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: