By Trenton Straube (Copy Editor, POZ)
Is the graphic image of a cancer-ridden buttock--flesh eaten away from the anus--terrifying enough to scare guys into wearing condoms?
That seems to be the hope of a controversial public service announcement (PSA) from the New York City Department of Health and Mental Hygiene. Titled "Never Just HIV," the fear-based ad illustrates the stark health risks associated with HIV while an ominous voice-over announces:
The spot is slated to run for two weeks in December and another two weeks in January. And already it has garnered plenty of ink and conversation (on those grounds, alone, you gotta admit the campaign's a success).
Gay Men's Health Crisis (GMHC) and the Gay & Lesbian Alliance Against Defamation (GLAAD) issued a joint statement denouncing the "sensationalistic" and "stigmatizing" campaign, saying that scare tactics don't work and that the ad "creates a grim picture of what it is like to live with HIV." Both groups want the ad pulled.
But the health department is standing firm. Monica Sweeney, MD, assistant commissioner for the city health department's Bureau of HIV/AIDS Prevention and Control, told the Wall Street Journal and FishbowlNY that the ads were tested in focus groups and vetted for technical accuracy. She added that other groups, such as Gay Men of African Descent, support the campaign.
Always outspoken AIDS activist Larry Kramer, in an e-mail blast, praised the health department and lambasted GMHC and GLAAD, writing: "This ad is honest and true and scary, all of which it should be. HIV is scary, and all attempts to curtail it via lily-livered nicey-nicey 'prevention' tactics have failed.... Of course people have to get scared. I have said this since day one, and I say it today. They need to be scared into using condoms, into getting tested, into being responsible human beings."
But do fear-based ads work? The idea behind them is that if you fear the consequences of getting HIV, then you'll be motivated to have safer sex. A quick perusal of online articles and postings related to this ad campaign shows support--"Seeing people die in the '80s scared the hell out of me, so I wore condoms. We need that fear again."--and condemnation. (Several commentators directed readers to this nuanced paper "The Role of Fear in HIV Prevention.")
On other themes brought up in the PSA, viewpoints remained mixed: The ads didn't stigmatize people with HIV. They did. The ads would scare people away from testing and treatment ("Why take meds if I'm doomed to insanity?"). Some even said the ads weren't scary enough ("Why didn't they show neuropathy?")!
Personally, I oppose sugarcoating reality--if the facts are scary, then so be it--and I suspect that most people, especially young men who have sex with men, are oblivious to the accurate statement "It's never just HIV." Let's tell that truth. It's important, especially in light of the bareback pornification and sexualization of, well, most everything nowadays, and in light of the growing belief that HIV is a manageable disease (surely, all the recent news about Truvada as a pre-exposure prophylaxis will convince some folks that high-risk behavior isn't so high risk after all).
However, let's talk about the PSA's tone and presentation. This 30-second horror show is one thunderclap away from parodying those "Gathering Storm" ads that warned about the impeding dangers of marriage equality. Such melodramatic delivery overshadows the important message. I get that the campaign is in line with the city's other fear-based PSAs against smoking, which relish in images of clogged arteries, diseased lungs and amputated fingers.
But do we really need to see a mutilated anus in association with HIV and men who have sex with men (MSM)? The ad does more to stigmatize anal sex than people living with HIV. Cigarettes and HIV aren't synonymous and the two shouldn't be treated identically in a campaign. As other online commentators pointed out, smoking, unlike sexuality, isn't part of your intrinsic identity as a person. Sexuality subjects you to discrimination in terms of human rights, religious equality, loving relationships, etc.
But maybe that's overthinking it--and that's a problem. We're too worried about offending or hurting anyone's feeling. We over analyze. The simple truth is that people still contract HIV. The New York Health department pointed out that the number of new HIV infections among those younger than 30 increased from 489 in 2001 to 747 in 2009.
(As an important side note: Most news outlets are reporting the department of health as saying, "Silence is no solution when the number of new HIV diagnoses among men who have sex with other men is up by more than 50 percent in eight years." Either this is a misquote or Sweeney misspoke. The number pertains only to MSM younger than 30. In fact, HIV diagnoses among MSM older than 30 is declining. According to health department records, there were 1,580 HIV diagnoses among all MSM in 2001. That number was 1,618 in 2008, the latest year records are posted online, which is an increase of less than 3 percent increase.)
What are your thoughts on the "Never Just HIV" ads? We'd love to hear from the HIV community. Do you find this specific ad stigmatizing? What, if any, aspects of the campaign do you applaud? What do you loathe? What are you thoughts on fear-based campaigns in general?
Personally, I'd like to see ads that accurately present scary truths in a manner that doesn't stigmatize people living with HIV. Here's an idea: Let's use the word "chemo" instead of "HIV meds" or "daily pills." As in, "HIV is totally manageable, all you have to do is go on chemotherapy every day, for the rest of your life!" Doesn't sound so nonchalant, does it?
Or how about this setup for a PSA: Film someone at the counter of his or her pharmacy--getting the bill. The camera would close up on the price tag juxtaposed with an empty wallet.
Now that's frightening.
Watch the PSA:
Is the graphic image of a cancer-ridden buttock--flesh eaten away from the anus--terrifying enough to scare guys into wearing condoms?
That seems to be the hope of a controversial public service announcement (PSA) from the New York City Department of Health and Mental Hygiene. Titled "Never Just HIV," the fear-based ad illustrates the stark health risks associated with HIV while an ominous voice-over announces:
When you get HIV, it's never just HIV. You're at a higher risk to get dozens of other diseases--even if you take medications--like osteoporosis, a disease that dissolves your bones, and dementia, a condition that causes permanent memory loss. And you're over 28 times more likely to get anal cancer. It's never just HIV. Stay HIV free. Always use a condom."
The spot is slated to run for two weeks in December and another two weeks in January. And already it has garnered plenty of ink and conversation (on those grounds, alone, you gotta admit the campaign's a success).
Gay Men's Health Crisis (GMHC) and the Gay & Lesbian Alliance Against Defamation (GLAAD) issued a joint statement denouncing the "sensationalistic" and "stigmatizing" campaign, saying that scare tactics don't work and that the ad "creates a grim picture of what it is like to live with HIV." Both groups want the ad pulled.
But the health department is standing firm. Monica Sweeney, MD, assistant commissioner for the city health department's Bureau of HIV/AIDS Prevention and Control, told the Wall Street Journal and FishbowlNY that the ads were tested in focus groups and vetted for technical accuracy. She added that other groups, such as Gay Men of African Descent, support the campaign.
Always outspoken AIDS activist Larry Kramer, in an e-mail blast, praised the health department and lambasted GMHC and GLAAD, writing: "This ad is honest and true and scary, all of which it should be. HIV is scary, and all attempts to curtail it via lily-livered nicey-nicey 'prevention' tactics have failed.... Of course people have to get scared. I have said this since day one, and I say it today. They need to be scared into using condoms, into getting tested, into being responsible human beings."
But do fear-based ads work? The idea behind them is that if you fear the consequences of getting HIV, then you'll be motivated to have safer sex. A quick perusal of online articles and postings related to this ad campaign shows support--"Seeing people die in the '80s scared the hell out of me, so I wore condoms. We need that fear again."--and condemnation. (Several commentators directed readers to this nuanced paper "The Role of Fear in HIV Prevention.")
On other themes brought up in the PSA, viewpoints remained mixed: The ads didn't stigmatize people with HIV. They did. The ads would scare people away from testing and treatment ("Why take meds if I'm doomed to insanity?"). Some even said the ads weren't scary enough ("Why didn't they show neuropathy?")!
Personally, I oppose sugarcoating reality--if the facts are scary, then so be it--and I suspect that most people, especially young men who have sex with men, are oblivious to the accurate statement "It's never just HIV." Let's tell that truth. It's important, especially in light of the bareback pornification and sexualization of, well, most everything nowadays, and in light of the growing belief that HIV is a manageable disease (surely, all the recent news about Truvada as a pre-exposure prophylaxis will convince some folks that high-risk behavior isn't so high risk after all).
However, let's talk about the PSA's tone and presentation. This 30-second horror show is one thunderclap away from parodying those "Gathering Storm" ads that warned about the impeding dangers of marriage equality. Such melodramatic delivery overshadows the important message. I get that the campaign is in line with the city's other fear-based PSAs against smoking, which relish in images of clogged arteries, diseased lungs and amputated fingers.
But do we really need to see a mutilated anus in association with HIV and men who have sex with men (MSM)? The ad does more to stigmatize anal sex than people living with HIV. Cigarettes and HIV aren't synonymous and the two shouldn't be treated identically in a campaign. As other online commentators pointed out, smoking, unlike sexuality, isn't part of your intrinsic identity as a person. Sexuality subjects you to discrimination in terms of human rights, religious equality, loving relationships, etc.
But maybe that's overthinking it--and that's a problem. We're too worried about offending or hurting anyone's feeling. We over analyze. The simple truth is that people still contract HIV. The New York Health department pointed out that the number of new HIV infections among those younger than 30 increased from 489 in 2001 to 747 in 2009.
(As an important side note: Most news outlets are reporting the department of health as saying, "Silence is no solution when the number of new HIV diagnoses among men who have sex with other men is up by more than 50 percent in eight years." Either this is a misquote or Sweeney misspoke. The number pertains only to MSM younger than 30. In fact, HIV diagnoses among MSM older than 30 is declining. According to health department records, there were 1,580 HIV diagnoses among all MSM in 2001. That number was 1,618 in 2008, the latest year records are posted online, which is an increase of less than 3 percent increase.)
What are your thoughts on the "Never Just HIV" ads? We'd love to hear from the HIV community. Do you find this specific ad stigmatizing? What, if any, aspects of the campaign do you applaud? What do you loathe? What are you thoughts on fear-based campaigns in general?
Personally, I'd like to see ads that accurately present scary truths in a manner that doesn't stigmatize people living with HIV. Here's an idea: Let's use the word "chemo" instead of "HIV meds" or "daily pills." As in, "HIV is totally manageable, all you have to do is go on chemotherapy every day, for the rest of your life!" Doesn't sound so nonchalant, does it?
Or how about this setup for a PSA: Film someone at the counter of his or her pharmacy--getting the bill. The camera would close up on the price tag juxtaposed with an empty wallet.
Now that's frightening.
Watch the PSA:
This awful, stigmatizing, not-a-little homophobic, factually fuzzy campaign has consumed me for the last week, responding and writing about it over and over again.
I have four words left:
Scary ads don't work.
They wasted money, and harmed many, many people.
Thank you for posting this articles about the new public service announcement (PSA) from the New York City Department of Health and Mental Hygiene. Titled "Never Just HIV," I agree with your opinion that fear based campaigns don't work. I am web & graphic designer who specializes in social marketing mainly focusing on projects that target queer men, the LGBT community, HIV issues and substance use. I have been involved in studies and focus groups of queer men that focus on how they percieve themselves. The overwhelming response of these focus groups tell us that queer men of all ages and health status feel that the onslaught of media campaigns that only focus on HIV and gay sex stigmatizes all queer men, shames us in thinking we are all diseased riddled whether we are HIV positive or negative. This perception tends make us feel that we are evil if we enjoy our sex life and the only way for true acceptance into our society is if we remain neutered. I find it ironic that we are all running to do trevor project videos telling our young queer brothers that it gets betters and at the same time shaming their budding sexuality and scaring them to death about their natural desires. I do think there needs to be realistic messages out there that do not shroud the many difficult aspects of living with HIV. It can be accomplished through humor, honesty and hope. I would like to see messages from queer men, and how they either overcame difficulty living with HIV or how they have stayed HIV negative. More images need to be out there of us living healthy long lives. Lets move away from the scare tactics, shock media videos and religious shame based outdoor campaigns and show real gay men of all ages living their lives and telling their stories of truth.
Matthew
San Francisco
In the 80s and 90's I watch many die of driffent illnesses related to HIV or AIDS,and this vedio is G rated compare to what I saw in the deaths of many. One friend that had scabs all over his body will never leave my mind where his complete body was engulfed with sores that were real. Or a case study I read that happen last year where a young man had a Johnson Rash all over his body a side effect from one of his newer meds, some believe. Another friend of mine die last year in a house firier where his pain meds cause him to fall asleep with a lite cigarettee and then cause his house to burn down that kill his mother in bed too, you see HIV attached his spinal cord and nerves where his leg had to be amputated because of a gain green and live in great pain for years. So the messaging is tame in my eyes of the truth of AIDS now and then. If this messaging stops one person from becoming HIV than it is a successful add. It is time to try new social marketing messages that are base on truth not wishes washing messaging. I am sorry for the HIV people that this ad causes fear and hope they can stand tall to face these fears to help some one esles from having to face them in the future by supporting these adds to see if they work in the future.
Sorry your week has been upset. What a terrible inconvienence that must be. However, I think the overreacting and ridiculous level of diva drama coming from so called 'activists' is pretty darned hypocritical here. HIV isn't pretty. AIDS isn't pretty. whimpy feel-good ads meant to not 'upset' us HIV positive people are NOT the right message for men at risk of HIV. We're in a place now where men actually need to think there is something WORSE than HIV because of our molly-coddling of HIV 'celebs". Well I'm HIV positive--it's no picnic--I AM at higher risck for bone density issues, anal cancer, dementia as well as MANY other things. This ad is honest and truthful. Our HIV positive 'spokespeople' need to quit feeding their own egos for awhile and go back to thinking about ALL people at risk for HIV.
I have to agree with Jim, HIV is no picnic. Buff models selling Atripla aren't the answer. I have been positive for 23 years, have a good t-cell count and an undetectable viral load. I also have Nueropathy that is hardly bearable and affects every aspect of my life. How pretty is that? It's time to be honest, especally with the kids who did not see the horrors we lived through in the 80's. I am sorry if other gay people are offended or if it prints a negative picture to some, it is honest. If we had not worried so much about our images and been honest all along, maybe we would be further along in fighting this horrible disease.
Thank you for posting this new ad for prevention and also I say hats off to the New York health dept for having the guts to be real with HIV prevetinon. These ads are offensive and scary thats the whole point and to bad if people who are posiative like myself get offended maybe thats what we need young people today have the mis belief that its no big deal being posiative I take a pill and everythings hunky dory and anyone one who has ever taken them knows that is TOTAL BULL If we have anyone to blame for the continuos spread of this disease it's the drug compainies tat sensationalize the meds with pictures of hunky gorgous guys taking their particular drug hell they almost make people want to become posiative
It's about time the truth is told. HIV-positives today may have been saved from the deadly opportunistic infections of the early years of the epidemic by HAART, but they are now beginning to see the ramifications of long-time (and, in some cases, relatively brief) HIV infection and/or antiretroviral use. There has been much recent (but only recent) observation and interest in the hastening and acceleration of the aging process among HIV-positives: brain fog, neurocognitive difficulties, cardiovascular problems, bone problems, co-morbidities and cancers (lung, liver, anal, lymphoma, etc.). It is possible that 30-, 40-, 50-, and 60-year-old bodies are succumbing to the medical depredations of 80-year-olds.
Sure it's true that osteoporosis is a disease of the elderly, but what is it when it keeps occuring in relatively young HIV-positives? Full-blown dementia may no longer be as prominent as it was, but what is it when so many HIV-positives are beginning to complain of "brain fog"? Yes, anal cancer is caused by HPV, but why are there now 174 annual cases per 100,000 among HIV-positive gay men, but 40 cases per 100,000 among HIV-negative gay men, and 2 per 100,000 in the general population? It used to take many years for anal cancer to develop from HPV-related lesions; now the many years have become few.
It is disgraceful that GMHC and GLAAD are condemning this video campaign. I remember in 1982 when GMHC, opposed to promoting safer-sex campaigns, said that "we can't tell people how to have sex." They have truly learned nothing.
This is indeed a very controversial topic, but if people stopped taking it personal and look at the facts we might be able to reach an agreement. Does fear stop people from having risky sex? No and yes. To some people it might work, to others it might not. Now if the ad did not exist the few people it would affect would not be affected and then we would pile them all into the unaffected group. Face it folks there is no ONE message that will reach everyone and save everybody. EVERY message that can prevent at least ONE person from getting infected is worth it to me. And whether scare tactics work or not, I will say that in the beginning of Anti-AIDS advertising, the ads worked in bringing down infection rates. Now 25 years later the ads are gone and HIV is still infecting our communities at alarming rates. To me whatever works...WORKS!!! Shut up and put all of that energy in creating something that works and is to your satisfaction!!!
did strong ads ever work for smoking? no. despite warning messages on packaging many continue to smoke. the same applies for hiv.
I agree with Larry Kramer. We are approaching 30 years into the official U.S. Aids epidemic and nice ads just do not work. Hey, all HIV'ers have to do is take a "cocktail" a day. This is the new mantra of our youth. My partner and President of Red Hispana Florida died in Venezuela after an excrutiating painful 2 years of treatments born in Hell; not to mention the financial debt of the co-pays, tests, etc.
When we sugar coat the truth, people just are not careful. Here in Broward County Florida, our infection rate is worse than ever with over 600 infections this year; bringing the total to over 16,000 infected people and those are the ones we know about.
IT ISN'T JUST HIV. Cudos to the NYC Health Dept.
W. JAMES PERIGNY
CEO
RED HISPANA FLORIDA
I agree with Larry Kramer. We are approaching 30 years into the official U.S. Aids epidemic and nice ads just do not work. Hey, all HIV'ers have to do is take a cocktail a day. This is the new mantra of our youth. My partner and President of Red Hispana Florida died in Venezuela after an excrutiating painful 2 years of treatments born in Hell; not to mention the financial debt of the co-pays, tests, etc.
When we sugar coat the truth, people just are not careful. Here in Broward County Florida, our infection rate is worse than ever with over 600 infections this year; bringing the total to over 16,000 infected people and those are the ones we know about.
IT ISN'T JUST HIV. Cudos to the NYC Health Dept.
W. JAMES PERIGNY
CEO
RED HISPANA FLORIDA
I think this is the best response. No one message can serve as the magic bullet and some people may be scared into thinking twice before they have unprotected sex. The problem is that most people will not be scared into protecting themselves. The research on scare tactics to change behavior have always shown that these approaches have little to no effect on people's actual behaviors. It may change their intentions but when it comes right down to it the research, world-wide, says that scare tactics do not lead to substantial behavior changes. So how much funding is going into these ads verses ads that promote a healthy life? How much funding is going into these ads verses programming to help men deal with issues of self-esteem and examining why we choose to put ourselves at risk. There is no one message and there is no one approach to this problem. We need a comprehensive, coordinated approach that addresses multiple issues through multiple channels. NYCDOHM is living in the dark ages and really does not have a good handle on how to address this epidemic among men and they are desperately grasping at anything that they think might work.
Compare the media and societal treatment of cancer with HIV.
Can you imagine the outrage with an ad campaign portrayed a woman with breast cancer on her deathbed, discussing how her life was effectively done? It would never happen. We stigmatize HIV because society blames the person who got it, it's their fault for having unprotected sex, they don't get the support people with diseases they couldn't help acquired.
That's one way to treat people, I subscribe to another POV. This is a huge step back in terms of HIV acceptance, and it's funny people who fought for societal support in the 80s don't get how this reverses that.
I beleieve these types of advertisment is more harmful. People will look at the negative aspect of each advertisment. They will get a message that is speaking to death not life.
Sex is a part of human nature. We are intelligent/passionate/irrational...sometimes all three in a few minutes. But is this tactic the best? We need to get to the root of the problem and only then will we get a shift in behavior change. Examples: it took the tobacco community/ industry 30 yrs to change, seatbelt wearing 10 yrs,drinking is still an issue, teen pregnancy - still going on and on the rise, underage drinking on the rise, suicide/suicide attempts continue...does this ad work and esp those w/mentally ill,w/substance abuse? Or does it anger people on both sides negs and pozs. What it does is it encourages arguements not discussion, fragmentation not unity among ourselves, gossip, and fear to disclose status, fear to ask the other person's status...esp in some communities where HIV is already a sitgma. Is this ad really helpful to those minorities communities where HIV is on the rise? Does this ad lack character and dignity. Is this ad a 'Sarah Palin' approach to a more complex issue?
Many people would like to see the gay community extinct, including some among us. We fight among ourselves, point fingers, some are self-righteous, self-absorbed, some are not. Does this ad help...esp w/negs and pozs peeps having sex. And maybe for that reason,there is a lot of anger/bitterness. Some that have been around for decades, angry as they saw their friends die, and they have every right...I am just questioning whether that is the right approach? Regardless-this is a poor judgement on an ad. I suggest addressing more the core of the behavior change/mind...no/low self esteem,no/low self preservation, no long term goals, deep depression, etc. Bad call on approving the ad.
on one hand this advertisement may make some people stop and think about not having unsafe sex, but will it be lasting. On the other hand, having a message that we don't have a cure it is better then not having a message out there at all. I wish the NYC health department had include a more diverse group then that shown.