The editorial by Joffe1 proposes that the Archives become more political. In his discussion of teenage pregnancy, he states:
It is hard to believe that the mere threat of eliminating the possibility of a welfare check will change the behavior of young people when the very much more real and proximate threat of the acquired immunodeficiency syndrome has not.
Although it is true that most physicians and other educated people would change their behavior to avoid the risk of encountering human immunodeficiency virus, reality shows us that adolescents often do not. Acquired immunodeficiency syndrome has spread so rapidly precisely because many young people do not consider the "real and proximate threat" of sexually transmitted diseases before they act. Historically, has it ever been otherwise? Practically speaking, the threat of losing money or other concrete benefit is a much more real and proximate problem to a typical adolescent.
Donnelly BW. Just Say No... Welfare. Arch Pediatr Adolesc Med. 1995;149(10):1178. doi:10.1001/archpedi.1995.02170230131026