Fear Never Work In NYC: HIV Prevention Strategies Should Have Known That Before They failed!

New York City can be a fierce city. Looks like NYC has outdone itself. As recently reported, the New York City Department of Health and Mental Hygiene has released a new ad campaign entitled It's Never Just HIV. The mission of the ads is to reduce HIV transmission among young gay men. You can take a look at the full ad here -- but be forewarned, it is quite graphic, even to jaded New Yorkers.

As a result of this campaign, there have been some heated discussions regarding the scare tactics used. The NYC Department of Health defends the ad. They cite statisticsthat HIV continues to spread at increasing rates, especially among young men who have sex with men.  The Gay and Lesbian Alliance Against Defamation (GLAAD) and the Gay Men's Health Crisis (GMHC) have released a joint statement condemning the public service announcement.

In an interesting twist, Larry Kramer has come forward in support of the campaign. HIV historians will remember Larry Kramer as one of the pioneering AIDS activists. In fact, he is one of the founders of GMHC, the very first AIDS service organization. He has since parted ways with GMHC and has spoken out against some of the organization's decisions in recent years. This is a clear example of where his opinion differs drastically from the influential organization he founded. Here is a taste of what he wroteregarding the ad:

To the nyc dept of health: thank you. it's about time. this ad is honest and true and scary, all of which it should be. hiv is scary and all attempts to curtail it via lily-livered nicey-nicey "prevention" tactics have failed. ... of course people have to get scared. i have said this since day one and i say it today. they need to be scared into using condoms. into getting tested, into being responsible human beings. nothing so far has been able to bring a sufficient result to these requirments. why can't anyone see that? why can't our oldest aids organization see that? ... just as i fimly [sic] believe that NO prevention effots can be rendered with the sugar coating it has been receiving since 1981. i congratulate the nyc board of health for finailly getting real. i look forward to even more and scarier public service annoucements [sic].

Do scare tactics work?  In some cases they do. NYC has another ad campaign focused on scaring people into quitting smoking. It showcases the graphic effects of smoking, most notably those of former smoker Ronaldo Martinez, who has to breathe through a hole in his throat due to smoking-related cancer. They are powerful, gritty messages and have been proven hugely successful.

Yet, HIV and smoking are not the same. Which is why the same strategies will not work for both. Here are a few reasons why.

First off, smoking has never been given the label of a group-specific disease. HIV was virtually ignored inthe early years due to its assumed direct connection to the gay community. AIDS seemingly started with a few gay men seeking treatment for a rare skin cancer in San Francisco and New York. Those are indeed the first documented cases. However, at the exact same time these men were receiving treatment, there were intravenous drug users and others presenting at emergency rooms in the same areas with rare forms of pneumonia and other obscure diseases. The main difference was that these individuals, who also were later proven to have AIDS, were not as readily documented. During this time of chaos and crisis, AIDS was declared to be gay disease by politicians, the media, and many other people in power. In fact, AIDS was referred to as GRID -- Gay Related Immune Disease. The gay community became the scapegoat for this epidemic.

Not until AIDS was found to be the result of a virus (HIV) did this term stop being used.  It was not until HIV was found to be able to be transmitted to women and children did any real treatment and prevention efforts begin. Yet the damage was done. Those infected were seen as "deserving" of their fate. Because of this horrific, blind ignorance, countless lives were lost and this virus was allowed to spread uncontrollably.

Yes, smoking has had its fair share of secrets and cover ups with regard to the health risks. Yet, none of the risks have ever been directly tied to a minority group and highly stigmatized population.  To resort to scare tactics now is too raw and offensive to those who have lived through the devastating early years of the epidemic.

Second, there is a huge morality component to HIV and AIDS. Those living with HIV are judged and stigmatized. There are a ton of myths and stereotypes linked to HIV, even though we are close to 30 years into the epidemic.  HIV is still sorely misunderstood. Smoking has almost never been misunderstood. If anything, smoking has had a history of being glorified and seen as something cool people do. Yes, those who smoke sometimes feel segregated to the streets now that there are smoking bans across the country. But no one would think twice about using a toilet after a smoker. People still believe HIV can be transmitted through toilets, drinking glasses, and sneezing. Smokers do not suffer from this type of shame and stigma. Those with HIV do.

And third, smoking has a direct effect to those nearby. There are health risks to breathing in second-hand smoke. An HIV+ person does not pose any health risks to anyone in direct contact. When it comes to casual contact, there is no such thing as "second-hand HIV".

Scare tactics are not the best way to prevent the spread of HIV. Yes, HIV does continue to spread. And yes, HIV and AIDS can be devastating diseases when not cared for. Yet, those living with HIV are already incredibly stigmatized and misunderstood. Watching the ad leads people to believe that everyone living with HIV will suffer these ailments. This is not true. And coupled with the tumultuous history of HIV, it all just makes the ad tasteless and offensive to those living with the disease.

There is one good thing about this ad campaign -- people are talking about HIV. That is never a bad thing. The intention of this campaign is good; the overall tone of the message is not. Certainly there are better ways to help prevent HIV that do not include the use of fear and stigma. Please join us in urging NYC to end this offensive ad campaign.

Photo Credit: Elizabeth Lombino

by Elizabeth Lombino