Should we dump on negative advertising?

HIV medicine: Toilet advertising

HIV medicine advertising: In the toilet

As competition to treat people for HIV has hotted up, pharmaceutical companies have started dumping on one another. Using innuendo and not-quite-stated factoids, they are beginning to imply that the rival camp has something to hide (something they’ve no doubt learned from political campaigns). Those other drugs are toxic, discolouring, inconvenient. Activist groups and HIV bloggers such as Peropheries are upset, but I wonder if Big Pharma might actually be doing us a favour.

I first saw the loo ad above looming down at me in a huge, back-lit poster form while I was wandering around New York one evening recently. It’s from Bristol Myers Sqibb — they make Reyataz, an antiretorviral which apparently doesn’t send you to the loo every two seconds. Sadly not true of Kaletra, made by rival Abbot Laboratories. Though this ad doesn’t actually point the finger, it’s a pretty good start as smear campaigns go. This and other examples have been picked up in a story by The Wall Street Journal, relayed by the always helpful Kaiser Family Foundation.

Treatment activism groups are upset because they think negative advertising might discourage infected people from taking their meds at all. That seems to me unlikely — the runs is an unpleasant but relatively small price to pay for an AIDS-free life. I do think we have a right to be upset about what these cut-throat smear campaigns tell us about what the marketing gurus think is acceptable corporate behaviour in our hyper-capitalist world. But I also think that the relentlessly upbeat advertising that has been the norm for HIV meds for years now might be just as damaging. The message: “Don’t worry if you get HIV, you can still go rock-climbing with your friends at the weekends”, has surely contributed to the “so what?” attitude that has led to rising risk behaviour and HIV rates among young gay men in many places. Perhaps inadvertently, Big Pharma is now sending a different message: being on HIV meds for the rest of your life may not be such a painless thing after all. As I said, I don’t think these ads are going to discourage people who are already infected from taking their meds. But they might just help on the prevention front, by signaling to uninfected people that it’s perhaps worth making a bit of an effort to stay that way.

This post was published on 26/08/08 in Money and AIDS.

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  1. Comment by Jim Pickett, 26/08/08, 02:04:

    Hey – I am on the fence about the ads – I think it is a bit of a game for us to get all upset about them – too aspirational, too scary, too whatever -, and we in fact miss the forest for the trees, and lose focus on the REAL issues like treatment access, like sound, evidence-informed prevention, like homophobic policies that keep so many gay and MSM at risk.

    However, I would like to just say – as someone who has spent about a decade making relatively regular, PANICKED, runs to the nearest bathroom – due to the runs – that this condition is both terribly unpleasant AND a high, high HIGH price to pay. I just went off Kaletra and the rest of my old regimen to one that actually has NO side effects. I left due to the continuous stomach/poopie factor – and I couldn’t be happier.

    No one can tell me it is not horrible to live on the edge of comfort and respectability for 10 years. Anyone who has shit their pants in public (yep, been there, the worst being in the DC metro on sunny Sunday morning) can say the price of that sort of shame and humiliation is acceptable, or relatively small.

    Of course, shit-filled culottes does not equate to death – but it IS a pretty miserable way to live when it happens more than once in an adult lifetime.

    So, while they did not play into my decision to change my HIV drug regimen, I guess the toilet-bowl ads DO speak to me….


  2. Comment by Roger, 26/08/08, 07:32:

    What I am concerned about and which does not come up in my blog post is that people are rarely offered a choice and when they are they have to take responsibility for it.

    This is particularly true in the UK where patients are treated as “customers” (the word is in a white paper). When diagnosed, HIV positive people are first told they will be put on a regimen, currently Atripla. Then a few months later, depending of how things go, they are offered the possibility to change treatment (for instance to go back to a 2-pills combinations where Efavirenz is replaced if it the drug that causes troubles such as very agitated night filled with dreams or nightmare). But how can the “customer “make a rational choice? Based on what? And then what happens if the new treatment does not work? The medical staff is not prepared to assume responsibility as it was the “customer” choice.

    This is what upset me most, the trends towards a consumerist science and a consumerist medicines. Science and medicine are not about satisfying customer but about providing the best treatment available and the best care possible.

  3. Comment by Roger, 08/09/08, 05:45:

    PS: According to The New Scientist, “companies that advertise prescription drugs directly to consumers may not get as much bang for their buck as they – or their critics – assume.


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