Matthew Hodson, Head of Programmes at gay mens health charity GMFA, explains the controversial subject of fear versus education in HIV prevention…
A TV ad campaign, produced by the New York City Department of Health last year, showed images of handsome, young, HIV-positive gay men being struck down by osteoporosis on the dance floor and graphic depictions of anal cancer. Both conditions are more likely amongst men with HIV, but are rare, particularly in men as young as the ones depicted in the campaign.
So does fear-based campaigning work? A large proportion of people believe that it does – but only for someone else. People are less likely to believe that fear-based campaigns are what they need to ensure their own safer sex behaviour.
A lot of evidence suggests that fear-based campaigning is not effective.
People tend to pay attention to campaigns that support their own world view. People who don’t wish to be challenged about their own behaviour, tend to ignore such messages. We see the same responses to stop smoking campaigns.
A study exploring the impact of the Iceberg and Tombstone AIDS campaign from the mid-80s found that anxiety was raised amongst those people who were not the intended target of the campaign, but not amongst the target audience.
The campaign was successful in drawing attention to HIV but no changes in behaviour were found in either group.
We all want HIV prevention campaigns to be as effective as possible. HIV remains a serious, potentially life-threatening, condition. However we cannot responsibly, or accurately, portray HIV as the killer that it once was. Campaigns that fail to acknowledge medical advances do nothing to encourage men to come forward for testing, and thus may increase the amount of undiagnosed infection.
“There is no magic bullet, no formula of fear or entreaty that will be able to prevent all future infections..”
Earlier intervention leads to a better prognosis, and HIV treatment makes men less infectious, so it’s important that campaigns do not discourage men from accessing treatment at the optimum time.
At the same time, HIV prevention should be honest about what it means to live with HIV in 2011. This includes the harsh truths, that you will be likely to face rejection, that your health will be affected, that the drugs will likely have an impact upon you and the way that you lead your life.
HIV positive men do not need to be protected from the truth of HIV infection – they live it, they already know.
In HIV prevention, from looking at what has been tried all around the world, it is clear that there is no magic bullet, no formula of fear or entreaty that will be able to prevent all future infections.
No single HIV prevention campaign will work for everyone but all gay men, as the group most vulnerable to infection in the UK, deserve to be given reliable, honest and accurate information about HIV.
• GMFA – the gay men’s health charity – Improving gay men’s health by increasing the control they have over their own lives.
• www.gmfa.org.uk
