DIRECT AIDS PAMPHLET RAISES ALARMS

It's a conundrum health policy professionals battle constantly - how
to warn young people about the dangers of risky behaviour without preaching.

Tell kids not to do something and they're bound to do it just because
adults say it's bad.

Choose the laissez-faire, non-judgmental route and you run the risk of
practically endorsing the activities you're trying to diminish.

Either way, feathers get ruffled. Witness the brouhaha over the
AIDS-prevention pamphlet put out last year by Health Canada and the
Canadian AIDS Society.

There's no question that youth are most at risk for contracting HIV.
The median age of infection was 32 in 1983. By 1990, it had fallen to
23.

And AIDS is not just a gay disease any more. Between 1985 and 1994,
for instance, homosexuals accounted for 75% of positive HIV tests.

By 1997, that number had dropped to 38%.

And injection drug use is now the primary risk factor in new HIV
infections.

In some places, particularly Vancouver, where injection drug users are
dying regularly, HIV transmission has become an epidemic.

The question is, how do you reach those putting their lives at risk
and persuade them to change their behaviour without tuning them out?

The federal Health Department and the Canadian AIDS Society (CAS)
decided to produce a no-nonsense pamphlet that didn't talk down to
their target audience - kids who drink and use drugs (injectable or
otherwise).

The CAS's youth advisory committee, made up of young people working
with community-based AIDS groups across the country, had the final say
on the pamphlet's wording and design.

That's why the brochure's "edgy, in your face and a little hard-core,"
says Health Canada spokesman Michael Jacino.

Hence the accepting attitude towards casual sex and drug use in the
pamphlet, which has been distributed to public health departments and
STD (sexually transmitted disease) clinics across Canada.

"Just because we've made the choice that we don't want AIDS, it
doesn't mean the party's over," it says. "We can still fool around
with sex and have a great time. Still shoot up if that's what we're
into."

The pamphlet describes how to reduce the chance of getting HIV by
always using condoms and new or clean needles.

It goes into detail about various activities and how dangerous they
are.

Included in the no-risk category, for example, are masturbating and
injection of drugs using new or clean syringes.

Having sex with a condom or injecting drugs with a needle that's been
cleaned with bleach and water is considered low-risk. And engaging in
unprotected sex or sharing needles is classified as high-risk activity.

What is conspicuously absent, though, is that injection drug use is
harmful whether you use clean needles or not.

You can use a brand new "rig" and still drop dead in a minute from a
cocaine or heroin overdose.

If you're lucky enough to cheat death, you can still end up in
hospital with an abscess or an infection in your bloodstream because
of the bacteria on your skin.

And once you're hooked, mainlining is not exactly cheap. It's also a
good way to lose your job, your spouse, your kids and everything else
dear to you.

The brochure just tells it like it is, says Jacino.

"We're not judging (injecting drugs), we're not endorsing it. We're
just acknowledging that it exists."

CAS chair Terrence Stewart feels the same.

"Too often, the HIV epidemic has been used to reinforce notions of
good and bad behaviour," he said last year.

It's better to give people options than to try to get them to conform
to a specific moral code, he explained.

That may be so but I can't help worrying that we've become too
permissive for our own good.