“It’s Never Just HIV” Subway Posters Are a Problem

Walk into an NYC subway, and you’ll see a poster that looks more like a horror movie advertisement than a public health message. With a black background, red and white font, and an image of a haunted-looking young man, it reads, “IT’S NEVER JUST HIV.”

After the success of its anti-smoking campaign, which featured a woman with amputated finger-tips, the Department of Health (DOH) decided to pursue a similar tactic with HIV prevention. The DOH released TV spots showing terrified men, disintegrating brains, and a now infamous photo of an anus with cancer. A deep voice stated: “When you get HIV, it’s never just HIV. You’re at a higher risk to get dozens of diseases, even if you take medications.” Next, they rolled out subway posters, which reach an even wider audience.

For many LGBTQ and HIV advocates, the campaign seems to be a reversal of thirty years of work to decrease stigma associated with HIV. According to the HIV-positive blogger Shawn, of Shawn & Gwenn, “It’s got a really retro feel, like the commercials and ads that used to run nationwide in the 1980′s, in the days when HIV was considered a death sentence.”

HIV Health and Human Services Planning Council of New York stated in its letter to Mayor Bloomberg, “The PSA intensifies stigma against people living with this condition and against gay and bisexual men, in general, at a time when we are encouraging young MSM to be tested for HIV, and people living with HIV/AIDS (PLWHA) to enter care and anticipate a long and healthy life.”

It is widely accepted that stigma and homophobia perpetuate the spread of the epidemic in a number of ways – by impeding HIV testing, disclosure, and treatment; decreasing feelings of self-esteem (and thus condom use); and placing young gay men in situations in which they are particularly vulnerable to infection, to name a few. (Consider the all-too-common instance of a teen getting kicked out of his home for being gay – then using drugs to cope or having sex for money/shelter.)

During last week’s “What Is the Message?!” forum at Gay Men’s Health Crisis (GMHC), Dr. Blayne Cutler of the DOH emphasized that focus groups with young men who have sex with men and other community members were held as part of the campaign development process.

One group of people with which the Department did not sufficiently consult is young, HIV-positive men who have sex with men. I recently spoke with a group of such men who told me that if they had seen this spot when they had first been diagnosed, they would have killed themselves. The DOH has some re-thinking to do.

The purpose of this campaign is to combat “HIV complacency” in men who understand that when treated properly, HIV is no longer a “death sentence.” The DOH is concerned that young men seeing pharmaceutical company’s antiretroviral (ARV) advertisements are coming to believe that HIV is no big deal – and are therefore not worried about the risks of unprotected sex. Clearly, the DOH understands that messages targeting HIV-positive men also affect HIV-negative men; it would be great if it understood the reverse.

In response to criticisms of the campaign, Dr. Monica Sweeney, Assistant Commissioner for HIV/AIDS Prevention and Control, stated: “We…stand strongly for the strength, dignity, and humanity of people living with HIV. We condemn stigma.” While these words are commendable, as the DOH knows best, messages are about more than words. The message the DOH is sending to HIV-positive men is that they are doomed. And the message it’s sending to the rest of us is that that isn’t the Department’s concern.

The DOH needs to consider the potential effects of its ads on HIV-positive men. The ads say that “even when you take HIV meds,” you are bound suffer. And for a young, gay man recently diagnosed with HIV, this message – which many argue misrepresents science – is dangerous.

Suicide among men recently diagnosed with HIV is a serious problem. But it’s not inevitable. Rates of suicide among people living with HIV have decreased since the introduction of HAART (highly active antiretroviral therapy), which allows HIV-positive people to manage the virus and lead long, healthy lives. If recently diagnosed men see other young men effectively managing HIV, they are more likely to feel empowered to take care of their own bodies. Which leads to the question: What should the message be?

First of all, HIV prevention is about more than messaging. It’s about reducing poverty, homelessness, unemployment, displacement, discrimination, violence, and stigma. But to the extent that “the message” can make a difference, the DOH would be advised to follow in the footsteps of GMHC, who put out the “i love my boo” campaign that depicts men of color in couples with the words “We’re about trust, respect and commitment. Safer sex is one way we show our love.” This campaign targets the perception that using condoms is either an admission of guilt or an expression of distrust by pairing relatable images with empowering text. If the DOH wants to target “HIV complacency,” it should sponsor media literacy groups that help HIV-negative men explore the motivation behind pharmaceutical advertisements. Such groups would help men see that ARV ads are intended to sell, not educate, and that pharmaceutical companies are invested in exaggerating the truth about their products.

Right now, my message is this: Tell the DOH that you care about people living with HIV. Sign this petition today.

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