WASHINGTON — Surgeon General C. Everett Koop, in his long-awaited report to the public on AIDS, calls for AIDS sex education as early as elementary school and opposes compulsory testing for exposure to the virus that causes the deadly disease, The Times has learned.
In the report, which is to be released today, Koop rejects proposals to quarantine or tattoo infected individuals. And he urges the nation to show compassion for AIDS patients, most of whom are homosexual and bisexual men or intravenous drug users.
"At the beginning of the AIDS epidemic, many Americans had little sympathy for people with AIDS," says the report, which Koop wrote. "The feeling was that somehow people from certain groups 'deserved' their illness. Let us put those feelings behind us.
Victims 'Need Our Care'
"We are fighting a disease, not people. Those who are already afflicted are sick people and need our care, as do all sick patients."
The report's recommendations are certain to be controversial because of the intense emotions surrounding AIDS.
Koop, long associated with right-wing causes, has served as a Reagan Administration point man on such volatile issues as opposition to abortion and the so-called Baby Doe rule, which required hospitals to treat severely deformed newborn infants. In addition, he drew the ire of homosexual groups several years ago when he called the gay rights movement "anti-family."
President Reagan last February ordered the AIDS report, described as a "primer" for the public, in an effort to reduce fears and misconceptions about the disease. White House officials said it was hoped that the report would prove to be a watershed in public thinking about AIDS, much as the surgeon general's report on smoking has defined that issue.
Koop presented the report to the President earlier this month, and it has been approved by the White House, according to knowledgeable sources.
In it, Koop becomes the first federal health official to recommend comprehensive AIDS sex education in the schools. He emphasizes that it "must start at the lowest grade possible . . . so that children can grow up knowing the behavior to avoid to protect themselves."
Although he concedes that the sex education proposal will be controversial, he insists that "the threat of AIDS should be sufficient to permit a sex education curriculum."
"There is now no doubt that we need sex education in schools and that it include information on heterosexual and homosexual relationships," he says. "The need is critical and the price of neglect is high. The lives of our young people depend on our fulfilling our responsibility."
Report Unusually Explicit
The report, unusually explicit for a government-sponsored publication, describes the specific activity that transmits the immune system-crippling disease, including homosexual and heterosexual contact and the sharing of hypodermic needles by intravenous drug users.
The report contains many illustrations, including one of a cross section of the "vulnerable rectum lining (that) provides avenue for entry of AIDS virus into the bloodstream." In describing precautions that can be taken to prevent the spread of AIDS, there is also a drawing of a condom, the use of which is recommended to block transmission of the virus.
Koop stresses in the report that "casual social contact between children and persons infected with the AIDS virus is not dangerous." He adds: "We would know by now if AIDS were passed by casual, non-sexual contact."
Testing Costs 'Prohibitive'
Of the controversial AIDS antibody blood test, which determines infection with the AIDS virus--but does not indicate whether a person has or will develop AIDS--Koop said that "compulsory blood-testing of individuals is not necessary. The procedure could be unmanageable and cost prohibitive."
Further, he said, "It can be expected that many who test negatively might actually be positive due to recent exposure to the AIDS virus and give a false sense of security to the individual . . . . The prevention behavior described in this booklet, if adopted, will protect the American public and contain the AIDS epidemic."
Last March, the Public Health Service recommended that individuals considered at risk for AIDS voluntarily undergo the test. At the time, spokesmen for gay and civil rights groups expressed concern that the federal government was moving toward a policy of mandatory testing.
Koop says the quarantining of AIDS patients "has no role in the management of AIDS because AIDS is not spread by casual contact." Of tattooing infected individuals, a course recommended by some conservatives, he says that "those who suggest the marking of carriers of the AIDS virus by some visible sign have not thought the matter through thoroughly."
"AIDS should not be used as an excuse to discriminate against any group or individual," he adds.
Although Koop's report is expected to be welcomed by gay and civil rights groups, it may come as a surprise to them and to others who recall Koop's association with conservative causes.
But, in a recent interview with The Times, when asked about the pending AIDS report and the concern of gay rights groups, Koop replied: "It doesn't matter how I feel about homosexuality. That's not my job as a health officer."
AIDS, or acquired immune deficiency syndrome, destroys the body's immune system, leaving it vulnerable to otherwise rare infections, cancers and neurological disorders. As of Monday, it had struck 26,566 people in this country, of whom 14,977 have died.