representing the people of Detroit, as you know, I am also a minister, a pastor in this community for almost 25 years. I have also served as an educator with the Detroit Public School System for some 16 years, and I am very much concerned with our President's position in that he has made the statement that he is the education President, and I simply want to say that we certainly do need more educational awareness as it relates to public enemy No. 1.

Mr. Conyers, and others, I completed a very significant study last year, and I can assure you that in the churches of the city of Detroit particularly, that there are large numbers of persons who would welcome this information, and seminars, workshops to be set up in such places, and in doing so I would always be sure that we could reach some 300,000 to 400,000 people to provide them with the necessary information that they could carry back to their homes and community. Therefore, I support what you are doing here this morning. Thank you very much.

Mr. CONYERS. Thank you very much. And that is precisely the next step after these hearings, is how we mobilize our church, public officials, community leadership, to begin the part two of these hearings.

I now recognize the gentleman from New Jersey, Mr. Payne. Mr. PAYNE. Thank you, Mr. Chairman, and councilmen. I am certainly pleased to hear that the church community has taken an interest, and will be mobilized in taking a lead. In too many of our communities around the country, including my own, we found reluctance on the part of the church community to really become involved and active as advocates. And I look at your model so we could possibly take that around the country to really activate some of our religious groups.

I would just like to ask the assistant superintendent, I assume you have a drug counseling program, and would each school have a drug counseling person or coordinator at the individual school, or is it at secondary level, and could you just explain that?

Dr. ELLIS. Each school would have a staff member responsible to teach, inform, and service staff as it relates to substance abuse. We have a curriculum entitled "Personal Health Management" that includes substance abuse, as well as human sexuality, and reproductive health. To answer your question, through that person, through our social workers, and through our counselors that are assigned in every one of our schools, that support service would be offered.

Mr. PAYNE. Thank you. I have no other questions.

Mr. CONYERS. Mayor Scott, can you for our record fill in the same situation that might be taking place in your health department and public school system in Highland Park? Can you give us additional information about this for the record.

Ms. SCOTT. OK. I cannot give you any concrete data, some numbers of that, but, yes, some of these same things that are going on in Detroit public schools are certainly going on in the Highland Park schools. We are educating them, and that is why I indicated in my statement that we need more moneys funneled through the communities so that we can have seminars and workshops to better educate the families, as well as our young people in schools, and we

are doing that through our human resources through the city with our employees also.

Mr. CONYERS. OK. That is good.

Dr. Ellis, you said that the city has adopted a training module on AIDS with modifications. Let us talk about modifications.

Dr. ELLIS. We are currently reviewing all our AIDS policy that I made reference to that the board approved August 1986. If you do not have copies I have them for you.

It was the general superintendent's concern that the State developed what they call a guiding model of AIDS policy in 1988, 2 years later. We felt that we should revisit our policy statement and make some recommendations. These recommendations are on the drawing board for board consideration. Some of the recommendations are rather cosmetic. For instance, some of the units have been renamed. We included the appeal language that the State's model had that we did not include. We included time lines that the State model had that we did not include. And we strengthened the language of parent participation.

An example of what I am alluding to, look at the very bottom of the first page of the policy statement. It says "parents or legal guardian and attendant physician of the child shall also be invited to participate." Well, we are recommending not be invited; will participate because they have that right.

These are some of the modifications, sir, that we are looking at that I made reference to.

Mr. CONYERS. OK. Now, how do I go about finding out how the module is working, training module on AIDS? I want to get right down on the table on this, so where do I go to see it? How do I take this off the paper and find out what is happening?

Dr. ELLIS. You are talking about what is going on in the classroom, sir?

Mr. CONYERS. Going on anywhere in the public school system. In other words, what does all this mean? I mean, the outlines, and the programs, and the suggestions, and the modification, so what does it boil down to? What is happening, as they say on the streets?

Dr. ELLIS. Human sexuality and reproductive health in terms of a course is happening in a classroom.

Mr. CONYERS. OK. Name me-you know, where will I go toNorthwestern?

Dr. ELLIS. You could go to Northwestern in either a science class, or a health class. All I would suggest that you do would be to contact the principal at school, find out what classes are carrying these courses, and visit at your own accord. At the middle school level, the same thing.

Mr. CONYERS. OK. Here is where we come into some further analysis, Dr. Ellis. See, the training module on AIDS is taught within the context of courses on communicable diseases, right? Dr. ELLIS. Yes.

Mr. CONYERS. OK. But the greatest risk of young people contracting AIDS comes from sexual transmission and IV drug use, right? Dr. ELLIS. Yes.

Mr. CONYERS. OK. So then it occurs to me that the teaching of AIDS education might be better off not just within the course-the context of courses on communicable diseases, but within the con

text of the sex education courses and the drug education courses, right?

Dr. ELLIS. That is correct.

Mr. CONYERS. Well, if that is correct, then you have to change the plan.

Dr. ELLIS. That is right. We are in the process of doing that.
Mr. CONYERS. OK. Well, that was easy enough. [Laughter.]

If we could do that in Congress it would be fabulous. The cooperation is enviable here this morning.

Dr. ELLIS. When our recommendations, sir, if I may. When our recommendations are in their final form, the point that you are making will be reflected in the new policy statement.

Mr. CONYERS. OK. You promised me under oath in broad daylight.

Dr. ELLIS. I understand that, sir.

Mr. CONYERS. OK. Let us get sensitive here. This is not a cosmetic hearing, is it?

What about the use of condoms and their-and how they help prevent the spread of AIDS. And before you answer, you know the Surgeon General has encouraged the education and use of this measure. The former Secretary of Education, Mr. William Bennett, was at disagreement with Surgeon General Koop's policy. Where does the condom issue come out on AIDS education in the Detroit Public School System?

Dr. ELLIS. Currently we have been teaching in our human sexuality/reproductive health classes that one of the preventive measures, if there is involvement, is the use of the condom. We have not gone beyond that level of dialog.

Mr. CONYERS. And that is because of community and parental hostility toward getting real on this subject, or what? Dr. ELLIS. Will you rephrase that, please?

Mr. CONYERS. Yes. Why have you not gone further?
Dr. ELLIS. We just have not, sir.

Mr. CONYERS. Well, I know you just have not, but why have you not just not gone further? I mean, here is what we are trying to get at, Dr. Ellis. I mean, the point is that either we are going to advocate the use of condoms for those youngsters who are participating in sexual activity, and our public records show it is jumping off the statistics page, and we are going to explain to them the importance of this prophylactic, or we are just not.

Now, this is just like just say no, you know. I mean, hey, if you understand what prophylactics are for, and what useful purpose they serve in terms of this No. 1 public health epidemic, great. If you do not, well, we followed the training module on AIDS, and the teacher may have mentioned it, and may not have mentioned it, the student may have heard about it, may not have heard about it. That reminds me of the war on drugs that never occurred.

In other words, I am encouraging that we think through this and we speak openly. If there is parental, or citizen, or community, or church hostility, I mean, let us put it on the record. If there is not, then there is no reason then to me why we should not go forward and let us bring this to the attention of youngsters who seem to be so proactive sexually.

I mean, we are talking now about drugs, pregnancy, AIDS, and all this is coming out of our-a lot of it is coming out of our youth population who do not happen to have a great body of knowledge about this subject. I mean, if they are not getting it in the schools, very little of this is going on in the homes, that we know, many of the adults do not have much more preparation on this subject, do you not see that this sort of falls in a void.

We comport with the statutory requirements, but when you come down on the table, what do the kids know? What about clean needles? Do you ever talk about what needles-the impact of dirty needles, and needle sharing, on the AIDS epidemic? Is that discussed under the AIDS module?

Dr. ELLIS. Yes, it is.

Mr. CONYERS. I am glad to hear that.

OK. To be continued, but you do see where this is all going, do you not?

Dr. ELLIS. Yes, sir.

Mr. CONYERS. All right. Any other comments from Mr. Weiss? Mr. WEISS. Only this, Mr. Chairman. Dr. Ellis, would you consider the extent of intravenous drug use by the youth community in Detroit to be a fairly serous one?

Dr. ELLIS. Yes, very serious.

Mr. WEISS. And within the public school system itself a fairly serious one?

Dr. ELLIS. That I would not be able to answer at this session. The general community, yes. What you are implying, is it going on in schools?

Mr. WEISS. Right.

Dr. ELLIS. I would almost have to say at this time no.

Mr. WEISS. Well, it does not necessarily have to be going on in schools, but I am really asking about the school body, the students. Dr. ELLIS. That is why I answered earlier it would be--I would have to answer at another session.

Mr. WEISS. Does that mean you do not have the numbers?
Dr. ELLIS. I do not have numbers.

Mr. WEISS. OK. Because we have an indication, again from the study that I cited before, that the cumulative percentage of opiate use by age 17 is 33.9 percent; of alcohol consumption is 74.5 percent. But opiate use is 33.9. Now, that would indicate to me that the problem is critical across-the-board that there is there is some distinction between youth in school and youth out of school that you would be facing probably a serious problem in your school system itself, and that would suggest to me that again the course of AIDS transmission will be present within the student body as well, to the alcohol, to the abusive drugs. Would you not agree with that?

Dr. ELLIS. The way it was stated, I would have to say yes.
Mr. WEISS. Thank you. Thank you very much, Mr. Chairman.
Mr. CONYERS. Thank you very, very much. We appreciate, Mayor
Scott, your presence here, Dr. Ellis, for your very thoughtful contri-
bution.

Dr. ELLIS. Thank you very much for your patience.
Mr. CONYERS. You are welcome.

Ms. SCOTT. Thank you.

Mr. CONYERS. Our next panel consists of the Deputy Director for AIDS Centers for Disease Control, Dr. Gary Noble, a former Michigander himself; Dr. Virginia Mesa, medical director, Detroit Health Department; Director Rick Talley, Drug Treatment Program, city of Detroit Neighborhood Services Department; Chief Randall Pope, Special Office on AIDS Prevention, Center for Health Promotion, Michigan Department of Public Health; Special Agent in Charge of Drug Enforcement Administration of Detroit Office, Mr. William Coonce.

Will you all join me in front of the table, raise your right hands. [Witnesses sworn.]

Mr. CONYERS. Let the record show the witnesses affirmed by saying yes.

Welcome, ladies and gentlemen. As is customary in this chivalrous city, the ladies will go first.

STATEMENT OF VIRGINIA MESA, M.D., M.P.H., MEDICAL

DIRECTOR, DETROIT HEALTH DEPARTMENT

Dr. MESA. Good morning, buenos dias, thank you, Congressman Conyers, Chairman Weiss, for allowing me the privilege to be present before you this morning. I also want to thank your staff for their patience since they waited for me to return their calls, and was returning their calls either placing them on hold, or not having sufficient time to speak with them. I hope they will understand and they are respectful of my other duties.

It is my hope that my presentation this morning will assist you in addressing a plan for programmatic and budgetary plans for the prevention, control, and surveillance of AIDS, and the medical and social concerns relating to AIDS.

I am not going to sensationalize any particular case scenarios. I will leave that to others. I will present to you epidemiologic facts, Detroit Health Department AIDS activities, what my views are of the political aspects of AIDS in Michigan, and my recommendations to you.

First, let me begin with the facts you are already aware of. AIDS is a fatal disease for which there is no cure. There is no vaccine to prevent infection with the AIDS virus. The only antiviral drug found to be effective to date is zidovudine, most commonly known. as AZT.

Nationally the majority of the victims of AIDS are white, male homosexuals and bisexuals. About 62 percent of the total national

cases.

Nationally IV drug abuse add up to 20 percent of the victims of AIDS. Blacks and Hispanics disproportionately fall victim to AIDS. Together these two minority groups make up approximately 12 to 15 percent of the general population in the United States, and both account for 39 percent of the AIDS patients in this country.

Now some facts on the epidemiology of AIDS, of which you may or may not be aware of in Michigan and in Detroit.

Michigan represents 1 percent of the total cases nationally, and it ranks 17th in the United States regarding numbers of reported AIDS cases to the Centers for Disease Control. Beginning in 1981 when statistics were compiled, Michigan reported two cases of

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