13/12/10

New York’s Brave New ad targets HIV complacency

Clearly someone in the New York City health department believes that HIV sucks, even in a post-AIDS world. Here’s their brave new ad, targeted at the gay men among whom the majority of new infections in the city occur in this age of treatment. Pity about the Hollywood trailer soundtrack.

Predictably, most of the comments on the YouTube site are of the “This stigmatises gay men, especially those with HIV” ilk. More nuanced views over at Towleroad, one of the most consistently rational and informative gay blogs.

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This post was published on 13/12/10 in Good sex and bad, Men, women and others.

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  1. Comment by David Hawthorne, 13/12/10, 02:39:

    This ad is a joke. It’s like something out of CSI Special Victims Unit. Is it not possible to be straight-up and honest with gay man about the potential repercussions of acquiring HIV without treating them like pathetic saps who need to hide from the bogeyman? Now *that* would be a rational approach to being direct about the realities of HIV that are worth avoiding. The tone of this ad suggests most people with HIV are walking, horror-show corpses-in-waiting, which isn’t quite accurate. For those who know real people with HIV, many of whom are healthy and happy despite but real occasional challenges, this is counterproductive dissonance. And for those who don’t know anyone with HIV, it sure dissuades them from any contact with them. You can say “pffft” to cries of stigma all you want; that doesn’t make its tangible effects on the perceptions and experiences of gay men, with and without HIV, any less real. NYC could have taken this factual information and done a hell of a better job in presenting it.

  2. Comment by Gus Cairns, 14/12/10, 02:51:

    I can’t agree with you on this one, Elizabeth.
    I think there are several reasons this ad may have a negative rather than positive effect.
    Yes, we know that fear-based campaigns can work: and I believe the US is about to follow the UK and a number of other countires in putting graphic images of rotting lungs etc on cigarette packets, because these work (though not, alas, for me so far).
    But unlike smoking, eating wrong, drink-driving etc HIV is an infectious disease and it takes both sides to modify their behaviour; you have to address the cigarette as well as the smoker, and I don’t think this will do anything to encourage healthy behaviours in guys with HIV – either diagnosed (it won’t help them disclose) or undiagnosed (it won’t encourage testing – who wants to find out their bones are going to snap and their brains melt? And don’t talk to me about the ad’s text, this deliberately used images beamed at the limbic system, so this is not a discourse about rates of osteopenia.)
    Ah, but the NYPHD is saying, it’s factual. Bollocks. No one’s denying that having HIV makes it more likely that you will develop certain conditions: we do. But we do NOT know that the mysterious bone mineral loss will mean out bones snap on the dancefloor: we do NOT know that the undoubtedly real mild impairment seen in peopel with HIV will lead to our brains imploding with Alzheimer’s 15 years early (it had better get on with it, I’m 54), and while we DO know PLHAs have much higher rates of anal cancer, no one should ever actually get it if they get their ass checked out regularly (but who would want to, seeing this ad?)
    Crying wolf has a long history of failure in HIV prevention. Remember superinfection? You mustn’t fuck bareback if you’re positive because you’ll get another NASTIER one. That was based on a few isolated cases, and because gay men never actually met anyone who’d suffered from a superinfection, it was widely discounted as a myth put out by ‘them’ to get ‘us’ to behave.
    Yes, PLHAs currently have lifespans about 13 years shorter than the general population but 10 of these (this is the UKCHIC study) are due to late testing. Who would test, seeing this?
    But that’s not the main reason it’s so nasty. I’m not worried about it being ‘stigmitising of people with HIV’ – I’m stigmatised already, I’m not a fan of liberal lets-outlaw-it response, and I think the only thing one can do about stigma is to decline to be stigamtised.
    The reason it’s so nasty is to do with issues that are, for gay men, much BIGGER than this increasingly treatable though lifelong and yes, still serious STD. There are much more important things than HIV around. What it’s really like being gay is one of them. You think having HIV is the worse thing that can happen to a gay man?
    I hate this ad because it’s sadistic and bullying or – because no doubt gay men were involved in it – masochistic too. It’s horrified by gay men and gay sex in general, using images of bodily corruption and disease to ram home things that – despite 50 years of gay lib – we still feel about ourselves (I point denyers to the suicide, depression and drug use statistics.) It think the message it gives – not overt, not factually, but with all the visceral power of that 5 frame shot of a ruined ass – is that if you’re out on the scene death and disease are stalking you, and serve you right if they get you. I remember being caught by a cop cottaging back in the bad old days when they still hauled gay men through the magistrates’ courts, yes I’m that old. He tried to scare me out of fucking by telling me gleeful stories about rectal prolapse which, luckily, I didn’t believe. That’s the attitude to fucking which this ad is trying to revive.
    I suspect it will work, a bit. A few young guys will probably be even more scared of gay sex than they already are and will probably shy away from the whole nasty business rather than stick a condom on. Abstinence programmes work for a while if you put enough fear of hell and damnation into people, but for a while is the point, and we know that when they stop being abstinent they’re less well equipped to have sex. This ad says your ass will fall to bits if you catch HIV which is I’d guess your average twink’s nearest equivalent to hell and damnation.
    I don’t think that will help HIV- guys look after themselves; I suspect it will just put them into a state of paralysing anxiety.
    In the long run, however, they’ll fail to notice lots of prematurely aged queens around drooling, hobbling and emptying their colostomies and will come to the conclusion that there are worse things in life than risking HIV, and maybe there are.
    I did a bit of number-crunching of my own recently and found that the percentage of gay men in the UK Gay Men’s Sex Surveys who sometimes don’t use a condom has scarecely varied in the last decade: from 1998 to 2007 it was 45% every year of all respondents and went from 50% to 55% of men who have anal sex. To the NYDPH that means we should do something NOW that’s much SCARIER and gives gay men a good SLAP! To me it says that this is a refractory issue, something that’s reached a homeostasis, something balanced between gay men’s fear of HIV and their dislike of condoms. So what’s the answer? Try and frighten them as much as we were frightened when AIDS was around? Or accept that there’s a limit to how much you can get people to use condoms (which doesn’t mean you don’t keep promoting them)and promote other choices too?
    My current favourite is GET F***ING TESTED AND GET ON THE F***ING PILLS, but there, I’m starting to sound like a public health ad…

  3. Comment by Trevor Hoppe, 14/12/10, 06:16:

    The way you shrug off stigma in this message is extremely discouraging, Elizabeth. Many of us in the Gay Men’s Health movement have had ambivalence about your writings in the past (the best we could hope for from within mainstream PH, I suppose), but it seems now we have confirmation that you just don’t have the analytic tools to tackle or even empathize with the issues facing HIV-positive people. I think I knew this before, but your galling endorsement of this ad just confirms it.

  4. Comment by elizabeth, 14/12/10, 06:44:

    Trevor,
    Thanks for your comment. I can see why you’re concerned. But my comments weren’t exactly intended as an endorsement. As I’m sure you know Brave New World is a novel by Aldous Huxley that paints a picture of a world “improved” by ambiguous developments in reproductive technology. The post was intended as mildly ironic. Having said that, I think that we have not yet found a way to address the tension inherent in the contradictory messages. Message 1: HIV is no big deal (which is the default position remaining when it is not possible to suggest that there is anything undesirable about living with HIV). Message 2: HIV causes you to be rejected and stigmatised, so if you don’t have it, try not to get it. I don’t think the NYC campaign does much in terms of resolving the tension, but I have to give them some credit for at least trying to address the issue. Still, I’m sorry to have offended.

  5. Comment by Gus Cairns, 14/12/10, 07:08:

    Here’s more the sort of thing: calm, well-informed, helpful, non-manipulative and in a UK tabloid newspaper:
    http://www.mirror.co.uk/advice/miriam/2010/12/14/routine-hiv-tests-can-save-lives-115875-22783304/
    I should add one thing to my previous comment: I was talking about gay men in settings where it’s easy to get treatment. I accept that the arguments for condom promotion are stronger and test-and-treat are weaker in a resource-poor context.
    Gus

  6. Comment by Roger, 18/12/10, 04:19:

    I have mixed feeling with this ad that I should put in writing at a later time.

    However I wanted to point to a recent full page advert from the HIV clinic on Dean Street in London highlighting that early treatment could extend life to 16 years (or something along that line, I am currently traveling and don’t have access to my files), whatever, the point is that someone closed to me who started ARV a few years ago told me, so I only have 14 years to live now?

    The problem with this type of advert and HIV preventionin general is that they target a particular audience but are received by a different one. In this business were many of ue spend time watching what is going on (and let’s be honnest sometine with tinted glasses), this ad and similar one is getting more attention that it should get and by a range of people who it is not targetting.

    If I could find it, but Elisabeth could probably do it better since it was on her blog, there was an ad a couple of years ago for an ARV with less side effects. Side by side this illustrate the contradiction of prevention messaging.

    Add alleged safer sex “methods” and new “options” that are only partially efficacious to the mix and no surprise that a gay men who would want to know what to do could not find an answer to his question and that the whole lot is in fact generating confusion and I dare say, stigma.

  7. Comment by Miriam in Vancouver, 12/01/11, 09:52:

    I’m sorry I’m a bit behind responding to this one, but there are two things that come to mind – both of which betray my age (i.e. youth). 1) This is EXACTLY the kind of message that will/does reach youth, not because it’s “scary” but because it’s presented in a quick, engaging and real way, rather than cushioned in the political-correctness of generations past. 2) Are we actually proposing censorship here? With the internet the way it is, I’m sorry, there is no such thing as censorship anymore (actually this is a good thing …) full freedom of speach means that when something offends, we have the talk about it, which is EXACTLY what’s happening in all the comment forums of every post about this ad – and that’s a good thing. Some people are learning for the first time that we have to be aware of not stigmatizing the LGBT community in our messaging … other people (young gay men hopefully) are learning that HIV is actually a big deal and that safe sex is possible and does matter. The discussion is happening and in a world with complete transparency (like it or not, this is the direction the internet is taking us), the only tool we have to “find the right answers” is discussion and debate. This is GOOD, not bad.
    As a young person, HIV prevention educator, and queer ally, I think the ad is great.

  8. Comment by Andrew, 23/02/11, 01:49:

    Always good to see people with names like “Miriam” and “Monica” making pronouncements on what “will/does reach” young gay men. HIV prevention efforts are unique for a number of reasons, not the least of which being that they seem to court the opinions of everyone except those they’re trying to reach.

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