theaters were closed, summer camps, swimming pools.
AIDS: The Burdus of
As with AIDS, there was a lot of ignorance. Thousands of
History
51
stray cats and dogs put to death. Kids sleeping with camphor
"
Dr. 619- Salk 453-4100
inhalers. At least one town was fumigated with D.D.T. -- doing
NYT 8-16-52
nothing to stop polio -- and unknowingly helping endanger the
American eagle.
AIDS: The
Burdeno
of
History There were terrifying outbreaks in the teens, in the
Dr
thirties, in the fifties. A cure was SO far distant the experts
NYT
Mag.
refused to speculate. One doctor observed: "We have learned
1-21-51
very little that is new about the disease, but much that is old
AIDS:
The
of about ourselves."
Bundns
0.55
History
And then, suddenly, it was over. It happened so fast. The
dreaded iron lung, unused, cluttering hospital hallways.
Children again growing up in a world without fear.
Many comparisons have been made to epidemics past. Cholera.
The Plague. Yellow fever. None of them perfect. So let me boil
down the lessons of polio to two:
There was a lot of ignorance -- let's learn from that. And
in the darkest of hours -- hope came unexpectedly, powerfully and
with finality. Let's work hard to see that day come to pass. \\\
Together, we will make a difference, for those with HIV and
AIDS -- and for all Americans.
Thank you. And may God bless the United States of America.
#
#
#
9
[ EXTRA MATERIAL -- NOT PART OF MAIN DOCUMENT]
Thank God for the heroes of modern medicine. And thank God
for you -- the leaders of American business and industry --
and for the support you get from labor leaders and from
your employees. I am proud of America's scientists and
health care workers at N.I.H. and in hospitals and hospices
and home across the country.
It is our duty to meet this disease not only with medication
but also education -- and with open-hearted concern and
compassion for those affected.
It's a credit to an almost wartime mobilization by concerned
Americans -- in government, business, health care,
education.
People with HIV and AIDS deserve the same dignity and the
same concern as all victims of injury or illness.
But they have help -- your help. We would not have come as
far as we have in helping people with HIV and AIDS without
committed people like you. I believe that those who want to
help are addressing the most precious gift of all -- the
gift of life.
It's time to act -- because "time" is the one thing we don't
have.
The statistics we are hearing today tell me that right here
in this room, as in businesses from the board room to the
mail room, and in every agency of our government, there are
Americans infected with HIV and AIDS. Some may not even
know it yet. They are our people. And we must never turn
our back on those who need our help. Never close our minds
to their problems. Never seal our hearts against their need
for hope and healing.
God bless you for all that you do. May He bring his comfort
to all those who suffer, and bless the hands and hearts of
those who heal.
You have my gratitude for your commitment, your
contributions, and your determination to offer care and
support to Americans with HIV and AIDS.
I say HIV and AIDS because it is HIV that causes AIDS.
People become infected with the HIV virus long before they
develop the symptoms and become sick with AIDS.
Now, even that pattern is beginning to change.
It's a start to it instrutt needs all
McNally/Simon
March 17, 1990
Draft One (B:AIDS)
PRESIDENTIAL REMARKS: NATIONAL COALITION ON AIDS
CRYSTAL GATEWAY MARRIOTT
THURS. , MARCH 29, 1990, 11:16 A.M.
Thank you,
.
[ACKNOWLEDGEMENTS]
There is no more important place for me to be right now than
with you -- the men and women who guide business and industry as
they focus on the best way to help our people with HIV and AIDS.
There are many team players in this struggle. The American
Red Cross and the United Way. Religious leaders of all
persuasions. AIDS service organizations created by volunteers
and supporters by hard-working staff, many of them also infected
with HIV. And corporations and private foundations that together
have given over $100 million to support literally thousands of
AIDS projects.
You make my heart glad. And you make our country proud.
Other generations have faced life-threatening medical
crises, from the plague to polio. HIV and Aids are our
challenge. It is our duty to meet this disease -- not only with
medication and education -- but with open-hearted concern and
compassion for those affected.
But it is also our duty to make certain that every American
understands that HIV and AIDS are preventable diseases. Every
American must have the essential information needed to prevent
the spread of HIV and AIDS. I say HIV and AIDS because it is HIV
that causes AIDS. People become infected with the HIV virus long
before they develop the symptoms and become sick with AIDS.
2
Now, even that pattern is beginning to change. The use of
new medicines such as A-Z-T- means that more and more people with
AIDS will be able to live and work because these therapies offer
the potential of making AIDS a more manageable disease. Thank
God for the heroes of modern medicine.
And thank God for you -- the leaders of American business
and industry -- and for the support you get from labor leaders
and from your employees.
[[GB, BB, and AIDS babies ]]
But adults with HIV and AIDS need just as much care and
concern as do the children. Ninety-five percent of the 115,000
Americans with AIDS are between the ages of 20 and 59. These
were the years they planned to work and create, and save for the
future. Now their struggle is to survive.
But they have help -- your help. We would not have come as
far as we have in helping people with HIV and AIDS without
committed people like you. I believe that those of us who want
to help are addressing ourselves to the most precious gift of all
-- the gift of life.
This is a fight against a disease -- not a fight against
people. And you are among the leaders in our Nation's fight
against this disease. You have my gratitude for your commitment,
your contributions, and your determination to offer care and
support to Americans with HIV and AIDS.
The roster of participants in the work of this Conference is
an honor roll. You are part of that great American spirit that
3
makes us want to volunteer -- to roll up our sleeves and do
something to make a difference.
American is learning of your good works. An insurance
company sponsored a landmark conference to help executives deal
with the impact of AIDS. A magazine launched a survey that
helped us understand the attitudes and actions of C.E.O.'s in
responding to AIDS. An industrial giant asked an AIDS expert to
brief its chairman and key officers on AIDS -- and pledged to
conduct an education program for employees.
You are turning out for gatherings like this all around the
country. This is America responding to a crisis. This is
America at its best.
Your employees will take their cues on how to react to those
afflicted with HIV and AIDS from you. You are in a powerful,
unique position to influence the response to AIDS. When someone
asks: "Who will volunteer to help care for our co-workers with
AIDS?" you should be the first to say, "I will." If you do that,
many more will follow.
Like many of you, and like many Americans across this
country, Barbara and I have had friends who have died of AIDS.
Our love for them when they were sick and when they died was just
as great and just as intense as for anyone we have lost to heart
disease or cancer or accidents. (These are the diseases of our
era. And we cannot escape the human condition )
Of course, we're not treating a disease -- we're treating
people. People with HIV and AIDS deserve the same dignity and
4
the same concern as all victims of injury or illness. When a
friend, family member or fellow worker is injured in a car
accident -- we don't spurn them because they should have worn
seatbelts. Or when someone we know is struck by lung cancer, we
don't reject them because they shouldn't have smoked. And we
must not single out anyone for discrimination or scorn simply
because they are ill.
Once disease strikes -- we do not blame those who are
suffering. We try to love them and care for them and comfort
them. We do not fire them, or evict them, or cancel their
insurance. We've never done that to those with heart disease or
cancer or Alzheimer. And we must never do that to people with
HIV and AIDS.
People with AIDS are no different than people with other
disabling and life-threatening diseases. They are our colleagues
and co-workers. Our friends. Our families, our flesh and blood.
They are US.
The statistics we are hearing today tell me that right here
in this room, as in businesses from the board room to the mail
room, and in every agency of our government, there are Americans
infected with HIV and AIDS. Some may not even know it yet. They
are our people. And we must never turn our back on those who
need our help. Or close our minds to their problems. Or seal
our hearts against their need for hope and healing.
We must increase our efforts to educate the public about
AIDS and how it is contracted. Oar goal is to turn irrational
5
fear into rational facts. Only education will prepare a
frightened and often unfairly suspicious society for the
increasing number of long-term AIDS survivors.
Because we're not just fighting a disease -- we're also
fighting discrimination
And today I call on the House of Representatives to get on
with the job of passing a law -- a good, fair, and effective law
-- just like the Senate gave us -- that prohibits discrimination
against those with HIV and AIDS. It's time to act -- because
"time" is the one thing we don't have.
Yes, we can be encouraged by the news that current
projections of the infection rate will not be as high as we
thought just a year ago. But the epidemic is not over. It took
two years to diagnose and report the first one-thousand cases.
It took three years to find the next ten-thousand cases. Now we
report tens of thousands of new cases every year. And many
predict we can expect to continue to do so in this decade, and
even into the next century.
This epidemic is having a major impact on our health care
system. It is altering spending patterns by our government. In
1982, we spent $8 million on AIDS -- less, even, than we spent on
Clm. Battle Monuents Commission
(studying bee pollination
??).
By 1989, that had
grown to almost $3 billion -- more, even, than we spent on
(curing cancer?? war on drugs?? feeding starving Sudan,
Ethiopia??).
entire budget of National Cancer Institute or FBI
aid to the homeless
5
And I have asked Congress for still more money -- almost
$3.5 billion in the next fiscal year. Money for basic research.
For treatment and education. For protecting the civil rights of
AIDS patients.
America has the most sophisticated health care system in the
world. But even that is not sufficient. Our system depends on
private insurance and individual payments, as well as government
programs. AIDS magnifies the challenges our system must
confront, including the challenge of providing fair access to
care.
In my State of the Union Address, I asked Dr. Louis Sullivan
-- who is doing such an outstanding job as America's Secretary of
Health and Human Services -- to lead a Cabinet-level review of
health care in the 1990's.
We don't know yet where this review will lead us. But we do
know that businesses like those you represent will be a big part
of the answer to improving health care and increasing access.
I am proud of you, and proud of the many members of my
Administration who are working on behalf of those with HIV and
AIDS. I am proud of America's scientists and health care workers
at N-I-H and in hospitals and hospices and home across the
country.
Conferences like this are part of the solution. You
represent one of the many beacons in the fight against AIDS, one
of those points of light that brighten America's future with a
can-do attitude and the volunteer spirit. Together, we will make
7
a difference, for those with HIV and AIDS -- and for all
Americans.
God bless you for all that you do. May He bring his comfort
to all those who suffer, and bless the hands and hearts of those
who heal.
And may God bless the United States of America.
#
#
#
L. experimated drugs
2. worked long after diagnosis
3. leargth of disease
Sign-in Sheet
NAME
ORGANIZATION
PHONE
Barby Jobe
WH STATE Advance
456-7565
Steve Broadbent
Leaa Advance
566-5847
Jim Lobminstere
GSA.
535-0800
Bob Simon
WH Speechwriting
456-7750
Jim Burch
usss / WFO
634-5100
James Bartee usss| PPP
395-4011
SEAN BYRNE
MIL AIDE
395-1747
Jerry S GRATE WHCA
395-6001
Jerry P. PATTTON U.S. SECRET SERVICE
395-5473
COT. BC3 CORNUELL Anb CO.P.D
358-4102
ALAN BENEDECK ALLSTATE 308-402 5974
greeter
B.J. Stiles
NLCA
202/429-0930
Mike Duncan
OPL
456-7845
Rager Thompsone
MARRIETT
920-3230
CECK ARMED
ARC. Co PD
358-4141
456-7565 OR
Mildred Cooper
WH Press Advance
377-2721
DAN CURRAN
MARRIOTT
920-3230
Larry Williford - allstate sponsor + greeter
-
no intro
80' x 80' 20' whing round tables for 400
HIMD FAX
TO: Bob Simon
FROM: Richard Turman
Date: 3/28
Time: 11:25
Number of attached pages: Y
Fax Destination
456-7750
Place:
Phone number:
Notes:
Per your request.
FAX Number: 202/395-3910
Voice Confirmation: 202/395-4922
-4926
-4686
Source: FY91 Justification of
HRS - 141
Appropriation, Estimated for the
AIDS:
Committee on Uppropunitions Health Resources
Services
Specifically greater emphasis will be placed on increasing effective training Administrafi
of health care providers on therapeutic advances and studies, targeting
training needs in minority communities, extending the developing of faculty
(HRSA)
training programs in health professional schools and providing increased
training for providers in high risk populations such as community health
centers, migrant health centers, sexually transmitted disease clinics,
substance abuse programs, and maternal and child health clinica. During the
past two years, the ETCs trained over 375,000 health care providers throughout
the nation.
Program Output Date:
FY 1990
Current
FY 1991
Estimate
Request
Information/Education
Education and Training Centers
Amount
$14,549,000
$21,000,000
Projects
15
18
Individuals Trained
400,000
802,000
Funding levels for the past five fiscal years were de follows:
1986
1987
$ 1,550,000
1988
$11,106,000
1989
$14,640,000
1990
$14,549,000
Rationale for the Budget Request
In FY 1991, $21,000,000 is requested for ETCs. This amount will support 18
projects training approximately 802,000 health practitioners and 1,200 staff
members of federally-funded health facilities.
>Bob
Services and Research/Evaluation/Demonstration Projects
Community Health Care Services for AIDS
The community health care services for AIDS program will concentrate on
providing care for persons with the AIDS/HIV infection in community health
centers and migrant health centers (C/MHC#) that may ultimately help to
relieve the burden on inpatient and long term care public facilities while
improving efforts to mainstream the care for this population into the general
health care system. These measures are consistent with HRSA's current efforts
to mainstream services for the HIV infected into existing primary care
networks.
RRS - 142
AIDS:
The C/MHCs provide health care to about six million underserved persons in
urban and rural settings. While no statistically reliable information is
available to estimate the potential number of AIDS/HIV infected patients, it
is quite likely that by FY 1991 the number of seropositive individuals will
reach 270,000 or higher.
Currently, available services in many communities for persons with AIDS/HIV
infection are relatively uncoordinated, fragmented, and often very expensive.
Reimbursement for these services is variable and may be inadequate,
particularly for out-of-hospital care, since a large and growing number of
persons with AIDS are also poor and medically uninsured, or are persons
covered only by Medicaid or other forms of public assistance. If a wider
range of community-oriented, coordinated, ambulatory health care is available,
hospital costs and possibly other related costs could be decreased. Focusing
resources on outpatient services, home health care, or hospice care is likely
to improve continuity and reduce the cost of HIV/AIDS patient care.
Program Output Data:
FY 1990
Current
FY 1991
Estimate
Request
Community/Migrant Health Centers
Amount
$10,777,000
$13,323,000
HIV/AIDS population served
32,800
38,200
Medical encounters
525,000
600,000
HIV Service Demonstration Grants
A principal emphasis of HRSA in addressing the health and medical care needs
created by the HIV epidemic is to facilitate the enhancement of health care
delivery by building on existing services and systems. Accomplishment of this
goal requires the organization of comprehensive service delivery systems
heretofore incompletely developed or missing entirely in many communities.
Grants to support service demonstration projects (SDP#) have been awarded to
25 metropolitan areas in 15 states, the District of Columbia, and Puerto Rico
which have the highest cumulative prevalence of AIDS cases. The major
purposes of these demonstration projects have been to support and facilitate
the organizations of systems of care for Persons with AIDS (PWAs) through the
development of a coalition of service providers and community organizations,
to identify gaps in service needs and develop a comprehensive continuum of
services to meet those needs; to promote coordination and integration of
community resources; to ensure continuity of services through effective case
management; and to provide appropriate and cost-effective alternatives to
hospitalization for PWAs.
me -
AIDS:
Output Data (5000s)
pun-1 un
FY 1990
Current
FY 1991
Estimate
Request
High Prevalence Areas:
Existing Projects (Non-Competing)
Amount
$13,314
$11,709
Grants
8
7
Existing Projects (Competing)
Amount
$ 3,895
$ 7,715
Grants
5-8
9-11
Total
$17,209
$19,424
Funding levels for the past five fiscal years were as follows
1986
$15,312,000
1987
$10,000,000
1988
$14,361,000
1989
$14,692,000
1990
$17,209,000
Pediatric AIDS Health Care Demonstration Grants
E
These grants are awarded to projects which demonstrate strategies and
innovative models of intervention in pediatric AIDS. Through November 1989,
115,158 cases of AIDS had been reported to the Centers for Disease Control
(CDC) - Of these, 1,947 were infants and children o to 12 years of age and 447
were adolescents 13 to 19 years of age. At least one half of the total of
2,394 cases in this pediatric population have died. The vast majority of
pediatric AIDS cases are found in minority groups. The PHS predicts an
increase in pediatric AIDS cases by 1991 to a total of 3,000 cases.
The cost of providing a full range of services for the padiatric AIDS
population is expected to continue to escalate. These high costs largely
reflect daily inpatient hospital rates for children and the long periods of
hospitalization these children often experience. Comprehensive ambulatory
care and community-based services, which pediatric AIDS demonstration projects
encourage, are expected to reduce these high costs. The projects are also
designed to further coordinate services for children and women of child-
bearing age with HIV infection, AIDS or related conditions, or those at risk
for developing infection and its consequences. More specifically, the
projects are intended to: (1) demonstrate effective ways to prevent
infection, especially through the reduction of perinatal transmission, (2)
develop community based, family centered, coordinated services for infected
infants and children; and (3) develop programs to reduce the spread of HIV
infection to vulnerable populations of young people.
AIDS:
Program Output Data:
FY 1990
Current
FY 1991
Estimate
Request
Amount
$14,803,000
$14,803,000
Projects
20 - 25
20 - 25
Funding levels for the past five fiscal years were as follows:
1986
0
1987
0
1988
$ 4,787,000
1989
$ 7,806,000
1990
$14,803,000
Rationale for the Budget Request
The FY 1991 Request of $47,550,000 for Patient Care and Health Care Needs will
provide $13,323,000 for Community Health Care Services for AIDS; $19,424,000
for AIDS Service Demonstration Grants, and $14,803,000 for Pediatric AIDS
Health Care Demonstration Grants.
The $13,323,000 request for the C/MHC programs will provide for the delivery
of outpatient services to approximately 38,200 AIDS/HIV infected persons
representing an estimated 600,000 medical encounters. In medically
underserved areas, the full range of health services required for intensive
treatment of AIDS is unavailable. Finding adequate numbers of physicians,
dentists and other primary care personnel who are willing to treat AIDS
patients has become an increasingly significant problem, particularly in the
high prevalence areas where recruitment of physicians is already difficult.
The $19,424,000 for HIV Service Demonstration Grants will provide limited
support for up to 18 of the 25 existing projects. AIDS service demonstration
projects are a high priority initiative cited in the Presidential Commission
report and the Institute of Medicine report.
The request of $14,803,000 for Pediatric AIDS Health Care Demonstration
Grants, will fund existing activities and some new activities designed to
reduce costs, increase the effectiveness of care and improved prevention of
AIDS infection among pediatric populations. Both the Presidential Commission
report and the Institute of Medicine report stress the need for community
based coordinated services and residential care for infants and children.
MAR 20 '90 14:12
CARE CONSULTANTS
191 P01
COPY
attn: Bob Simon
THE
CENTER
December 27, 1989
The Honorable George Bush
The White House
Washington, D.C. 20050
Dear Mr. President:
Thank you for taking the time last Friday, in the midst
of great strife and turmoil in the world, to meet with me and
my fellow AIDS trials participants at the National Institutes
of Health. The heartfelt concern you and Mrs. Bush displayed
was evident to all present, and I hope you are able to
communicate the same to the hundreds of thousands of HIV-
infected Americans unable to be part of our discussion.
The meeting was also historic and important to the
twenty-five million gay and lesbian Americans who can share
in the knowledge that the President of the United States, for
the first time, sat down to discuss our issues and hear our
concerns.
There are many who will criticize me for having been SO
polite and diplomatic when it has taken eight years of a
pandemic of death to achieve this first meeting. Indeed, for
much of the morning, awaiting your arrival, we discussed our
issues and our pent-up frustrations. Dr. Fauci described to
us the concerned and compassionate George Bush he knows. The
consensus was to avoid confrontation or indictment of past
silence and inaction. The result was a warm and cordial
holiday visit for which I am grateful but after which I am
compelled to elaborate on issues we discussed and to raise
others WE didn't broach.
When America lost Rock Hudson to AIDS, Americans were
able for the first time to put a familiar face with a strange
and hysteria-provoking disease. The amount of media coverage
skyrocketed overnight. The image of the man, emaciated from
AIDS and unable to purchase a miracle with the millions he'd
earned as = macho leading man, invaded our living rooms and
forced us to confront some tough issues. For many, it was
difficult to consider that a national film and television
FOR THE LESBIAN & GAY
COMMUNITY OF BALTIMORE
241 WEST CHASE STREET, BALTIMORE, MARYLAND 21201 301-837-5445
MAR 20 '90 14:13
CARE CONSULTANTS
191 P02
hero was dying of a disease he contracted through closeted
homosexual behavior. For many Americans, serious questions
arose about their own vulnerability and about their
homophobia as Hudson personalized both the epidemic and the
pressures on gays to pass as straight.
The Federal government participates, actively and
passively, in the continued assaults on the self-worth and
self-esteem of gay people in general and the HIV-infected in
particular. The policies of the Department of Defense on
fitness to serve with regard to gays and HIV-infected people
are clearly in conflict with their own research. The
Immigration and Naturalization Service policies on HIV-
infected visitors help perpetuate myths about the dangers of
casual contact and contribute to the public's irrational fear
of HIV.
One might have thought that the Congress would have
become more sensitized and moved to action after losing one
of its own in Rep. Stewart McKinney. Instead we saw the
demagoguery and obstructionism of Senator Helms and Represen-
tative Dannemeyer. I cannot express how difficult it is to
live with HIV and to spend a half hour with the President of
the United States controlling my anger and frustration, and
being grateful for the visit.
I lost another friend to AIDS on Tuesday. We told you of
some of the discrimination that we face living with HIV. It
doesn't end with our deaths. Two funeral homes have falsely
claimed that it is against state law to embalm Joseph because
he was infected and autopsied. His expressed wishes were to
be viewed in his new tuxedo. Today he was cremated.
Dr. Fauci told us you have asked him often what you can
do. Mr. President, you can do a great deal, and what you
cannot do or have been advised you should not do you can
publicly acknowledge as having been considered and rejected.
You can personally appeal to Americans at risk for HIV
infection to seek anonymous counseling and testing. Those of
us who know our HIV status are more likely to be responsible
in our behavior and protect others from transmission. AZT
therapy and other preventive measures such as aerosolized
pentamidine have been shown to be effective in delaying or
ameliorating opportunistic infections. As we move toward the
day of AIDS the manageable condition, the greatest tool those
already exposed will have will be early detection and care.
You can help to expedite the testing and approval of new
drugs and the release of experimental drugs for compassionate
use. You can call for more emergency funding for those unable
to pay for their medication.
MAR 20 '90 14:13
CARE CONSULTANTS
191 P03
You can lead the nation to a moral posture that will not
tolerate discrimination and dehumanization of ill people who
now frequently lose their homes, jobs, insurance, and dignity
because of a virus that primarily impacts people often viewed
and dismissed as throw-aways who didn't matter or deserve
basic human dignity before they got infected.
You can take the message that fear must be replaced with
compassion to the INS in time for the next International AIDS
Conference in San Francisco.
You can act on the HHS Secretary's Task Force Report on
Youth Suicide, which documents the disproportionate incidence
of suitidal behaviors among gay youths. If W# don't move to
educate our educators and counselors, if we don't buttress
the self-esteem of our youth, they will be more likely to
engage in self-destructive behaviors including unprotected
sex.
You can ask the Names Project to display a portion of
the Quilt in the public rooms of the White House.
You can call for an incentive program for people to
train for careers in research and patient care to cope with
the inevitable geometric growth of our needs.
You can make the plight of HIV-infected people and their
families and care-providers a focal point in your upcoming
State or the Union message. I can think of no better example
OF the spirit of volunteerism or the success of thousands of
points of light than the grassroots responses to the AIDS
pandemic. Individuals and community organizations across
America, originating in the Gay community, have risen to meet
the needs of persons with AIDS unable to care for themselves.
Sing the unsung praises of those volunteer buddies, patient
care assistants, AIDS prevention educators and pro bano
lawyers, dentists and social workers. They are an inspiration
to us all.
I had been able to spare my family the years of worry
and anguish I've experienced because, 50 far, my health has
been stable. In anticipation of possible media coverage, I
shared my diagnosis with my family the day before our
meeting. That was not easy for me, but for them, the
journey's just begun. For my family and for families across
this country, please treat AIDS and people with AIDS with the
urgency and compassion you called for in January.
Sincerely,
Len Jackson
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:06 ;HIV/AIDS 14046392029-
2024566218:# 1
FACSIMILE TRANSMISSION COVER SHEET
Division of HIV/AIDS
A
Center for Infectious Diseases
Centers for Disease Control
CDC
1600 Clifton Road (G-29)
Atlanta, Georgia 30333 USA
CDC Switchboard: (404) 639-3311
TO:
MR. BOB SIMON
White House
Addressee fax number:
202-456-6218
Addressee voice telephone number:
FROM:
Dr. Jim Curran
CDC/CID/DHA
Date:
3/19/90
Sender voice telephone number: (404) 639 .
2000
Number of pages
[FTS: 236-1
(including this one):
31
CALL IMMEDIATELY If re-transmission is necessary.
Sender fax number: (404) 639-2029 (FTS: 236-2029]
Alternate (main CDC) fax number: (404) 639-3296
Message:
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:06 ;HIV/AIDS 14046392029-
2024566218:# 2
SERVICES
RUMAN
Name
DEPARTMENT OF HEALTH & HUMAN SERVICES
Public Health Service
Centers for Disease Control
Atlanta GA 30333
404 639-2000
FTS 236-2000
March 19, 1990
Mr. Bob Simon
The White House
Washington, DC
Dear Mr. Simon:
Enclosed per your request for background material for the President's
speech at the National Coalition on AIDS meeting are:
(1) February 9, 1990 MMWR - 1989 AIDS Update
(2) February 23, 1990 MMWR - Summary of HIV Projections Workshop
(3) HIV/AIDS Surveillance Report - Through February 1990
If you have any questions, please feel free to call me
Office (404) 639-2000
Home (404) 491-7370
Ms. Smalls will know how to reach me when I am out of town.
Sincerely,
James W. Curran, M.D., M.P.H.
Director
Division JonCerran of HIV/AIDS
Enclosures
CC:
Dr. Roper
Dr. Noble
Dr. Murphy
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:07 ;HIV/AIDS 14046392029-
2024566218;# 3
Reprinted by the
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
PUBLIC HEALTH SERVICE
CENTERS FOR DISEASE-CONTROL
February 9, 1990 / Vol. 39 / No. Б
Update: Acquired Immunodeficiency Syndrome - United States, 1989
During 1989, state and territorial health departments reported 36,238 cases (14.0
per 100,000 population) of acquired immunodeficiency syndrome (AIDS) to CDC.
Rates (reported cases per 100,000 population) were highest for blacks and Hispanics;
for persons 30-39 years of age; in the Northeast region and In U.S. territories
(primarily reflecting rates in Puerto Rico); in the largest metropolitan areas; and for
men (Table 1). Rates varied widely among states (Figure 1).* As in previous years,
most reported cases occurred among men who had had sex with other men
(hormosexual/bleexual men) (60%) and among heterosexual intravenous-drug users
(IVDUs) (23%).
*The U.S. map will appear quarterly in the MMWR. More detailed Information on AIDS cases is
provided in the monthly HIV/AIDS Surveillance Report, including an expanded 1989 year-end
summary Issued January 1980; single copies are available free from the National AIDS
Information Clearinghouse, P.O. Box 6003, Rookville, MD 20880.
FIGURE 1. Reported AIDS patients per 100,000 population, by state of residence -
United States, 1989
104
1.8
1.1
84
4.1
Vt.
3.6
22
2.7
N.H.
as
:
M
Mars. 120
$8.8
RJ.
a.e
SD
124
3.0
Cenn. 12.3
0.4
4.1
4.5
0.8
N.J.
me.9
11.4
Del.
123
227
4.8
9.7
8.6
3.0
Md.
18.0
D.C.
80.5
5.4
02
6.0
4.9
32
0.3
8.2
8.2
173
13.5
0-45
11.
5-99
27.0
10-14.9
18+
28
P.R. 44.8
16.8
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:07 ;HIV/AIDS 14046392029->
2024566218:# 4
82
MMWR
February 9, 1890
AIDS - Continued
TABLE 1. Characteristics of reported persons with AIDS and percent change in cases,
by year of report and year of diagnosis - United States, 1988 and 1989
1889
Persont change (1889 to 1999)
1998
Reported
Reported
Reported
Diagnosed'
Characteriotic
08838
(%)
Rate*
cases
cases
cases
Sex
Male
31,307
( 88.8)
25.8
28,654
9
13
Female
3,931
( 11.2)
3.1
3,642
11
23
Age (yrs)
<8
625
( 1.5)
2.8
465
13
34
5-9
82
( 0.3)
0.5
100
9
T
10-19
160
( 0.4)
0.4
154
7
wp
20-29
7,002
( 19.9)
16.8
6,648
5
11
30-39
16,270
( 46.2)
39.1
14,780
10
18
40-49
7,837
21.7)
25.8
6,781
13
19
50-59
2,526
7.2)
11.3
2,226
13
12
>60
1,037
( 2.9)
2.6
1,044
T
3
Rese/Ethnicity"
White, non-Hispanic
18,689
( 53.0)
9.8
17,248
8
10
Black, non-Hispanic
10,316
( 28.3)
36.4
9,128
13
22
Hiapanic
5,813
( 16.5)
26.4
5,511
$
14
Asian/Pacific Islander
228
( 0.8)
4.5
185
17
24
American Indian/
Alaskan Native
61
I 0.2)
3.2
32
91
73'
Region
Northeast
10,718
( 30.4)
21.3
11,574
-7
6
Midwest
3,436
( 9.8)
6.8
2,919
18
22
South
11,053
1 31.4)
13.0
9,091
22
22
West
8,518
24.2)
16.8
7,324
16
12
U.S. territories
1,516
1 4,3)
40.5
1,288
18
19
Population size of metropolitan area
<100,000**
2,799
1 7.9)
5.1
2,067
35
31
100,000-499,999
3,758
( 10.7)
8.1
2,853
32
38
500,000-399,992
3,068
( 11.3)
10.8
3,681
8
29
>1,000,000
24,713
( 70.1)
22.9
23,616
5
8
HIV exposure group
Homosexual/olsexuai men
19,652
( 58.8)
++
18,130
a
"
Intravenous-drug users
Women and heterosexual man
7,870
( 22.5)
tt
7,580
5
20
Homosexual/blsexuail man
2,138
5.1)
tt
2,128
0
6
Persons with hemophilis
Adult/adolescent
295
( 0.8)
"
300
N
9
Child
26
( 0.1)
TT
39
7
6
Transfusion recipients
Adult/adolescent
768
(
2.2)
++
869
-12
1
Child
40
0,1)
++
66
-39
-42°
Heterossxuel contacts
1,562
(
4.4)
11
1,229
27
38
Persons born in countries
where hetercesxuel
transmission predominates
392
1 1.1)
79
374
&
24"
Perinatel
547
1 1.6)
TT
468
17
38
No Identified risk
1,548
1 5.2)
**
1,012
-
-
Total
35,238
(100.0)
14.1
32,196
9
14
*Per 100,000 population.
Based on cases from October 1, 1988, through September 30, 1889, compared with cases from October 1,
1987, through September 30, 1988, and adjusted for reporting delay. Reporting delays can be estimated
reliably for cases disgnosed through September 1989.
"Excludes persons with unreported race/ethnicity.
"Estimate of percentage change in cases may be unrellable because of small number of casss.
**includes nonmetropolitan areas.
"Census data not available for calculation of rates.
"This increase la due solely to en Incresse in cases diagnosed In the third quarter of 1989, which did not
continue In the fourth quarter.
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:08 ;HIV/AIDS 14046392029-
2024566218:# 5
Vol. 39 / No. 5
MMWR
83
AIDS - Continued
The number of AIDS cases in 1989 can be compared with those in 1988 in two
ways: 1) by using cases reported during these two periods, although these cases may
have been diagnosed in earlier periods, and 2) by using cases diagnosed in these two
periods and adjusting for reporting delays (1). These two comparisons yield different
results for some categories of AIDS cases primarily because of changes in surveil-
lance criteria, which were implemented in late 1987 (2).
Surveiliance based on date of report. Compared with the 32,196 cases reported in
1988, AIDS cases reported in 1989 increased 9%. Large proportional increases
occurred for cases reported in the South, in metropolitan areas with populations
<500,000, and for persons exposed to human Immunodeficiency virus (HIV) through
heterosexual contact or perinatal transmission (Table 1). The largest proportional
declines occurred among children infected with HIV through receipt of transfusions or
clotting factors; smaller proportional declines occurred for adults who had received
transfusions (Table 1).
Surveiliance based on date of diagnosis. When 1989 and 1988 were compared
based on cases diagnosed in comparable 1-year periods (October 1-September 30
[adjustments for reporting delays cannot be done reliably for the most recent
quarter]), cases increased 14% Other differences were: proportional increases
among both blacks and Hispanics exceeded the increase for whites; cases Increased
In the Northeast, although proportionately less than eisewhere; the percentage
increase for women was substantially greater than that for men; the percentage
increase for heterosexual IVDUs exceeded that for homosexual/bisexual men; and
cases due to perinatal HIV transmission had the largest Increase among HIV exposure
groups (Table 1).
Long-term trands. in mid-1987, trends in AIDS cases by date of diagnosis (adjusted
for reporting delays) shifted-primarily reflecting a shift In trends for homosexual/
bisexual men (Figure 2a). Cases among adult transfusion recipients and persons with
hemophilia did not increase as rapidly as in earlier years and may have reached or
neared their peaks (Figure 2b). Cases associated with heterosexual IV-drug use
(Figure 2ab heterosexual contact (Figure 2c), and perinatal transmission (Figure 2d)
continued to increase.
Reported by: Local, state, and territorial health departments. Div of HIV/AIDS, Center for
Infectious Diseases, CDC.
Editorial Note: Analysis of surveillance data for AIDS cases elucidates trends in the
characteristics of persons with severe HIV disease. Varying trends for different
categories of AIDS patients in 1989 highlight the increasing complexity and extent of
the HIV/AIDS epidemic.
Interpretation of these trends is complex because of the expansion of AIDS
surveillance criteria in late 1987 (2), which extended the usefulness of surveiliance in
describing severe HIV disease. The new criterie led to greater increases in reporting
for cases in IVDUs, blacks and Hispanics, and persons Ilving in the Northeast (4) than
for AIDS cases in other persons. Also, some areas retrospectively reported cases that
met the new criteria but were diagnosed before the new criteria were Implemented
(2289 such cases were reported in 1988 and 623 in 1989). There are also other
temporal and geographic variations in reporting delays; thus, comparisons between
1988 and 1989 differ depending on whether date of diagnosis or date of report is used.
Cases diagnosed among homosexual/bisexual men continued to increase but not
as rapidly 88 in previous years; this change is most apparent in cities such as New
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:08 ;HIV/AIDS 14046392029-
2024566218;# 6
84
MMWR
February 9, 1990
AIDS - Continued
FIGURE 2. AIDS cases, by month of diagnosis - United States, January 1983-
September 1989*
a. All cases, homosexual/bisexual man, and heterosexual Intravenous-drug users (IVDUs)
3600
*
- Total Cases
A - Homosexual/Blsexual Ment
3000
Ф - Heterosexual IVDUs
2500
Cases
2000
1600
1000
500
0
1983
1984
1985
1986
1987
1988
1989
Month and Year of Diagnosis
b. Adult and adolescent recipients of transfusions and cletting factore
100
*
-
Transfusion
80
-
Clotting Factor
so
Cases
40
20
0
1983
1984
1986
1986
1987
I
1988
1989
Month and Year of Diagnosis
*Adjusted for reporting delays, by mode of HIV transmission. Points represent monthly
incidence, lines represent "smoothed" Incidence (3). The vertical lines represent the date of
expansion of the AIDS case definition in 1987.
Excludes IVDUs.
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:09 ;HIV/AIDS 14046392029-
2024566218;# 7
Vol. 39 I No. 5
MMWR
=
AIDS - Continued
FIGURE 2. AIDS cases, by month of diagnosis - United States, January 1983-
September 1989* - Continued
c. Men and women Infected with HIV through heterosexual contact (excludes persons
born in countries where heterosexuel transmission predominates)
140
# = Female
120
- Male
100
Cases
80
80
40
20
o
1983
1984
1985
1986
1987
1988
1989
Month and Year of Diagnosis
d. Children Infected with HIV by perinatal transmission
so
70
80
80
Cases
40
30
20
10
o
I
1983
1984
I
1985
1988
1987
1988
1989
Month and Year of Diagnosis
*Adjusted for reporting delays, by mode of HIV transmission. Points represent monthly
Incidence, lines represent "smoothed" Incidence (3). The vertical lines represent the date of
expansion of the AIDS case definition in 1987.
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:09 ;HIV/AIDS 14046392029-
2024566218:# 8
86
MMWR
February 9, 1990
AIDS - Continued
York, San Francisco, and Los Angeles (5). Possible reasons for this observation
include actual declines in the incidence of HIV infection, perhaps due to the success
of prevention programs; the effect of treatments that delay progression of HIV
disease; and & decrease in the completeness of reporting (5,6).
Since routine screening of donated blood for HIV antibody began in 1985,
transmission of HIV through blood transfusions has become rare (7). Transfusion-
associated AIDS now occurs predominantly among persons who received transfu-
sione before screening began. Occurrence of such cases has leveled or possibly
begun to decline, demonstrating the effectiveness of screening.
Increases in diagnosed cases were greatest for groups with little or no evidence of
reductions in HIV incidence, such as IVDUs and associated groups (i.e., persons
infected with HIV by haterosexual contact and perinatal transmission). Even though
AIDS cases are heavily concentrated In the largest cities, the epidemic is increasingly
affecting smaller communities.
References
1. Karon JM, Devine OJ, Morgan WM. Predicting AIDS Incidence by extrapolating from recent
trands. In: Castielo-Chavez C. ed. Mathematical and statistical approaches to AIDS epi-
demiciogy: lecture notes in biomathernatics. Vol 83. Berlin: Springer-Verlag, 1989.
2. CDC. Revision of the CDC surveillance case definition for acquired immunodeficiency syn-
drome. MMWR 1987;36(no. 18).
3. Chambers JM, Cleveland WS, Kieiner B, Tukey PA. Graphical methods for data analysis.
Belmont, California: Wadsworth International Group, 1983:91-104,121-3.
4. Selik RM, Buehier JW, Karon JM, at al. Impact of the 1987 revision of the case definition of
acquired Immune deficiency syndrome in the United States. J AIDS 1990;3:73-82.
5. Berkelman R, Karon J. Thomas P, Kerndt P, Rutherford G, Stehr-Green J. Are AIDS cases
among homosexual males leveling? [Abstract]. V International Conference on AIDS. Mont-
real, June 4-9, 1989:68.
6. Gail MH, Rosenberg PS, Goadert JJ. Therapy may explain recent deficite in AIDS incidence.
J AIDS 1990 (In press).
7. Ward JW, Holmberg SD, Allen JR, et al. Transmission of human Immunodeficiency virus
(HIV) by blood screened as negative for HIV antibody. N Engl J Med 1988;318:473-8.
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:10 ;HIV/AIDS 14046392029-
2024566218;# 9
Reprinted by the
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
PUBLIC HEALTH SERVICE
CENTERS FOR DISEASE CONTROL
from MMWR. February 23, 1990, Vol. 39, No. 7,
pp. 110-112 and 117-119
Current Trends
Estimates of HIV Prevalence and Projected AIDS Cases:
Summary of a Workshop, October 31-November 1, 1989
Currently about 1 million persons in the United States are Infected with human
immunodeficiency virus (HIV). The number of cases of acquired Immunodeficiency
syndrome (AIDS) will continue to Increase over the next 4 years, with & projected
52,000-57,000 cases to be diagnosed In 1990. These estimates are based on AIDS
case surveillance data, HIV seroprevalence data, and information provided by
epidemiologists, statisticians, and mathematical modelers who attended a workshop
on October 31-November 1, 1989, in Atlanta. More than 70 specialists from federal
agencies, state and local health departments, academic centers, and voluntary
organizations met to evaluate methods and data concerning HIV prevalence and
incidence, AIDS case projections, the spectrum of HIV-related immunologic defi-
ciency, and the impact of therapeutic Interventions on AIDS incidence.* A summary
of the conclusions from the workshop, together with current estimates of HIV
prevalence and AIDS case projections, are summarized below.
Prevalence and Incidence of HIV Infection
HIV Prevalence. Workshop participants assessed the 1986 Public Health Service
(PHS) estimate of 1 million to 1.5 million HIV infections (1) and evaluated the range
of current estimates derived from statistical models and from direct estimation based
on HIV seroprevalence survey data. Based on analyses presented at the workshop, it
is estimated that about 750,000 persons in the United States were Infected with HIV
at the beginning of 1986 (Table 1). This estimate is lower than the 1986 estimate,
which was based on the more limited data available at that time. In 1989, an estimated
1 million living persons in the United States were Infected with HIV (Table 1).
Estimates of current HIV prevalence derived from statistical models ranged from
650,000 to 1.4 million, after adjustments for previous deaths, underreporting of AIDS
cases, and nonascertainment of HIV disease outside the AIDS surveillance definition.
Preliminary HIV seroprevalence survey data provided estimates most consistent with
between 800,000 and 1.2 million HIV infections (3). Although based on Independent
data sources and subject to different biases, both methods provide estimates that
overlap and center around the 1 million estimate.
Discussions at the workshop highlighted the importance of estimates obtained
using back-calculation, a statistical method that estimates the number of prior HIV
Infections that would account for the AIDS cases that have subsequently occurred
(4,5). Difficulties in the use of this method were also discussed. Current HIV
*Eatimates were developed from workshop reports and may not be endorsed by all participants.
Single copies of this document will be available until February 23, 1991, from the National AIDS
Information Clearinghouse, P.O. Box 6003, Rockville, MD 20850; telephone (800) 458-5231. The
full report and recommendations from the workshop will be published in a future issue of
MMWR Recommendations and Reports.
SCDC estimates that 70%-90% of all HIV-related deaths in young adult men are reported through
AIDS surveiliance (2) and that 85% of all diagnosed AIDS cases are reported.
1
SENT BY:CDC Atlanta USA
; 3-19-90 17:10 ;HIV/AIDS 14046392029-
2024566218:#10
prevalence estimates derived from back-calculation depend on the Interpretation of
the slowing in the rate of Increase in reported AIDS cases that occurred in mid-1987,
particularly among homosexual/blsexul men who were not users of intravenous (IV)
drugs (6). Variations in the methods, assumptions, and data used by different
statisticiens make direct comparisons difficult and led to the wide range (650,000 to
1.4 million) in current HIV prevalence estimates derived from back-calculation.
HIV Incidence. The incidence of new HIV infections in the U.S. population is an
indicator of the growth of the epidemic at a given time. Incidence can be either
observed directly in groups that are repeatedly screened for HIV Infection or
estimated from serial prevalence measurements. incidence estimates derived from
HIV serosurveys based on, blood specimens from newborn infants indicate that
1500-2000 HIV-infected infants (0.5 per 1000 births) were born in 1989 (Table 1).
According to data from the U.S. Department of Defense, approximately 0.6-0,8 per
1000 active-duty personnel acquired HIV infection each year since 1986 (7,8).
Extrapolation from the lower estimate (0.6 per 1000) suggests that at least 40,000 new
HIV infections occurred in adults and adolescents in the United States during 1989,
assuming that the risk of new infection is at least as high for young adult civilians as
for military personnel (Table 1). This is a plausible assumption because the military
actively discourages homosexual/bisexual men and IV-drug users (IVDUs) from
applying for service and has policies against homosexual and drug-using behavior
among military personnel.
Spectrum of Immunologic Deficiency In HIV-Infected Persons
Assessments of immune status in a population Infected with HIV help quantify
morbidity, estimate the future burden of HIV disease, and estimate the potential need
for antiretroviral and other therapies. Because the primary target of HIV is the
T-helper lymphocyte (CD4+ cell), monitoring the CD4+ cell counts of persons with
HIV Infection provides 8 measure of HIV-related immune dysfunction. Workshop
participants reviewed data from immunologic studies in active-duty military person-
nel with HIV Infection (9; National Naval Medical Center, unpublished data) and in
cohorts of homosexual/bisexual men (10,11). These studies suggest that by 1989
TABLE 1. Estimates of HIV prevalence* and annual Incidence of new HIV Infections -
United States, 1986 and 1989
Category
January 1988
June 1989
Prevelence
-750,000
-1 million"
Annual incidence
Newborns
NA**
1,500-2,000ᵀ¹
Adults
NA
30,000"
*Total current Infactions, excluding persons who have died.
Based on unadjusted figures of 500,000-650,000 HIV infections from back-calculation models,
adjusted to 650,000-900,000 for the effects of AIDS underreporting, HIV disease not meeting the
AIDS case definition, and deaths before the time of the estimate.
'Based in part on unadjusted figures of 550,000 to 1.1 million HIV infections from back-
calculation modals, adjusted to 650,000 to 1.4 million (as in preceding footnote).
Based in part on the range of 800,000 to 1.2 million HIV infections most consistent with
preliminary seroprevalence data from CDC's family of surveys.
**Not evallable.
National seroprevalence of 1.5 per 1000 for-childbearing women multiplied by approximately
1/3 (rate at which Infected women transmit HIV perinatally to their Infants) times the number of
births (about 4 million).
"Assumes that the observed HIV seroconversion rate in active-duty military personnel is
equalled or exceeded in the general population aged 15-39 years.
2
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:11 ;HIV/AIDS 14046392029-
2024566218:#11
approximately 17%-19% of HIV-infected persons evaluated between 1985 and 1989
had <200 CD4+ cells/mm³. An additional 41%-45% had between 200 and 500 CD4+
cells/mm³. Thus, 58%-64% of persons with HIV infection may have CD4+ cell counts
of <500/mm³.
AIDS Case Projections
Participants concluded that AIDS cases in the United States will continue to
increase through 1993 in each of the current principal transmission categories (i.e.,
homosexual/bisexual men, IVDUs, persons infected through heterosexual transmis-
sion, and children infected perinatally). An estimated 37,500 cases diagnosed from
October 1988 through September 1989 eventually will be reported, a 14% increase
over the corresponding count for October 1987 through September 1988 (6).
Between 52,000 and 57,000 cases of AIDS will be diagnosed during 1990, and the
annual count will increase to 61,000-98,000 cases diagnosed during 1993 (Table 2).
These projections include an adjustment for the estimate that about 85% of diag-
nosed AIDS cases are eventually reported.
Effects of Therapy on Disease Progression
Data presented at the workshop indicate that the use of zidovudine (formerly called
AZT) initially reduces the risk for developing AIDS in HIV-infected persons who are
asymptomatic or mildly symptomatic but who have CD4+ cell counts of <500/mm³.
Current data indicate that, in a clinical trial setting, the risk in treated patients is one
third to one half the risk In untreated patients (National Institute of Allergy and
Infectious Diseases [NIAID], unpublished data). Although the use of zidovudine only
temporarily delays onset of AIDS, the therapeutic benefit may be extended by new
therapies currently being evaluated. Data available at the workshop were insufficient
to estimate the relative contribution of therapeutic interventions, such as zidovudine
or prophylaxis for Pneumocystis carinii pneumonia, to the slowing in the rate of
increase in reported AIDS cases that occurred in the middle of 1987.
Reported by: Div of HIV/AIDS, Center for Infectious Diseases, CDC.
Editorial Note: Estimates of the number of HIV-infected persons, the number with
laboratory evidence of immune dysfunction, and the projected number of persons
with AIDS are used to assess current and future health-care needs. Although these
TABLE 2. Projected numbers of AIDS cases, deaths attributable to AIDS, and living
may
persons with AIDS, after adjustments for underreporting* - United States, 1989-
1993
AIDS cases
Year
New cases*
Alive"
Deaths
1989
44,000-50,000
92,000-98,000
31,000-34,000
Nom
1990
52,000-57,000
101,000-122,000
37,000-42,000
1991
56,000-71,000
127,000-153,000
43,000-52,000
1992
58,000-85,000
139,000-188,000
49,000-64,000
1993
61,000-98,000
151,000-225,000
53,000-76,000
Through 1993'
390,000-480,000
285,000-340,000
3
*Projections are adjusted for unreported diagnoses of AIDS by edding 18% to projections
obtained from reported cases (corresponding to 85% of all diagnosed cases being reported:
1/0.85 1.18) and rounded to the nearest 1000.
Number of cases diagnosed during the year.
'Persons with AIDS alive during the year.
Rounded to the nearest 5000. Includes an estimated 120,000 AIDS cases diagnosed through
1988, 48,000 persons alive with AIDS at the end of 1988, and 72,000 deaths in diagnosed patients
through 1988.
deying thingh/ OFAIDS AIDS
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:11 ;HIV/AIDS 14046392029-
2024566218:#12
estimates cannot be made precisely, ongoing studies will provide additional data to
improve the estimates and test the assumptions on which they are based.
Current HIV prevalence estimates and AIDS case projections are influenced by the
slowing of the rapid upward trend in AIDS Incidence that occurred in 1987. The
number of AIDS cases diagnosed per month continued to Increase in 1987, but the
rate of Increase declined in the middle of that year, particularly in non-IV-drug-using
homosexual/bisexual men (6). Reasons for this change in trend include: 1) a decline
In the incidence of new HIV infections in homosexual/biaexual men in the early 1980s,
leading to 8 subsequent decline in AIDS case Incidence (12): 2) use of antiretroviral
and other therapies by mid-1987, leading to a lengthening of the Incubation period
from infection to AIDS; and 3) possible decreases in the completeness or timeliness
of reporting. The accuracy of HIV prevalence estimates and AIDS case projections
depends in part on the determination of the relative contribution of these or other
factors.
After the workshop, additional data became available on zidovudine use in
mid-1987, and estimates were made of the possible effect of medical therapy on the
change in trend in AIDS Incidence that occurred In that year. One study estimated that
zidovudine treatment given during early 1987 to 5000-7000 homosexual/bisexual
men with severe Immunodeficiency but without AIDS could account for the change in
the trend in AIDS Incidence in that group in the last half of 1987 (13). More than
10,000 persons received zidovudine from the manufacturer under a limited drug
distribution system during March-September 1987. Date from a 4% systematic
sample of this group indicate that about 4000 homosexual/blsexual men who were
infected with HIV and had low CD4+ counts but who had not yet developed AIDS
received zidovudine during that time (14). While this suggests that medical therapy
could have made a substantial contribution to the change in trend in AID$ incidence
in this group since 1987, the relative contribution of this and the other factors noted
above requires further study.
Despite the apparent change in reported AIDS incidence In 1987, needs for current
and future health-care services are expected to increase. AIDS has been diagnosed in
no more than 10% of the approximately 1 million persons currently Infected with HIV.
Recent studies Indicate that early treatment with zidovudine can slow disease
progression in asymptomatic persons with CD4+ counts <500/mm³ (NIAID, unpub-
lished data). As discussed in the report, about 60% of the estimated 1 million
HIV-Infected persons In the United States-including about 500,000 persons without
AIDS-may have CD4+ counts <500/mm³ and may benefit from such therapy.
In addition to the suffering and health-care burden involving those already
infected, a major concern is the number of new Infections that continue to occur.
Currently an estimated 1600-2000 new infections occur each year in newborns as a
result of perinatal transmission, and a minimum of 40,000 new Infections occur each
year in adults end adolescents. Comparing the estimate of about 750,000 HIV-Infected
persons alive at the beginning of 1986 with the current estimate of about 1 million
alive in mid-1989 suggests that an average of more than 80,000 new infections have
occurred yearly since 1986.
These incidence estimates must be refined to measure the growth of the epidemic
and the effectiveness of current and future prevention efforts. Nonetheless, AIDS case
projections and HIV-prevalence estimates Indicate that the annual toll of AIDS cases
and the nationwide burden of HIV-related disease will continue to grow, requiring
further prevention efforts and increased medical and social services for the next
several years for persons with HIV infection.
4
SENT BY:CDC Atlanta USA
; 3-19-90 17:12 ;HIV/AIDS 14046392029-
2024566218:#13
References
1. Public Health Service. Coolfont report: a PHS plan for prevention and control of AIDS and
the AIDS virus. Public Health Rep 1996;101:341-8.
2. Buehier JW, Devine OJ, Berkelman RL, Chevarley FM. Impact of the human immunodefi-
ciency virus epidemic on mortality trands In young men, United States. Am J Public Health
(in press).
3. Dondero TJ, St. Louis M, Anderson J, Petersen L, Pappaloanou M. Evaluation of the
estimated number of HIV infections using a spreedsheet model and empirical data [Ab-
stract). V International Conference on AIDS. Montreal, June 4-9, 1989:45.
4. Brookmeyer R, Damiano A. Statistical methods for short-term projections of AIDS Incidence.
Stat Med 1989;8:23-34.
5. Brookmeyer R, Gail MH. A method for obtaining short-term projections and lower bounds
on the size of the AIDS apidemic. J Am Stat Assoc 1998;83:301-8.
6. CDC. Update: acquired Immunodeficiency syndrome- United States, 1989. MMWR 1990;
39:81-6.
7. Garland FC, Mayers DL, Hickey TM, et al. Incidence of human immunodeficiency virus
seroconversion in U.S. Navy and Marine Corps personnel, 1986 through 1988. JAMA
1989;262:3161-5,
8. McNeil JG, Brundage JF, Wann ZF, Burke DS, Miller RN, and the Walter Reed Retrovirus
Research Group. Direct measurement of human immunodeficiency virus seroconversions in
a serially tested population of young adults in the United States Army, October 1985 to
October 1987. N Engl J Med 1989;320:1581-5.
9. Brundage JF, McNell JG, Miller RN, et al. The current distribution of CD4+ T-lymphocyte
counts among adults in the United States with human immunodeficiency virus Infection:
estimates based on the experience of the U.S. Army. J AIDS 1990;3:92-4.
10. Munoz A, Carey V, Saah A, et al. Predictors in the decline in CD4 lymphocytes in a cohort of
homosexual partners infected with the human immunodaficiancy virus. J AIDS 1988;
1:396-404.
11. DeGruttole V, Lange N, Dafni U. Modeling the progression of HIV infection. Presented at the
47th session of the International Statistics institute, August 1989.
12. CDC. Human Immunodeficiency virus infection In the United States: a review of current
knowledge. MMWR 1987;36(no. S-6).
13. Gall MH, Rosenberg PS, Gosdert JJ. Therapy may explain recent deficits in AIDS Incidence.
J AIDS (in press).
14. Andrews EB, Creagh-Kirk T, Pattishall K, Tilson H. Number of patients treated with
zidovudine in the limited distribution system, March-September 1987 [Letter]. J AIDS (In
press).
5
U.S. GOVERNMENT PRINTING OFFICE : 1990 - 731-011 / 09183
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:13 ;HIV/AIDS 14046392029-
20245662181#14
HIV/AIDS
SURVEILLANCE
U.S. AIDS cases reported through February 1990
Issued March 1990
Contents
Figure 1. AIDS annual rates per 100,000 population
3
Figure 2. Adult/adolescent and pediatric AIDS cases
4
Figure 3. Pediatric AIDS cases
4
Table 1. AIDS cases and annual rates per 100,000 population, by state
5
Table 2. AIDS cases and annual rates per 100,000 population, by metropolitan
area with 500,000 or more population
6
Table 3. AIDS cases by age group, exposure category, sex, and year of report
8
Table 4. AIDS cases by age group, exposure category, and race/ethnicity
9
Table 5. Adult/adolescent AIDS cases by sex, exposure category, and race/ethnicity
10
Table 6. AIDS cases In adolescents and adults under age 25, by exposure category
and year of report
11
Table 7. AIDS cases by sex, age at diagnosis, and race/ethnicity
12
Table 8. AIDS cases, case-fatality rates, and deaths, by half-year and age group
13
Table 9. AIDS cases by year of diagnosis and definition category
14
Table 10. Adult/adclescent AIDS cases by single and multiple exposure categories
15
Figure 4. Results of investigations of AIDS cases with undetermined risk
16
Technical notes
17
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Health Service
Centers for Disease Control
Center for Infectious Diseases
Division of HIV/AIDS
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:13 ;HIV/AIDS 14046392029->
2024566218:#15
The HIV/AIDS Surveillance Report Is published each month by the Division of HIV/AIDS, Center for
Infectious Diseases, Centers for Disease Control, Atlanta, GA 30333. An expanded, year-end edition is
published each January. All data contained in the Report are provisional.
Suggested Citation: Centers for Disease Control. HIV/AIDS Surveillance Report, March
1990:1-18
Centers for Disease Control
William L. Roper, M.D., M.P.H.
Director
Gary R. Noble, M.D., M.P.H.
Deputy Director (HIV)
Center for Infectious Diseases
Frederick A. Murphy, D.V.M., Ph.D.
Director
Division of HIV/AIDS
James W. Curran, M.D., M.P.H.
Director
Surveillance Branch
Ruth L. Berkelman, M.D.
Chief
Reporting and Analysis Section
Jeanette K. Stehr-Green, M.D.
Chief
Statistics and Data Management Branch
W. Meade Morgan, Ph.D.
Chief
Xenophon M. Santas
Computer Specialist
Single copies of the HIV/AIDS Surveillance Report are available free from the National AIDS Information
Clearinghouse, P.O. Box 6003, Rockville, MD 20850. Individuals or organizations can be added to the
mailing list by writing to Centers for Disease Control, CID/DHA/TIA, Mailstop G-29, Atlanta, GA 30333.
Confidential information, referrals, and educational material on AIDS are available from the National
AIDS Hotline: 1-800-342-AIDS, 1-800-342-SIDA (Spanish access), and 1-800-AIDS-TTY (deaf access).
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:13 ;HIV/AIDS 14046392029-
20245662181#16
Figure 1. AIDS annual rates per 100,000 population, for cases reported March 1989 through
February 1990, United States
9.9
1.9
1.0
9.0
26
0.3
3.0
38.8
-
Mass. 13.4
2.3
R.L.
8.6
1.6
10.1
Conn. 13.5
29
N.J. 29.8
17.0
10.0
Del. 11.4
11.4
3.0
Md. 17.4
9.8
23.1
9.4
D.C. 78.1
8.0
9.8
6.1
38
9.7
Legend
(rate per
7.8
17.8
100,000)
14.6
0- 3
12.0
3-6
26.7
6-8
9-12
12-18
15-20
P.R. 47.7
3.8
20+
18.0
March 1990
3
HIV/AIDS Surveillance Report
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:14 ;HIV/AIDS 14046392029->
2024566218:#17
Figure 2. Adult/adolescent and pediatric AIDS cases, reported March 1989 through
February 1990, United States
458
16
7
59
246
181
X
27
$3
2
148
Mass.
791
12
491
6,977
R.I.
85
47
46
1,191
Conn. 437
178
515
N.J. 2,301
88
1,169
298
Del.
74
392
57
577
Md.
789
127
6,691
401
119
D.C.
472
392
248
350
209
95
92
341
210
211
1,145
2,599
550
3,355
23
a
P.R. 1,577
%
208
Figure 3. Pediatric AIDS cases, reported March 1989 through February 1990, United States
S
5
1
1
,
202
Mass,
18
7
R.I.
2
18
Conn.
18
1
1
N.J.
6
34
18
4
Del.
3
6
Md,
20
55
2
3
D.C.
12
8
3
1
4
9
N
3
10
23
7
100
1
to
P.R. 56
HIV/AIDS Surveillance Report
4
March 1990
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:14 ;HIV/AIDS 14046392029-
2024566218:#18
Table 1. AIDS cases and annual rates per 100,000 population, by state, reported
March 1988 through February 1989, March 1989 through February 1990; and
cumulative totals, by state and age group, through February 1990
Mar. 1988-
Mar. 1989-
Cumulative totals
Feb. 1989
Feb. 1990
Adults/
Children
State of residence
No.
Rate
No.
Rate
adolescents
< 13 years old
Total
Alabama
218
5.3
211
5.1
672
16
688
Alaska
15
2.6
23
3.8
80
2
82
Arizona
256
7.3
350
9.8
1,045
6
1,051
Arkansas
80
3.3
92
3.8
274
3
277
California
5,779
20.6
6,591
23.1
24,095
169
24,264
Colorado
325
9.6
392
11.4
1,290
8
1,298
Connecticut
423
13.1
437
13.5
1,476
62
1,528
Delaware
77
12.0
74
11.4
235
4
239
District of Columbia
515
82.8
472
76.1
2,004
29
2,033
Florida
2,895
23.6
3,355
26.7
9,944
276
10,220
Georgia
903
14.3
1,145
17.8
3,237
38
3,275
Hawaii
84
7.5
206
18.0
499
2
501
Idaho
12
1.2
27
2.6
55
2
57
Illinois
1,021
8.8
1,159
10.0
3,584
51
3,635
Indiana
176
3.2
298
5.4
743
8
751
lowa
54
1.9
46
1.8
167
3
170
Kansas
84
3.4
127
5.1
328
3
329
Kentucky
110
2.9
119
3.2
338
5
343
Louisiana
425
9.2
558
12.0
1,699
25
1,724
Maine
34
2.9
66
5.5
167
2
169
Maryland
608
13.5
789
17.4
2,283
52
2,335
Massachusetts
732
12.4
791
13.4
2,612
50
2,662
Michigan
464
5.1
491
5.4
1,492
22
1,514
Minnesota
166
3.9
181
4.2
652
7
659
Mississippi
120
4.5
210
7,8
431
7
438
Missouri
424
8.3
481
9.4
1,359
10
1,369
Montana
12
1.4
16
1.9
42
-
42
Nebraska
42
2.6
47
2.9
142
1
143
Nevada
119
11.8
175
17.0
463
4
467
New Hampshire
41
3.9
53
5.0
148
4
152
New Jersey
2,448
31.8
2,301
29.8
8,137
222
8,359
New Mexico
58
3.8
95
6.1
249
1
250
New York
7,006
39.1
6,977
38.8
27,370
635
28.005
North Carolina
337
5.2
392
6.0
1,141
23
1,164
North Dakota
4
0.6
7
1.0
18
-
18
Ohio
486
4.5
515
4.8
1,710
27
1,737
Oklahoma
136
4.0
209
6.1
539
9
548
Oregon
173
6.4
246
9.0
740
3
743
Pennsylvania
855
7.2
1,191
10.1
3,443
61
3,504
Rhode Island
91
9.3
85
8.6
298
7
305
South Carolina
185
5.3
341
9.7
732
19
751
South Dakota
7
1.0
2
0.3
17
-
17
Tennessee
301
6.2
248
5.1
780
12
792
Texas
2,396
13.7
2,599
14.6
8,583
74
8,657
Utah
75
4.3
86
4.9
257
5
262
Vermont
11
2.0
21
3.8
58
1
59
Virginia
316
5.3
577
9.6
1,504
25
1,529
Washington
405
8.8
458
9.9
1,584
11
1,595
West Virginia
24
1.3
57
3.0
124
2
126
Wisconsin
107
2.2
145
3.0
442
2
444
Wyoming
9
1.7
12
2.3
31
-
31
U.S. total
31,644
12.9
35,546
14.3
119,311
2,000
121,311
Guam
1
0.8
2
1.5
7
-
7
Pacific Islands, U.S.
1
0.7
-
-
1
-
1
Puerto Rico
1,401
42.5
1,577
47.7
3,481
112
3,593
Virgin Islands, U.S.
47
41.5
17
14.8
68
4
72
Total
33,094
13.3
37,142
14.8
122,868
2,116
124,984
March 1990
5
HIV/AIDS Surveillance Report
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:15 ;HIV/AIDS 14046392029-
2024566218:#19
Table 2.
AIDS cases and annual rates per 100,000 population, by metropolitan area with
500,000 or more population, reported March 1988 through February 1989, March
1989 through February 1990; and cumulative totals, by area and age group,
through February 1990
Mar. 1988-
Mar. 1989-
Cumulative totals
Metropolitan
Fab. 1989
Feb. 1990
Adults/
Children
area of residence
No.
Rate
No.
Rate
adolescents
<13 years old
Total
Akron, Ohio
28
4.4
19
3.0
81
-
81
Albany-Schenectady, N.Y.
67
7.9
67
7.9
246
2
248
Allentown, Pa.
31
4,7
45
6.8
115
4
119
Anaheim, Calif.
245
11.0
276
12.2
943
7
950
Atlanta, Ga.
673
24.9
871
31.5
2,447
21
2,468
Austin, Tex.
113
14.0
226
27.0
528
5
533
Bakersfleld, Calif.
21
4.0
36
6.6
81
I
81
Baltimore, Md.
363
15.9
499
21.7
1,293
37
1,330
Baton Rouge, La.
41
7.2
53
9.1
146
-
146
Bergen-Passaic, N.J.
275
21.1
249
19.1
1,040
24
1,064
Birmingham, Ala.
77
8.4
67
7.3
215
8
221
Boston, Mass.
585
15.6
617
16.5
2,073
42
2,115
Bridgeport, Conn.
124
14.9
130
15.6
429
16
445
Buffalo, N.Y.
40
4.2
63
6.7
174
-
174
Charleston, S.C.
43
8.4
68
13.0
164
-
164
Charlotte, N.C.
77
7.0
78
7.0
242
4
246
Chicago, III.
866
13.9
941
15.0
3,025
36
3,061
Cincinnati, Ohio
62
4.4
73
5.1
236
3
239
Cleveland, Ohio
128
7.0
138
7.5
464
7
471
Columbus, Ohio
116
8.8
108
8.1
374
3
377
Dallas, Tex.
574
22.6
600
23.0
2,107
8
2,115
Dayton, Ohio
52
5.6
60
6.5
176
3
179
Denver, Colo.
265
15.5
313
18.0
1,047
5
1,052
Detroit, Mich.
326
7.6
344
8.1
1,048
16
1,064
El Paso, Tex.
13
2.3
34
5.8
76
1
77
Fort Lauderdale, Fla.
427
35.9
537
44.4
1,622
25
1,647
Fort Worth, Tex.
137
10.3
146
10.6
450
5
455
Fresno, Callf.
46
7.4
52
8.2
140
1
141
Gary, Ind.
12
2.0
35
5.8
71
-
71
Grand Rapide, Mich,
28
4.2
20
3.0
71
1
72
Greensboro, N.C.
56
6.1
55
5.9
169
3
172
Greenville, S.C.
16
2.6
36
5.8
84
-
84
Harrisburg, Pa.
40
6.9
48
8.3
131
4
135
Hartford, Conn.
121
11.1
143
13.1
412
10
422
Honolulu, Hawaii
71
8.2
135
15.4
379
2
381
Houston, Tex.
964
28.2
969
27.7
3,630
31
3,661
Indianapolis, Ind.
85
6.9
147
11.9
333
2
335
Jacksonville, Fla.
155
17.4
205
22.5
508
11
519
Jersey City, N.J.
453
81.4
307
55.2
1,395
33
1,428
Kansas City, Mo.
236
15.4
260
16.8
744
3
747
Knoxville, Tenn.
26
4.3
22
3.6
83
-
83
Las Vegas, Nev.
82
13.5
126
20.2
331
4
335
Little Rock, Ark.
33
6.4
42
8.1
119
1
120
Los Angeles, Callf.
1,946
23.0
2,278
26.5
8,472
73
8,545
Louisville, Ky.
55
5.7
52
5.4
150
2
152
Memphis, Tenn.
92
9.5
75
7.7
248
4
252
Miami, Fla.
774
42.9
856
47.1
2,921
124
3,045
Middlesex, N.J.
217
22.6
179
18.5
650
21
671
Milwaukee, Wis.
60
4,4
81
5.9
253
1
254
Minneapolis-Saint Paul, Minn.
148
6.3
161
6.8
566
6
572
Monmouth-Ocean City, N.J.
145
14.9
186
18.9
484
17
501
Nashville, Tenn.
123
13.0
75
7.8
259
6
265
Nassau-Suffolk, N.Y.
358
13.4
362
13.5
1,285
37
1,322
New Haven, Conn.
137
17.4
120
15.2
462
26
488
New Orleans, La.
241
17.8
339
24.9
1,090
16
1,106
New York, N.Y.
6,055
70.7
5,953
69.3
23,885
576
24,461
Newark, N.J.
1,054
56.0
979
52.1
3,450
99
3,549
Norfolk. Va.
80
5.8
127
9.1
322
7
329
HIV/AIDS Surveillance Report
6
March 1990
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:16 ;HIV/AIDS 14046392029-
2024566218:#20
Table
2.
AIDS cases and annual rates per 100,000 population, by metropolitan area with
500,000 or more population, reported March 1988 through February 1989, March
1989 through February 1990; and cumulative totals, by area and age group,
through February 1990 - Continued
Mar. 1988-
Mar. 1989-
Cumulative totals
Metropolitan
Feb. 1989
Feb. 1990
Adults/
Children
area of residence
No.
Rate
No.
Rate
adolescents
<13 years old
Total
Oakland, Calif.
380
19.0
391
19.3
1,460
10
1,470
Oklahoma City, Okla.
23
2.3
24
2.3
152
-
152
Omaha, Neb.
32
5.1
34
5.4
100
-
100
Orlando. Fla.
179
18.5
165
16.5
493
5
498
Oxnard-Ventura, Callf.
40
6.3
35
5.4
114
-
114
Philadelphia, Pa.
643
13.3
853
17.6
2,594
40
2,634
Phoenix, Ariz.
187
9.0
263
12.3
765
4
769
Pittsburgh, Pa.
80
3.8
174
8.4
444
1
445
Portland, Oreg.
138
11.8
186
15.7
580
1
581
Providence, R.I.
85
9.5
79
8.8
277
6
283
Raleigh-Durham, N.C.
71
10.4
96
13.8
257
7
264
Richmond, Va.
55
6.7
121
14.5
290
1
291
Riverside-San Bernardino, Calif.
170
8.0
243
11.0
724
12
736
Rochester, N.Y.
85
8.6
60
6.0
272
1
273
Sacramento, Callf.
162
11.9
155
11.2
510
5
515
Saint Louis, Mo.
187
7.7
202
8.2
578
6
584
Salt Lake City, Utah
63
5.8
70
6.4
221
4
225
San Antonio, Tex.
267
20.1
207
15.2
604
9
613
San Diego, Calif.
424
18.4
548
23.3
1,702
16
1,718.
San Francisco, Calif.
1,734
105.3
1,866
112.1
7,707
15
7,722
San Jose, Calif.
151
10.3
141
9.5
553
6
559
San Juan, P.R.
866
77.4
968
86.1
2,155
80
2,235
Scranton, Pa.
22
3.1
34
4.7
90
3
93
Seattle, Wash.
296
16.4
349
19.1
1,204
9
1,213
Springfield, Mass.
31
5.3
46
7.8
122
1
123
Syracuse, N.Y.
23
3.5
39
5.9
122
4
126
Tacoma, Wash.
18
3.3
34
6.2
100
1
101
Tampa, Fla.
435
21.6
367
17.8
1,155
21
1,176
Toledo, Ohio
21
3.5
26
4.3
80
1
81
Tucson, Ariz.
41
6.6
57
9.1
195
2
197
Tulsa, Okla.
46
6.0
63
8.1
155
2
157
Washington, D.C.
820
22.6
907
24.6
3,420
53
3,473
West Palm Beach, Fla.
310
38.5
319
38.3
1,043
44
1,087
Wilmington, Del.
62
11.1
62
11.0
192
3
195
Worcester, Mass.
45
6.8
36
5.4
127
3
130
Metropolitan area subtotal
27,870
19.6
30,303
21.1
104,496
1,777
106,273
All other areas
5,224
4.9
6,839
6.3
18,372
339
18,711
Total
33,094
13.3
37,142
14.8
122,868
2,116
124,984
1
Only Includes data from metropolitan areas which have populations of 500,000 or more.
March 1990
7
HIV/AIDS Surveillance Report
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:16 :HIV/AIDS 14046392029-
2024566218:#21
Table 3. AIDS cases by age group, exposure category, and sex, reported March 1988
through February 1989 and March 1989 through February 1990; and cumulative
totals, by age group and exposure category, through February 1990, United
States
Males
Females
Totale
Mar. 1988-
Mar. 1989-
Mar. 1988-
Mar. 1989-
Mar. 1988-
Mar. 1988-
Cumulative
Fab. 1989
Feb. 1990
Feb. 1989
Feb. 1990
Feb. 1989
Feb. 1990
total'
Adult/adoleecent
exposure category
No. (%)
No. (%)
No. (%)
No. (%)
No. (%)
No. (%)
No. (%)
Male homosexual/bisexual
contact
18,563 (84)
20,572 (63)
-
-
18,563 (57)
20,572
(56)
73,990 (60)
Intravenous (IV) drug use
(female and heterosexual male)
6,087
(21)
6,619 (20)
1,823
(54)
1,944
(50)
7,910 (24)
8,563 (23)
26,092 (21)
Male homosexual/bisexual
contact and IV drug use
2,193 ( 8)
2,193 7)
-
1
2,193 ( 7)
2,193 ( 6)
8,530 ( 7)
Hemophilla/coagulation disorder
304 ( 1)
268 ( 1)
4 (0)
9 ( 0)
308 ( 1)
277 ( 1)
1,114 ( 1)
Heterosexual contact:
634 ( 2)
834 ( 3)
1,044
(31)
1,265 (33)
1,678 ( 5)
2,099 ( 6)
6,027 ( 5)
Sex with IV drug user
273
391
673
815
946
1,206
3,102
Sex with bisexual male
-
-
99
97
99
97
366
Sex with person with hemophilla
1
3
10
22
11
25
55
Born in Pattern-IF country
256
301
121
133
377
434
1,724
Sex with person bom in
Pattern-il country
18
13
5
12
24
25
89
Sex with transfusion recipient
with HIV infection
9
13
21
21
30
34
90
Sex with HIV-infacted person,
risk not specified
77
113
114
165
191
278
601
Receipt of blood transfusion,
blood components, or tissue³
505 ( 2)
471 ( 1)
345 (10)
322
( 8)
850 ( 3)
793 ( 2)
2,984 ( 2)
Other/undetermined⁶
852 ( 3)
1,622 ( 5)
177
(
5)
348
(
9)
1,029 ( 3)
1,970 (5)
4,131 ( 3)
Adult/adoleecent subtotal
29,138 (100)
32,579 (100)
3,393 (100)
3,888 (100)
32,531 (100)
36,467 (100)
122,868 (100)
Pediatric (<13 years old)
exposure category
Hemophilla/cosqulation disorder
34 (11)
24 ( 7)
-
1 ( 0)
34 (6)
25 ( 4)
108 ( 6)
Mother with/at risk for HIV
infection:
232 (74)
293 (83)
229
(92)
285
(89)
461 (82)
578 (86)
1,734 (82)
IV drug use
122
142
118
119
240
261
881
Sex with IV drug user
51
73
37
67
88
140
364
Sex with bisexual male
3
7
6
6
9
13
39
Sex with person with hemophilia
-
-
1
-
1
-
7
Born In Pattern-Ii country
24
28
23
27
47
55
182
Sex with person born
in Pattern-II country
-
1
-
3.
-
4
7
Sex with transfusion recipient
with HIV infection
2
1
2
4
4
5
10
Sex with HIV-infected person.
risk not specified
13
9
8
15
21
24
66
Receipt of blood transfusion,
blood components, or tissue
1
4
9
7
10
11
36
Has HIV infection, risk not
specified
16
28
25
37
41
65
142
Receipt of blood transfusion,
blood components, or tissue
40 (13)
27 ( 8)
14 (6)
17 ( 6)
54 (10)
44 7)
219 (10)
Undetermined
8 ( 3)
11 ( 3)
6 ( 2)
17 ( 5)
14 (2)
28 ( 4)
56 ( 3)
Pediatric subtotal
314 (100)
355 (100)
249 (100)
320 (100)
563 (100)
675 (100)
2,116 (100)
Total
29,452
32,934
3,642
4,208
33,094
37,142
124,984
: Includes 3 patients known to be infected with human immunodeficiency virus type 2 (HIV-2). See MMWR 1989;38:572-580.
R See technical notes.
2 includés 6 transfusion recipients who received blood screened for HIV antibody, and 1 tissue recipient.
4 "Other" refers to 2 health-care workers who seroconverted to HIV and developed AIDS after occupational exposure to HIV-infected blood. "Undetermined"
refers to patients whose mode of exposure to HIV is unknown. This includes patients under investigation; patients who died, were lost to follow-up, or refused
interview; and patients whose mode of exposure to HIV remains undetermined after investigation. See Figure 4.
HIV/AIDS Surveillance Report
8
March 1990
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:17 :HIV/AIDS 14046392029-
2024566218:#22
Table 4. AIDS cases by age group, exposure category, and race/ethnicity, reported
through February 1990, United States
White, not
Black, not
Asian/Pacific
American Indian/
Adult/adolescent
Hispanic
Hispanic
Hispanic
Islander
Alaskan Native
Total
exposure category
No. (%)
No. (%)
No. (%)
No. (%)
No. (%)
No. (%)
Male homosexual/bisexual contact
53,155 (77)
12,222
(37)
7,808 (41)
567 (74)
83 (52)
73,990 (60)
intravenous (IV) drug use
(female and heterosexual male)
5,244 ( 8)
13,010
(39)
7,704 (40)
31 ( 4)
27 (17)
26,092 (21)
Male homosexual/blsexual contact
and IV drug use
5,031 ( 7)
2,225 ( 7)
1,229 ( 6)
12 ( 2)
21 (13)
8,530 ( 7)
Hemophillia/coagulation disorder
932 ( 1)
72 (0)
85 ( 0)
15 ( 2)
6 ( 4)
1,114 ( 1)
Heterosexual contact:
1,217 { 2)
3,747 (11)
1,012 ( 5)
29 ( 4)
9 ( 6)
6,027 ( 5)
Sex with IV drug user
681
1,572
827
12
4
3,102
Sex with bisexual male
192
120
46
6
1
366
Sex with person with hemophilia
49
4
1
1
-
55
Born in Pattern-II country
3
1,703
9
4
I
1,724
Sex with person born in
Pattern-II country
26
60
3
-
I
89
Sex with transfusion recipient
with HIV Infection
66
14
8
1
-
90
Sex with HIV-infected person,
risk not specified
200
274
118
5
4
601
Receipt of blood transfusion,
blood components, or tissue²
2,147 ( 3)
482 ( 1)
285 ( 1)
61 ( 8)
3 ( 2)
Other/undetermined³
2,984 ( 2)
1,552 ( 2)
1,569 ( 5)
913 ( 5)
48 ( 8)
10 ( 6)
4,131 ( 3)
Adult/adolescent subtotal
69,278(100)
33,327 (100)
19,036(100)
763(100)
159(100)
122,868(100)
Pediatric (<13 years old)
exposure category
Hemophilia/coagulation disorder
75 (16)
15 ( 1)
14 ( 3)
3 (33)
-
Mother with/at risk for HIV
108 ( 5)
infection:
259 (56)
1,012 (92)
452 (85)
3 (33)
4(100)
1,734 (82)
IV drug use
126
512
239
1
2
881
Sex with IV drug user
55
163
145
-
I
364
Sex with bisexual male
13
18
8
-
-
39
Sex with person with hemophilia
5
1
1
I
-
7
Born in Pattern-II country
2
179
1
-
-
182
Sex with person born in
Pattern-II country
-
6
I
-
1
7
Sex with transfusion recipient
with HIV infection
5
3
2
-
-
10
Sex with HIV-infected person,
risk not specified
11
28
24
1
1
Receipt of blood transfusion,
66
blood components, or tissue
13
13
10
-
-
Has HIV infection, risk not
36
specified
29
89
22
1
1
142
Receipt of blood transfusion,
blood components, or tissue
122 (26)
48 ( 4)
46 ( 9)
3 (33)
-
Undetermined
219 (10)
9 (2)
29 ( 3)
17 ( 3)
I
-
55 ( 3)
Pediatric subtotal
465(100)
1,104 (100)
529(100)
9(100)
4(100)
2,116(100)
Total
69,743
34,431
19,565
772
163
124,984
1 See technical notes.,
3 2 Includes 5 transfusion recipients who received blood screened for HIV antibody, and 1 tissue recipient.
"Other" refers to 2 health-care workers who seroconverted to HIV and developed AIDS after occupational exposure to HIV-infected blood. "Undetermined"
refers to patients whose mode of exposure to HIV is unknown. This includes patients under investigation; patients who died, were lost to follow-up, or refused
interview; and patients whose mode of expesure to HIV remains undetermined after investigation. See Figure 4.
4 Includes 310 persons whose race/ethnicity is unknown.
March 1990
9
HIV/AIDS Surveillance Report
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:17 :HIV/AIDS 14046392029-
2024566218:#23
Table 5. Adult/adolescent AIDS cases by sex, exposure category, and race/ethnicity,
reported through February 1990, United States
White, not
Black, not
Asian/Pacific
American Indian/
Male
Hispanic
Hispanic
Hispanic
Islander
Alaskan Native
Total⁴
exposure category
No. (%)
No. (%)
No. (%)
No. (%)
No. (%)
No. (%)
Male homosexual/bisexual contact
53,155
(80)
12,222
(45)
7,808
(47)
567 (81)
83 (62)
73,990 (66)
Intravenous (IV) drug use
(heterosexual)
3,987
(6)
9,606
(35)
6,498
(39)
20 ( 3)
13
(10)
20,186 (18)
Male homosexual/bisexual contact
and IV drug use
5,031
(
8)
2,225
(
B)
1,229
(
7)
12 ( 2)
21 (16)
8,530 ( 8)
Hemophilia/coagulation disorder
908 ( 1)
69 (0)
84 ( 1)
15 ( 2)
6 ( 4)
1,086 ( 1)
Heterosexual contact:
379
(
1)
1,887 ( 7)
186
(
1)
5 ( 1)
1 ( 1)
2,462 ( 2)
Sex with IV drug user
245
491
130
1
1
868
Sex with person with hemophilia
4
1
-
-
-
5
Born in Pattern-II country
2
1,250
7
3
-
1,265
Sex with person born in
Pattern-II country
24
25
3
-
-
52
Sex with transfusion recipient
with HIV infection
16
7
1
-
-
25
Sex with HIV-infected person,
risk not specified
88
113
45
1
-
247
Receipt of blood transfusion,
blood components, or tissue²
1,392 ( 2)
255 ( 1)
153 ( 1)
38 ( 5)
1 ( 1)
Other/undetermined³
1,844 ( 2)
1,336
(2)
1,166 ( 4)
787
(
5)
41 ( 6)
9 ( 7)
3,369 ( 3)
Male subtotal
66,188
(100)
27,430 (100)
16,745 (100)
698 (100)
134 (100)
111,467 (100)
Female
exposure category
IV drug use
1,257
(41)
3,404
(58)
1,206
(53)
11 (17)
14 (56)
Hemophilla/coagulation disorder
5,906 (52)
24 (1)
3 (0)
1 (0)
-
-
Heterosexual contact:
28 (0)
638 (27)
1,860 (32)
826 (36)
24 (37)
8 (32)
3,565 (31)
Sex with IV drug user
436
1,081
697
11
3
2,234
Sex with bisexual male
192
120
46
6
1
366
Sex with person with hemophilia
45
3
1
1
-
50
Born in Pattern-II country
1
453
2
1
-
459
Sex with person born in
Pattern-II country
2
35
-
-
-
37
Sex with transfusion recipient
with HIV infection
50
7
7
1
-
65
Sex with HIV-infected person,
risk not specified
112
161
73
4
4
354
Receipt of blood transfusion,
blood components, or tissue
755 (24)
227 ( 4)
132 ( 6)
23 (35)
Other/undetermined
2 ( 8)
1,140 (10)
216 (7)
403 ( 7)
126
(
5)
7 (11)
1 ( 4)
762 (7)
Female subtotal
3,090 (100)
5,897 (100)
2,291 (100)
65 (100)
25 (100)
11,401 (100)
Total
69,278
33,327
19,036
763
159
122,868
, See technical notes.
3 2 Includes 6 transfusion recipients who received blood screened for HIV antibody, and 1 tissue recipient.
"Other" refers to 2 health-care workers who seroconverted to HIV and developed AIDS after occupational exposure to HIV-infected blood. "Undetermined"
refers to patients whose mode of exposure to HIV is unknown. This includes patients under investigation; patients who died, were lost to follow-up, or refused
4
Interview: and patients whose mode of exposure to HIV remains undetermined after investigation. See Figure 4.
Includes 272 males and 33 females whose race/ethnicity is unknown.
HIV/AIDS Surveillance Report
10
March 1990
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:18 ;HIV/AIDS 14046392029-
20245662181#24
Table 6. AIDS cases in adolescents and adults under age 25, by exposure category,
reported March 1988 through February 1989, March 1989 through February 1990,
and cumulative totals through February 1990, United States
13-19 years old
20-24 years old
Mar. 1988-
Mar. 1989-
Cumulative
Mar. 1988-
Mar. 1989-
Cumulative
Feb. 1989
Feb. 1990
total
Feb. 1989
Feb. 1990
total
Exposure category
No. (%)
No. (%)
No. (%)
No. (%)
No. (%)
No. (%)
Male homosexual/bisexual contact
32 (27)
33
(25)
139 (29)
812
(57)
792
(52)
3,104
(58)
Intravenous (IV) drug use
(female and heterosexual male)
19 (16)
13
(10)
55 (11)
254
(18)
277
(18)
842
(16)
Male homosexual/blsexual contact
and IV drug use
6 (5)
3 (2)
23 ( 5)
121 (8)
133 ( 9)
507
(9)
Hemophilis/cosgulation disorder
35 (30)
40 (31)
150 (31)
43 ( 3)
35 ( 2)
141 ( 3)
Heterosexual contact:
11 ( 9)
23
(18)
57
(12)
120 ( 8)
168 (11)
466
(
9)
Sex with IV drug user
5
17
34
75
94
250
Sex with bisexual male
-
1
3
12
9
43
Sex with person with hemophilia
-
1
1
1
8
12
Born in Pattern-II' country
3
1
12
11
23
94
Sex with person born in
Pattern-II country
-
-
-
-
2
5
Sex with transfusion recipient
with HIV infection
-
-
I
I
2
3
Sex with HIV-infected person,
risk not specified
3
3
7
21
30
59
Receipt of blood transfusion,
blood components, or tissue
13 (11)
5 ( 4)
38 ( 8)
25 ( 2)
8 ( 1)
79 ( 1)
Undetermined²
1 ( 1)
14 (11)
24 ( 5)
58 ( 4)
99 ( 7)
225
(
4)
Total
117 (100)
131 (100)
486 (100)
1,433 (100)
1,512 (100)
5,364 (100)
1 See technical notes.
2 "Undetermined" refers to patients whose mode of exposure to HIV is unknown. This includes patients under investigation; patients who died, were lost to
follow-up, or refused interview; and patients whose mode of exposure to HIV remains undetermined after investigation. See Figure 4.
March 1990
11
HIV/AIDS Surveillance Report
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:18 ;HIV/AIDS 14046392029-
2024566218:#25
Table 7. AIDS cases by sex, age at diagnosis, and race/ethnicity, reported through
February 1990, United States
White, not
Black, not
Asian/Pacific
American Indian/
Males
Hispanic
Hispanic
Hispanic
Islander
Alaskan Native
Total1
Age at diagnosis (years)
No. (%)
No. (%)
No. (%)
No. (%)
No. (%)
No. (%)
Under 5
161 (0)
493 ( 2)
246 ( 1)
3 ( 0)
2 ( 1)
907 ( 1)
5-12
125 ( 0)
68 ( 0)
42 ( 0)
3 ( 0)
-
240 ( 0)
13-19
195 ( 0)
112 ( 0)
68 ( 0)
5 ( 1)
3 ( 2)
384 ( 0)
20-24
2,389 ( 4)
1,336 ( 5)
813 ( 5)
27 ( 4)
9 (7)
4,582 ( 4)
25-29
10,071
(15)
4,538 (16)
2,930 (17)
98 (14)
26 (19)
17,696 (16)
30-34
15,690
(24)
7,106 (25)
4,408 (26)
149 (21)
36 (26)
27,454 (24)
35-39
14,501
(22)
6,395 (23)
3,697
(22)
151
(21)
23 (17)
24,835 (22)
40-44
9,848 (15)
3,581 (13)
2,301
(14)
107
(15)
17 (13)
15,899 (14)
45-49
5,853 (9)
1,997 (7)
1,155 (7)
72 (10)
11 (8)
9,107 (8)
50-54
3,307 (5)
1,126 ( 4)
659 ( 4)
39 ( 6)
3 ( 2)
5,147 ( 5)
55-59
2,110 ( 3)
688 ( 2)
426 (3)
23 ( 3)
4 ( 3)
3,263 ( 3)
60-64
1,150 ( 2)
349 ( 1)
175 ( 1)
8 ( 1)
2 ( 1)
1,689 ( 1)
65 or older
1,074 ( 2)
202 ( 1)
113 ( 1)
19 ( 3)
-
1,411 ( 1)
Male subtotal
66,474 (100)
27,991 (100)
17,033
(100)
704 (100)
136 (100)
112,614 (100)
Females
Age at diagnosis (years)
Under 5
150 (5)
480 ( 7)
209 ( 8)
1 ( 1)
2 ( 7)
843 ( 7)
5-12
29 ( 1)
63 ( 1)
32 ( 1)
2 ( 3)
-
126 ( 1)
13-19
23 ( 1)
59 ( 1)
18 ( 1)
1 ( 1)
1 ( 4)
102 ( 1)
20-24
224 (7)
361 ( 6)
188 (7)
3 ( 4)
1 (4)
782 (6)
25-29
592
(18)
1,196 (19)
561
(22)
6 ( 9)
5 (19)
2,368 (19)
30-34
710
(22)
1,790 (28)
617
(24)
15 (22)
9 (33)
3,149 (25)
35-39
481
(15)
1,288 (20)
451 (18)
6 (8)
4 (15)
2,237 (18)
40-44
252 (8)
586 (9)
235 ( 9)
13 (19)
2 (7)
1,088 (9)
45-49
134 ( 4)
252 ( 4)
96 ( 4)
6 ( 9)
-
492 ( 4)
50-54
113 ( 3)
147 ( 2)
48 ( 2)
4 ( 6)
1 ( 4)
313 ( 3)
55-59
121 ( 4)
92 ( 1)
35 ( 1)
3 ( 4)
I
252 ( 2)
60-64
119 (4)
58 ( 1)
19 ( 1)
5 ( 7)
1 ( 4)
202 ( 2)
65 or older
321 (10)
68 ( 1)
23 ( 1)
3 ( 4)
1 ( 4)
416 ( 3)
Female subtotal
3,269 (100)
6,440 (100)
2,532 (100)
68 (100)
27 (100)
12,370 (100)
Total
69,743
34,431
19,565
772
163
124,984
94,9%
1 includes 310 persons whose race/ethnicity la unknown.
between
age 20-59
HIV/AIDS Surveillance Report
12
March 1990
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:19 ;HIV/AIDS 14046392029->
2024566218:#26
Table 8. AIDS cases, case-fatality rates, and deaths by half-year and age group, through
February 1990, United States'
Aduits/adolescents
Children <13 years old
Cases diagnosed
Case-fatality
Deaths occuring
Cases diagnosed
Half-year of diagnosis
Case-fatality
Deaths occuring
during Interval
rate
during interval
during interval
rate
during Interval
Before 1981
77
83.1
30
6
66.7
1
1981 Jan.-June
91
92.3
38
8
62.5
2
July-Dec.
196
91.8
83
5
100.0
6
1982 Jan.-June
385
90.6
153
13
76.9
9
July-Dec.
665
89.5
277
14
78.6
4
1983 Jan.-June
1,250
91.4
508
33
93.9
13
July-Dec.
1,613
91.2
904
40
75.0
16
1984 Jan.-June
2,522
88.0
1,361
47
83.0
24
July-Dec.
3,315
88.7
1,896
63
73.0
24
1985 Jan.-June
4,745
87.6
2,706
97
71.1
43
July-Dec.
6,122
85.9
3,682
127
74.8
68
1986 Jan.-June
8,007
83.3
4,829
130
71.5
64
July-Dec.
9,594
79.5
6,125
164
66.5
82
1987 Jan.-June
12,294
76.2
7,092
207
58.9
111
July-Dec.
13,569
66.5
7,429
243
55.1
153
1988 Jan.-June
15,006
56.5
8,556
218
45.0
122
July-Dec.
15,010
47.6
9,594
280
38.2
146
1989 Jan.-June
15,549
34.9
10,340
251
37.1
140
July-Dec.
12,044
21.6
8,576
163
25.8
105
1990 Jan.-Feb.
814
10.4
546
7
0.0
5
Total²
122,868
60.9
74,887
2,116
54.0
1,143
1 Reporting of diagnosed AIDS cases and deaths in more recent time periods is incomplete. See technical notes.
2 Death totals include 162 adults/adolescents and 5 children known to have died, but whose date of death is unknown.
March 1990
13
HIV/AIDS Surveillance Report
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:19 ;HIV/AIDS 14046392029-
2024566218:#27
Table 9. AIDS cases by year of diagnosis and definition category, diagnosed through
February 1990, United States
Year of diagnosis
Before
Mar. 1986-
Mar. 1987-
Mar. 1988-
Mar. 1989-
Cumulative
Mar. 1986
Feb. 1987
Feb. 1988
Feb. 1989
Feb. 1890
total
Definition category'
No. (%)
No. (%)
No. (%)
No. (%)
No. (%)
No. (%)
Pre-1987 definition
23,005( 96)
17,212 (89)
21,350 (78)
21,645 (70)
1987 definition:2
16,056 (68)
99,268 (79)
957 ( 4)
2,072 (11)
5,860 (22)
9,188 (30)
Specific disease
7,639 (32)
25,716 (21)
presumptively diagnosed
508
1,119
3,166
5,195
4,304
Specific disease
14,292
definitively diagnosed
189
282
522
622
523
HIV encephalopathy
2,138
70
228
769
1,111
843
HIV wasting syndrome
3,021
190
443
1,403
2,260
1,969
6,265
Total
23,962(100)
19,284(100)
27,210(100)
30,833 (100)
23,695(100)
124,984 (100)
1 Persons who meet the criteria for more than one definition category are classified in the definition category listed first.
2 Persons who meet only the 1987 AIDS case definition and whose date of diagnosis is before September 1987 were diagnosed retrospectively.
HIV/AIDS Surveillance Report
14
March 1990
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:20 ;HIV/AIDS 14046392029->
2024566218:#28
Table 10. Adult/adolescent AIDS cases by single and multiple exposure categories,
reported through February 1990, United States
AIDS cases
Exposure category
No.
( %)
Single mode of exposure
Male homosexual/bisexual contact
71,026
(58)
Intravenous (IV) drug use (female and heterosexual male)
22,332
(18)
Hemophilia/coegulation disorder
668
( 1)
Heterosexual contact
5,737
( 5)
Receipt of transfusion of blood, blood component, or tissue
2,984
( 2)
Other/undetermined
4,131
( 3)
Single mode of exposure subtotal
106,878
(87)
Multiple modes of exposure
Male homosexual/bisexuai contact; IV drug use
7,707
( 6)
Male homosexual/bisexual contact; hemophilia
27
( 0)
Male homosexual/bisexual contact; heterosexual contact
1,441
( 1)
Male homosexual/bisexual contact; receipt of transfusion
1,400
( 1)
IV drug use; hemophilla
30
IV drug use; heterosexual contact
( 0)
2,933
( 2)
IV drug use; receipt of transfusion
602
Hemophilla; heterosexual contact
( 0)
5
Hemophilia; receipt of transfusion
( 0)
432
( 0)
Heterosexual contact: receipt of transfusion
290
( 0)
Male homosexual/bisexual contact; IV drug use: hemophilia
11
( 0)
Male homosexual/bisexual contact; IV drug use; heterosexual contact
548
( 0)
Male homosexual/bisexual contact; IV drug use; receipt of transfusion
229
Male homosexual/bisexual contact; hemophilia; heterosexual contact
( 0)
2
Male homosexual/bisexual contact; hemophilia; receipt of transfusion
( 0)
17
( 0)
Male homosexual/bisexual contact; heterosexual contact; receipt of transfusion
77
IV drug use: hemophilla; heterosexual contact
( 0)
4
IV drug use; hemophilia: receipt of transfusion
( 0)
17
IV drug use; heterosexual contact; receipt of transfusion
( 0)
169
Hemophilia; heterosexual contact; receipt of transfusion
( 0)
9
Male homosexual/bisexual contact; IV drug use; hemophilia; receipt of transfusion
( 0)
8
Male homosexual/bisexual contact: IV drug use; heterosexual contact: receipt of transfusion
( 0)
27
IV drug use; Hemophilia; heterosexual contact; receipt of transfusion
( 0)
5
( 0)
Multiple modes of exposure subtotal
15,990
(13)
Total
122,868
(100)
March 1990
15
HIV/AIDS Surveillance Report
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:20 ;HIV/AIDS 14046392029-
2024566218:#29
Figure 4. Results of investigations of adult/adolescent AIDS cases with undetermined risk,
reported through February 1990¹
7,173 AIDS cases Initially reported
with undetermined risk
3,729 Incomplete
3,444 Interviews or
Information
other follow-up
Information
3,078 Under
651 Died, refused
investigation
interview, or lost
402 No risk
3,042 Reclassified
to follow-up
Identified/
other 2,3
1
Excludes 55 children under 13 years of age who have an undetermined risk: 48 children are under investigation and 7 have died,
refused interview, or were lost to follow-up. An additional 82 children who were Initially reported with an undetermined risk have been
reclassified after Investigation.
2
Health-care workers. 2 of the 402 adults/adolescents are classified as "other" and are health-care workers who seroconverted to
HIV and developed AIDS after occupational exposure to HIV-infected blood. For the remaining 400, the mode of exposure to HIV
remains undetermined after investigation. 66 of these are health-care workers, 59 of whom responded to a standardized
questionnaire. 34 (58%) reported needlesticks and/or mucous membrane exposures to blood and other body fiuids of patients. None
of the source patients was known to be Infected with HIV at the time of the exposure and none of the health-care workers was
evaluated at the time of the exposure to document seroconversion to HIV antibody. See MMWR. "Update: Acquired Immunodeli-
3
ciency Syndrome and Human Immunodeficiency Virus Infection Among Health-Care Workers," (April 22, 1986)37:229-234,239.
Heterosexual transmission. 333 of the 400 patients who had no risk Identified after follow-up responded to a standardized
questionnaire; 110 (37%) of 297 persons responding to questions related to sexually transmitted disease gave a history of such
disease and 71 (34%) of 209 interviewed men reported sexual contact with a prostitute. Some of these persons may represent
unreported or unrecognized heterosexual transmission of HIV. See MMWR. "Update: Heterosexual Transmission of AIDS and HIV
Infection - U.S.," (June 23, 1989) 38:423-424,429-434.
HIV/AIDS Surveillance Report
16
March 1990
SENT BY:CDC Atlanta USA
; 3-19-90 17:21 ;HIV/AIDS 14046392029-
2024566218;#30
Technical notes
Surveillance and reporting of AIDS
city In the MSA or NECMA, may include several
counties, and may cross state boundarles. For ex-
All 50 states, the District of Columbia, U.S. de-
ample, AIDS cases and annual rates presented for
pendencies and possessions, and independent na-
the District of Columbia in Table 1 include only
tions in free association with the U.S.¹ report AIDS
persons residing within the geographic boundarles
cases to CDC using a uniform case definition and
of the District. AIDS cases and annual rates for
case report form. The original definition was modi-
Washington, D.C., in Table 2 Include persons resid-
fied in 1985 (MMWR 1985;34:373-5) and again in
ing within several counties in the metropolitan area.
1987 (MMWR 1987;36 [suppi. no. 1S]:18-15S). The
State or metropolitan area data tabulations are
revisions incorporated a broader range of AIDS-
based on the person's residence at diagnosis of the
indicator diseases and conditions and used human
first AIDS-indicator disease(s).
immunodeficiency virus (HIV) diagnostic tests to
Data in this report are provisional. Fifty percent of
improve the sensitivity and specificity of the defini-
patients are reported to CDC within 3 months of
tion. For persons with laboratory-confirmed HIV in-
diagnosis. However, reporting delays vary widely
fection, the 1987 revision incorporated HIV enceph-
and have been as long as several years for some
alopathy, wasting syndrome, and other indicator
cases. The median delay in reporting appears to
diseases that are diagnosed presumptively (i.e.,
have increased, from about 2 months in 1982 to
without confirmatory laboratory evidence of the op-
about 3 months in 1988; however, recent analyses
portunistic disease). AIDS cases that meet the ori-
suggests that reporting delay may be decreasing.
teria of both the pre-1987 and 1987 definitions are
Completeness of reporting of diagnosed cases to
classified in the pre-1987 definition category. Com-
state and local health departments varies by geo-
pared with patients who meet the pre-1987 case
graphic region and patient population; however,
definition, a higher proportion of patients who meet
mortality studies suggest that 70 to 90 percent of
only the 1987 case definition were female, black, or
HIV-related deaths in men 25 to 44 years old are
Hispanic, or were intravenous drug users (MMWR
Identified through national surveillance of AIDS
1989;38:229-36).
MMWR 1989;38:561-3). In addition, multiple routes
Each issue of this update includes information
of exposure, opportunistic diseases diagnosed after
received and tabulated by CDC through the last day
the Initial case report was submitted to CDC, and
of the previous month. Data are tabulated by date of
vital status may not be determined or reported for all
report to CDC unless otherwise noted. Data for U.S.
cases. Caution should be used in interpreting case-
dependencies and possessions and for associated
fatality rates because reporting of deaths is known to
independent nations are included In the totals.
be incomplete.
Age group tabulations are based on the person's
age at diagnosis of AIDS: adult/adolescent cases
include persons 13 years of age and older; pediatric
Exposure categories
cases include children under 13 years of age. Age
group tabulations in Table 13 (only included in the
year-end edition) are based on age at death.
For surveillance purposes, AIDS cases are
Metropolitan areas are defined as the Metro-
counted only once in a hierarchy of exposure cate-
politan Statistical Áreas (MSA) for all areas except
gories. Persons with more than one reported mode
the 6 New England states. For these states, the New
of exposure to HIV are classified in the exposure
England County Metropolitan Areas (NECMA) are
category listed first in the hierarchy, except for
used. Metropolitan areas are named for a central
persons with a history of both homosexual/bisexual
contact and intravenous drug use. They make up a
'Included among the dependencies, possessions, and Independent nations
separate exposure category.
are Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, the
Republic of Paleu, the Republic of the Marshall Islands, the Commonwealth
"Heterosexual contact" cases include persons
of the Northern Mariana Islands, and the Federated States of Micronesia.
who report either specific heterosexual contact with
The latter 5 comprise the category "Pacific Islands, U.S." listed in Table 1.
a person with, or at Increased risk for, HIV Infection
March 1990
17
HIV/AIDS Surveillance Report
SENT BY:CDC Atlanta USA
; 3-19-90 ; 17:21 ;HIV/AIDS 14046392029->
20245662181#31
(e.g., an intravenous drug user), or persons pre-
Trends in AIDS Incidence
sumed to have acquired HIV Infection through het-
erosexual contact because they were born In coun-
tries with a distinctive pattern of transmission termed
Tabulations of AIDS cases by date of report give
"Pattern II" by the World Health Organization
a general description of AIDS cases, but analyses
(MMWR 1988;37:286-8,293-5). Pattern II transmis-
by date of dlagnosis give a more accurate descrip-
sion is observed in areas of central, eastern, and
tion of trends. Delays in reporting, however, can
southern Africa and in some Caribbean countries. In
have a substantial Impact on tabulated numbers of
these countries, most of the reported cases occur in
cases diagnosed in recent time periods. About half
heterosexuais and the male-to-female ratio Is ap-
of all cases are reported within 3 months of diagno-
proximately 1:1. Intravenous drug use and homo-
sis, but about 15% are reported more than 1 year
sexual transmission either do not occur or occur at a
after diagnosis. Delays are substantially longer for
low level.
pediatric cases and for transfusion-associated
cases in adults.
"Undetermined" cases are persons with no re-
ported history of exposure to HIV through any of the
Figure 5 (Included only in the year-end report)
routes listed in the hierarchy of exposure categories.
shows trends in AIDS incidence by month of diag-
Undetermined cases include persons who are cur-
nosis. The points on the plot show the estimated
rently under investigation by local health department
numbers of cases diagnosed, after adjusting for
officials; persons whose exposure history is incom-
estimated reporting delays. The smooth curve is
piete because of death, refusal to be interviewed, or
computed using the Lowess procedure (J.M. Cham-
loss to follow-up; and persons who were interviewed
ber, W.S. Cleveland, B. Kleiner, and P.A. Tukey.
or for whom other follow-up Information was avail-
Graphical Methods for Date Analysis. Duxbury
able and no exposure mode was identified. Persons
Press, Boston, 1983, Chapter 4).
who have an exposure mode identified at the time of
Reporting delays were estimated by a maximum
follow-up are reclassified into the appropriate expo-
likelihood statistical procedure for each HIV expo-
sure category.
sure category (J.M. Karon, O.J. Devine, and W.M.
Morgan "Predicting AIDS Incidence by extrapolating
from recent trends." In: C. Castillo-Chavex, ed.
Rates
Mathematical and Statistical Approaches to AIDS
Epidemiology. Lecture Notes in Biomathematics,
Rates are on an annual basis per 100,000 popu-
vol. 83, Springer Verlag, Berlin, 1989). The adjusted
lation. The denominator for computing the rates is
incidence used in Figure 5 is the sum of the adjusted
based on population estimates derived from 1980
incidences for each HIV exposure group.
census data and post-census population estimates.
The Lowess procedure makes no assumption
Each 12-month rate is the number of cases for a
about the overall trends In the data. A fitted value is
12-month period divided by the estimated midyear
computed for each month by weighted least squares
1988 or 1989 population multiplied by 100,000.
regression using only the adjusted number of cases
The denominators for computing race-specific
diagnosed during an interval about the month (in
Figure 5, the 20% of months closest to the chosen
rates (Table 9, included only in the year-end edition)
month); the weights decrease for times further from
are based on 1988 census estimates, the latest
which contain racial breakdowns. Race-specific
the chosen month. The procedure assumes that
incidence during the Interval about each month Is
rates are the number of cases reported for a partic-
ular race/ethnicity during the preceding 12-month
approximately a linear function of time. Lowess
period, divided by the 1988 census population for
tends to produce a curve that is linear at each end,
that race/ethnicity, multiplied by 100,000.
as observed in the figure; predictions of future
Case-fatality rates are on a semiannual basis by
numbers of cases should not be made by extrapo-
lating the Lowess curve.
date of diagnosis. Each 6-month case-fatality rate is
the number of fatal cases reported, divided by the
The Lowess curve should be considered a de-
scription of the overall trend in AIDS cases. This
number of total cases diagnosed in that period,
multiplied by 100.
curve emphasizes that the rate of increase in inci-
dence slowed during the middle of 1987. See
MMWR 1990;39:81-86.
HIV/AIDS Surveillance Report
18
March 1990