Gay men in San Francisco are being targeted with a series of “provocative” ads highlighting the side-effects of anti-HIV medication. The ad campaign, developed by the Stop AIDS! Project, is in response to several reports suggesting that gay men in the city are having more unprotected anal sex. The campaign has the strap-line “HIV is no picnic” and includes posters which will be placed in public toilets and on bus shelters. One shows a man sitting on the toilet with diarrhoea caused by his medication and another shows a man with the distended abdomen seen in some people with lipodystrophy syndrome.
The ads differ from recent HIV prevention campaigns which have tended focused on providing gay men with non-judgmental information about how to prevent themselves from being infected with or passing on HIV. However, right-wing Republicans have attacked many of these campaigns as being “sexually explicit” or for “encouraging sex.” The Bush administration is increasingly favouring “just say no” style abstinence campaigns to the alarm of sexual health workers. In September New York based Human Rights Watch published a highly critical report documenting how the Bush administration was funding "abstinence-only-until-marriage" education initiatives and threatening the health of young people by censoring the provision of information about the use of condoms to prevent HIV and other sexually transmitted infections or distorting information about their effectiveness.
Report researcher Rebecca Schleifer highlighted how abstinence-only programmes in Bush’s home state, Texas were actively promoting "misinformation about condoms" thereby depriving "adolescents of one of the most important tools that they need to protect themselves from HIV."
At the same time the US Department of Health and Human Services (HHS) is reviewing the work of HIV prevention organisations funded by the Center for Disease Control. The investigations followed complaints by right wing members of the US Congress that HIV prevention organisations such as Stop AIDS! San Francisco were “promoting” sexual activity and using “obscene” material, even thought the materials were specially developed with sexually active gay men in mind.
The Human Rights Watch report concludes that “Federally funded abstinence-only programs, in keeping with their federal mandate, deny children basic information that could protect them from HIV/AIDS infection and discriminate against gay and lesbian children. In so doing, these programs not only interfere with fundamental rights to information, to health and to equal protection under the law. They also place children at unnecessary risk of HIV infection and premature death. In the case of HIV/AIDS, what they don't know may kill them.”
In avoiding sex the latest San Francisco campaign looks like it has an eye on the political right rather than the health education needs of gay men, particularly as research shows that HIV “shock” campaigns may be ineffective at changing behaviour.
The latest San Francisco ads also stand in ironic contrast to drug company promotions for their anti-HIV medications which invariably show youthful, handsome, healthy men, and which have been criticised - particularly in San Francisco - for failing to show the potentially severe side-effects which HAART can cause.
Soames J Effective and ineffective use of fear in health promotion campaigns. Am J Public Health 78 (2): 163-7, 1988.