Thursday, December 16, 2010

Kramer Says Yale Expert
Backs His View of Scary HIV Ads

This is the third in an on-going series of exchanges about New York City's Department of Health's recent launch of a fear-driven HIV prevention campaign. Click here and here for previous posts. My view is that an already over-stigmatized population, the gays, should not have to accept that the best method of starting a discussion about sensitive sexuality and health issues is from controversy and alarm.

Larry Kramer contacted his Yale buddy and researcher yesterday, prompting this note:

Here is Peter Salovey's response below. in every way it supports what i am saying, that scare tactics can work best, "especially for early detection behaviors." You can plow your way through his two papers attached (they are very technical), but they too support in essence the same game plan. [See the 1997 paper here, and the 2003 findings here.]

and the first salovey paper sean sent me also pretty much supports my agument against you as well. sean, i dont know how you were able to pluck out of it just what you wanted. this paper says over and over again that all research into prevention strategies, and its success or lack of it, is weak, is ot strong enough, is not based on big enough samplings, and is open to being challenged.

i think it is time once and for all to stop this argument and get to work, to roll up our sleeves and try to eliminate hiv as best we can once and for all. marjorie's "dream-world" prose below is just tragic, as is the claptrap from glaad. gay men, or MSM as we are now so euphoniously called, definitely are part of the problem and to deny this is to just prolong the rising numbers of infections around the world. that one out of five gay american men are now hiv positive should prove without any doubt that all prevention efforts have thus far failed mightily.
these nyc department of health public service announcements are in fact not strong enough! How about trying this one on for size (pun intended):

men, what you carry between your legs is a potential lethal weapon!
it can murder people.
before you stick it anywhere

i bet you'll get better results with this one.

And this is the note Peter Salovey emailed to Larry:

It is true, many people don’t like what psychologists call “loss-framed messages” (messages focusing on the negative consequences of not taking a health action). Nonetheless, there are many situations in which they are effective. In general, the more “uncertainty” or “psychological risk” associated with a behavior, the better the loss-framed messages work. So, we are definitely NOT against loss-framed messages in these situations.

I’ve attached the original paper we did laying out this idea as well as one most relevant to HIV. That one was focused on testing rather than condom use, but it showed that for people who were uncertain of their HIV status, loss-framed messages (emphasizing the negative consequences of not being tested)motivated more testing than gain-framed messages (emphasizing the positive consequences of being tested).

I should also mention that our study focused only on low-income women, so we also need to be careful about over-generalizing from these data. Nonetheless, our findings suggest that especially for early detection behaviors, loss-framed messages work best. (Our data are especially strong in other health areas such as mammography and pap testing.)

If anyone knows of other studies among women that have or can be used to make arguments about gay male health, please lemme know about them. I'm not sure it's best to extrapolate findings from female health research, and apply the work to the gay community, but I remain open to hearing counter-arguments.

And I disagree with Larry equating the cock with lethal weapons and murder. Gay men should adore and appreciate the cock, treat it with respect, and be taught proper and healthy ways to do that, without inflammatory and alarmist messages.

Maybe everyone in this debate can agree that debating these issues are healthy, and will pledge to keep the discussion going.


Sean said...

Larry is misinterpreting Salovey's research as well as Salovey's email to him. Salovey makes the distinction in his paper between how fear motivates people to get tested for HIV versus how it affects changes in sexual behaviors.

Michael, urge your readers to read Salovey's paper as well as the paper from Sygma Research "The Role of Fear in HIV Prevention".

The papers can be found at:

I am drafting something that addresses this in more detail, but I don't want your readers to read Larry's spin on Salovey's research without knowing others interpret it much differently.

I understand and share Larry's frustration with the glossing over of what it means to live with this virus. But if one believes the research, the NYC DOH campaign is not likely to achieve its intended objective--less transmission--and may actually make things worse. Plus there are a number of other unintended consequences that were either not taken into consideration or are considered unimportant.

More later.

DavidEhrenstein said...

As usual, I'm with Larry.