Thursday, November 09, 2006

(CDC-funded ad that was so controversial, it was pulled from the streets of Philadelphia within days after it was unveiled on bus shelters, this past August.)

BAR: Gays Split Over HIV Ads, Ex-POZ Editor Wants Ads Halted

For the past two or three months, I've been engaged in an online discussion with several people with AIDS or HIV and prevention advocates regarding the non-stop barrage of social marketing campaigns, which all too frequently are driven by fear, alarm and hysteria, targeting HIV poz folks and sexually active gay men.

We've debated the harmful effects of hostile ads over the course of the epidemic, the federal government funding the controversial ads, diminishing stigma against people living with HIV, getting AIDS Inc and the queens working at the ad agencies behind the ads to stop ignoring our concerns and begin a respectful dialogue with us about the ads, the benefits and demerits of serosorting, and lots and lots of other important related HIV issues.

Now, Zak Szymanski over at the Bay Area Reporter, has written a fairly comprehensive and lengthy article in today's paper that provides fair and balanced coverage to these matters, with many voices speaking up about improving HIV prevention plans. (I wish this were the first of three or four part series of articles on the problems caused by needlessly controversial social marketing campaigns, because the issues are so complex and can't be fully addressed in a single BAR article.)

These are my favorite excerpts from the BAR story today:

To a welcome reception on Monday, November 6, the San Francisco Department of Public Health released its long-anticipated "Disclosure" campaign. Featuring psychedelic photographic images by photographer Duane Cramer and emphasizing HIV status disclosure as a means of prevention, the DPH bus stop and billboard effort is a groundbreaking, community-led prevention method that marks the first time a public health agency has recognized the validity of "serosorting" – a longtime gay community practice where men have a variety of sex, some of it unprotected, with men of the same HIV status. [...]

The San Francisco campaign comes several weeks after the Los Angeles Gay and Lesbian Center launched its controversial "HIV is a gay disease" campaign, and about 10 months after gay men grew vocally critical of the billboard in San Francisco's Castro District earlier this year that proclaimed, "New Years Resolution: I Won't Infect Anyone." All of the campaigns were designed by the San Francisco-based firm Better World Advertising, which has attracted a growing number of critics in recent years.

Critics of HIV social marketing campaigns often find their objections described as problems with the messages, while sponsors of the messages often point to the discussion generated by the controversy as a mark of success.

But there is more to the debate than a simple disagreement over the slogans and images in HIV prevention advertisements. At the core of such campaigns is a set of assumptions or conclusions drawn about gay men, namely, that they are not talking enough about HIV.

It's a reasonable conclusion, said Les Pappas, founder and president of Better World Advertising and a former HIV prevention staffer at the San Francisco AIDS Foundation. Pappas – who conducts focus groups with men who have sex with men and who said he has been astounded by some of the misinformation that continues in the gay community – said there is no other way to explain why seroconversions continue. [...]

But there is another possibility, say some longtime AIDS activists and educators: that gay men are in fact talking about HIV and taking care of each other, but that a post-crisis climate has meant more people – positive and negative – are using harm reduction approaches and taking calculated risks they can live with. Critics of marketing said the evolution of the disease from a death sentence to a more manageable condition – combined with the declining HIV rates among gay men – mean that sex with without condoms is often practiced with thought, discussion, and safety rather than recklessness.

"The tone of many of these campaigns presume the lowest common denominator of gay men. But the gay men I know are smart, savvy, sophisticated, and caring of one another. They are talking about HIV and interested in serosorting and knowing more of the science behind it," said Los Angeles-based HIV activist and writer Tony Valenzuela. [...]

Such a prevention trend is something that has already been acknowledged by AIDS health advocates: earlier this year, San Francisco's DPH predicted a 10 percent drop in new HIV infections in San Francisco in 2006 compared to 2001, with another 20 percent decline in the rate of HIV transmission among gay and bisexual men. Chief reasons cited by AIDS groups for such progress was the decline in meth use and the increase in serosorting. [...]

Messages that imply an irresponsible community can further stigmatize gay men and thus encourage new infections, said Walter Armstrong, former editor-in-chief of the internationally distributed Poz magazine. Recently troubled by the Los Angeles "HIV is a gay disease" campaign, Armstrong is among a growing chorus calling for an end to all HIV social marketing.

Such measures "may seem controversial or even counterproductive on the surface. but I think this would, at best, force us and the prevention 'establishment' to find more scientific, more innovative, more responsive forms of HIV prevention and, at worst, just silence all the slogans that have never been anything but truisms, half-truths, or outright lies, starting with 'Safe Sex Is Hot' back in 1986."

Armstrong said such campaigns are always steps behind what gay men are already doing; "it wasn't until the mid-1990s that the big gay groups officially ranked oral sex as low risk, despite the fact that gay men had never used condoms for blowjobs." [...]

Valenzuela, whose grassroots group "Real Prevention" has taken to task recent HIV marketing efforts, said his group was mixed on the L.A. campaign, but that most people agreed it's counterproductive to measure a campaign's success by the community in-fighting that occurs as a result of its controversy.

"[LA Center officials] said their goal was to get people talking. In the forums and meetings I attended, people were talking, but not about how to have safer sex or do real HIV prevention," said Valenzuela, who also takes issue with the campaign's "Own It. End It" slogan, which he says promotes a "fantasy" that it is possible to end HIV through prevention alone.

Valenzuela is not convinced that a moratorium is the solution to the inherent limitations of HIV prevention marketing – "maybe we are expecting too much of this vehicle" – but he would like to see posters that are arming gay men with information that is useful for what they are already practicing, rather than telling them what to do. A recent anti-smoking ad, he said, told people who wanted to quit that they would "need a plan," acknowledging the complexities of that decision without resorting to scare tactics. [...]

"I beg to profoundly differ with Better World; poz guys are not the cure," said one man in response to the ads on an e-mail list that discusses prevention campaigns. "The cure is a scientific breakthrough that we have been denied as a society by inadequate early response and funding for research that goes all the way back to the Reagan administration. The cure is not anything young poz men can do; it's the charge of scientists and researchers the world over from an infectious disease, medical, and biochemical approach. Even if there is a role for positive men to attempt to prevent new infections, they share this responsibility with negative men who need to also protect themselves."

What do you think about these HIV prevention issues? Express your opinion by leaving a comment here, or sending a letter to the Bay Area Reporter at: BARpaper (at)

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