Petrelis Files

SF Weekly: Why HIV Rates Are Falling

For a number of years I've demanded the Centers for Disease Control, the S.F. Department of Public Health and HIV prevention groups, particularly the Stop AIDS Project, produce verifiable evidence AIDS prevention social marketing campaigns actually reduce infection rates.

One gay paper, Atlanta's Southern Voice, wrote an excellent article about demands raised in 2003 that federal and local health experts prove HIV prevention messages were effective. The story showed how after more than two decades of campaigns targeting gay men, the CDC and San Francisco officials couldn't just whip out studies validating how the prevention programs were either stabilizing or decreasing infections.

Now, I am so pleased to report, the SF Weekly newspaper today has published a truly fine article about all the social marketing targeting sexually active gay men to engage in safe sex and not transmit HIV, and there's little evidence to show the campaigns have worked to reduce HIV.

Highlights from the article:

> City-funded HIV prevention campaigns have used such "social marketing" methods -- a popular technique that applies commercial marketing principles to social and behavioral issues -- since the late 1980s as a way to persuade gay men to practice safer sex. [...] But a recent article in a local gay newspaper has reignited a strong and long-standing debate over the ads, and the community is once again wondering whether the city needs a new approach to HIV prevention. Besides, new evidence proves that another factor -- tied neither to city programming nor to advertising -- is what's really causing infection rates to drop.

The other factor driving down HIV rates is serosorting, the practice of gay HIV poz men sleeping only with other HIV poz men.

> However, that effort is something of an exception, because the majority of these campaigns still use sex and anger to get their messages across.

This attitude of equating gay sex with anger to deliver a safe sex message reinforces negative beliefs about gay sex that I believe is very harmful to sexually active gays. At times, it's been beyond my comprehension that San Francisco, of all places, has operated under the premise that gays require hostile messages about our sex lives in order to have healthy sex. Need proof of one of the extremely hostile campaigns hitting gay men? Go here.

> As is the case with all advertising, it's difficult to measure a campaign's direct impact. Better World Advertising claims that 70 percent of gay men in the city "like or strongly like" the "HIV Stops With Me" effort, according to a 123-person survey it conducted in 2003. The S.F. Department of Public Health has never retained an independent firm to analyze the effectiveness of its ad campaigns.

It's not shocking to me to finally read in print that the local health department has never bothered to spend money evaluating whether its bombardment of gay men with campaigns is working. Why analyze the effectiveness of HIV prevention when millions of dollars, and hundreds, maybe thousands of jobs depend on coming with new campaigns, regardless of their impact on stats? You'd think twenty-five years into the AIDS epidemic the city of San Francisco the basic idea of proving effectiveness of prevention would have been addressed, right? Guess again.

> For many gay men and activists, frustration with the tone of recent HIV prevention messages is rising. When SF Weekly interviewed more than two dozen gay men in and around the Castro District last week, only one man said he liked and was affected by "HIV Stops With Me." Comments about other HIV ad campaigns in the city were equally negative, the impression being that the messages of prevention and testing are often lost amid sexy models and harsh slogans.

Let's hope the HIV experts pay attention to this rising frustration and the way safe sex messages are getting lost.

> Some men express confusion at the idea of using fear or sex to spread messages of safety, trust, and communication; others have chosen to ignore the ads altogether.

> When Castro resident James Serrano, 27, was asked about the effectiveness of HIV marketing campaigns, he replied, "Don't ask me. I haven't paid attention to that shit for years."

Yep, after so many years of angry, gay sex negative HIV prevention campaigns, younger gays are tuning out the message. You can bet the HIV prevention groups here are probably thinking of even more hostile fear-driven messages to reach the audience already blocking out the safe sex messages.

> Despite the controversy over social marketing, San Francisco does have reason to celebrate. New evidence shows that HIV infection rates are dropping, but not because of any ad campaign or city-funded program.

The SF Weekly speaks some unvarnished truth that has been denied for too long!

> Mounting data now suggests that "serosorting" -- the practice by which gay men choose to have sex only with those who share their HIV status -- might be primarily responsible for the decrease in new infections. [...]

> But neither the city nor the AIDS Foundation has endorsed or sponsored any programming or advertising about serosorting. This successful technique has emerged from within the gay community itself without any sexy models or punchy slogans to urge it on.

So HIV rates fall in America's AIDS Model City, not because of government or nonprofit social marketing campaigns, but because of gay men devising our own methods of averting transmission that had nothing to do with the official prevention messages!

Maybe it's time for the folks pushing the angry, ineffective HIV prevention campaigns to give us a break from their alarmism.

If you want to read what one gay youth, Trevor Hoppe, wrote a few weeks back in the Bay Area Reporter about what's wrong with HIV prevention, go here. Hoppe raises many issues that must be address by gay men, not just in San Francisco, but across the country.