SACRAMENTO — In a development that would significantly expand the scope of AIDS educational efforts, Surgeon General C. Everett Koop said Thursday that the U.S. Public Health Service is considering mailing a simplified version of his widely publicized AIDS report to every household in the country.
"I am morally certain that before long there will be some kind of report in as close to every household as we can make it," Koop said in an interview with The Times.
Details of the plans to distribute between 70 million and 100 million reports designed to be readable at an eighth-grade level are still being discussed, according to Koop.
A decision on whether to proceed with the project will probably be made by the Public Health Service and White House officials before the end of the month, he said.
Koop's report emphasized the use of condoms to prevent sexual transmission of the AIDS virus and AIDS education for children beginning in elementary school, themes he has stressed in speeches around the country in recent months.
Koop talked about expanded educational efforts after he addressed an unusual joint session of the California Legislature called to discuss the acquired immune deficiency syndrome epidemic.
Every American must "do his or her part to stop the spread of AIDS," Koop said, a message he reiterated in a day of private meetings with state officials, including Gov. George Deukmejian.
Since releasing a report on AIDS last October, Koop, who previously had not spoken out about it, has emerged as one of the strongest voices in the nation in the fight against the deadly disease, which is spread through sexual contact, from pregnant women to unborn children and by exposure to contaminated blood. More than 31,000 Americans have contracted AIDS and more than 17,000 have died.
Koop acknowledged that the call in his report for AIDS education to start in "early elementary school," perhaps in kindergarten, has caused "undue alarm."
"I would be willing today to make that single change in the report . . . to take out the word 'early' and just let the sentence read, 'education about AIDS should start in elementary school,' " he said.
Koop's speech appeared to be well received by the legislators, who listened intently and gave the surgeon general a standing ovation.
Discussions about widespread distribution of a simplified version of Koop's AIDS report are focusing on such practical issues as who should prepare it, how it should be written and what mailing lists to use.
Koop said the Public Health Service has translated his original report into Spanish and is discussing the preparation of public service announcements about AIDS for television, featuring well-known entertainers and sports figures.
A key issue in the discussions is the use in AIDS educational materials of graphic and vernacular terms for sexual practices. Some public health officials believe that it is necessary to make educational efforts more effective, but others, including some Reagan Administration officials, have objected to using government funds for such materials.
Koop said his original AIDS report was "an expurgated form of what we thought of initially." He added: "Nothing I know of is not going to get some amount of criticism; we have to face that issue."
The joint legislative session was part of an effort by Assemblyman Art Agnos (D-San Francisco) to mobilize bipartisan support for his omnibus AIDS legislation, which would incorporate into state law many recommendations to control AIDS made by Koop and the Institute of Medicine in their widely publicized reports on the disease released last year.
Among the provisions of the bill are a requirement that as a condition for graduating from high school, California students receive instruction in the causes and prevention of AIDS and other sexually transmitted diseases. The bill would also protect individuals infected with the AIDS virus against discrimination and create a commission on AIDS to advise the governor and the Legislature.
Nobel Laureate Speaks
Nobel laureate David Baltimore of the Massachusetts Institute of Technology, co-chairman of the Institute of Medicine AIDS task force, also addressed legislators.
Baltimore said many additional steps are needed to combat the spread of the AIDS virus, including a national program with a "Manhattan Project atmosphere"--a reference to the University of Chicago effort to develop the atom bomb--to develop an AIDS vaccine.
The scientist also called for the provision of free sterile needles to intravenous drug users and the placement of condom dispensers in every public restroom for both men and women.