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May 24, 2005

AIDS and fear campaigns

Andrew Sullivan makes an interesting point about HIV prevention campaigns in one of his Monday entries:

Your life is not as definitively shortened with HIV as it is with diabetes; the treatment is far less onerous; the lifestyle changes are fewer, compared with daily injections, monitoring your diet, and so on. All of this poses a big challenge to those trying to craft safer sex messages. When the costs of infection are this low and the sexual benefits as immediate and attractive as they always are, the current strategy of scaring people to death won't work. We have to find a better, more positive way to encourage safer sex.

I'll have to agree with his idea and take back what I said on one of my rants from 4 years ago. Back in 1990 or so when I came out and the scary numbers of quick deaths were only just starting to subside, fear tactics in persuasive health campaigns were the norm, but don't seem to be doing much these days. Having just finished a class in persuasion and one in the rhetoric of social movements, I have gained some insight on the efficacy of negative fear campaigns. They work in the right conditions, and may have been effective 15 years ago, but not so much these days.

MLK never said, "I have a nightmare!" and posed many of his arguments at times in a positive light. Similarly, environmental movements have learned to do away with a lot of doomspeak and put success stories in a positive spin rather than the typical declarations that the sky is falling. In a nutshell many of their current campaigns are saying: the world around us is a bit cleaner since the '70s, keep up the good work.

I don't have any easy answers on how to convince the young'uns and not-so-young sexually active gay men to be safe though. Some of the retroviral drugs will still mess you up a bit, even though they are more effective and you have to take fewer pills.

My roomate came home with a styrofoam cooler one day and plunked it on the counter and said, "Here is a down payment for a house!" He said the cooler contained about $10,000 worth of HIV medications for his treatments. Having gone through a period of unemployment sans health coverage, I can only wonder about the hoops one would have to go through to get meds without coverage, especially considering the troubles some HIV clinics are going through these days. Simple red tape and having to take any more medication other than Advil (for rugby) and Allegra is enough to scare me. Perhaps posing that a simpler life can be maintained without HIV is an idea? Discuss.

Posted by jimbo at May 24, 2005 3:35 PM

Comments

I think you and Sullivan are dead on here. HIV isn't the bogeyman it once was; even the straight community has their struggling hero with HIV quota filled with Magic Johnson. The 20-something set that I'm a part of just doesn't "get" the AIDS scare. We were mere babes when Rock Hudson, Freddie Mercury and thousands of other gay men died. We see the ribbons but haven't lost friends. We don't get it.

I guess some comparisons could be made between smoking and risky sex. You know smoking is bad for you, but it feels too good to quit. You know it might catch up with you someday, and will probably shorten your life, but it just doesn't outweigh the benefits you get today. And people still smoke, just as they still bareback. But for some of us, knowing we'd have to go on a ventilator or buy thousands of dollars in drugs is enough to not do either.

Good post.

PS...Didn't Kylie have successful boob cancer surgery the other day?

Posted by: Dunner at May 24, 2005 2:00 PM

Jimbo,

This is going to rile those who are in the HIV camp.

I was alive and an active gay man in 1982, back when we did not know what caused GRID, now known as AIDS.

Once we found out what was going on, we protected ourselves. But now, all it takes is a cocktail of medicine to keep us alive.

The idea that AIDS is a managable disease like diabetes is so in keeping with Andrew Sullivan's whore identity where he was exposed as a cum dumper.

It is not now, nor ever in the future, acceptable to practice unsafe sex. And cum dumpers should be avoided at all costs.

Seamus

Posted by: Seamus at May 24, 2005 3:48 PM

I just posted a link to Dan Savages response to someone, on my site. Fear tactics didn't always work in the early 90's. Sometimes it did. Saying that the disease is manageable hasn't worked. The drugs fuck with your system. My kidneys will attest to that. They're doing shitty again.

I for one think that if we can't scare the living shit out of people NOT to have unsafe sex, then I'm at a loss. What's the best way to convince people? I don't know. I just try to be open, honest and tell people some of the hell myself and so many others have had to deal with. I tell then what it was like "way back when". I tell them the horrors of crystal meth use, barebacking parties, circuit parties, etc. Basically, I'm trying to instill fear in them, in hopes of making them think twice before making the stupid ass mistake I made 13 years ago.

Posted by: mark at May 25, 2005 9:25 AM

Jimbo:

You and I are part of the most-paranoid generation when it comes to AIDS. When I first moved to San Francisco in 1991, you could still see extremely sick people walking around or being pushed in wheelchairs. Within one year of being in SF, a friend of mine died (and I didn't know very many people) from pneumonia. We came out at a time when there was extensive AIDS education, and unsafe sex was not only seen as foolish, it was seen as immoral.

Then, so quickly, all of that changed, and people started getting healthier (although one other close friend was too late to benefit from the meds, and died as well).

Even though I am slightly less afraid than I used to be, the idea of having unprotected anal sex still seems completely unconscionable, even with a partner. “You never know if he’s cheating on you!” was also drilled into my head (and that message found fertile ground in my paranoid imagination).

How to make the kids these days wise up? I don’t know. Dangerous things (especially when the consequences aren’t immediate) are usually seen as “cool” because remaining calm in the face of some form of danger is what “cool” is all about. It didn’t seem “cool” when we were coming out because there is nothing cool about being covered with sores and weighing 90 pounds. But now, having unsafe sex shows that you aren’t some dork with a lot of hang-ups. And it’s not just the kids – a lot of people our age and older are now getting infected.

Making unsafe sex “uncool” again is probably the only answer. But I have no idea how to do that.

Posted by: Eric at May 25, 2005 10:07 AM

While scare campaigns don't work, I have to agree with Seamus about the Sullivan. This whole "but there are meds, it's not so bad" idea is precisely why we have recidivism today.

And the meds are not a walk in the park. You get the weird fatty hump on your back, you get "meds face" and your liver gets screwed. Not to mention the litany of side effects. Is there a way to get this information out without our being shrill about it? Yes. But most young gay men only think that you pop a pill.

Posted by: sam at May 25, 2005 11:44 AM

I'm glad that Andrew has found his condition and HIV treatments little debilitating, and I hope his good fortune continues. The men I know who live with HIV had similar experiences, initially. The effects of 7 or 8 years of meds can be extreme and are almost certain to reduce quality of life. Plus there are the psycological stresses which come with the likelyhood of accelerated mortality, the possibility (even with "protection" ) of infecting others, and the diminished self esteem accompanying almost inevitible physical changes. I'm incensed by advertisements for HIV meds depicting the buff and beautiful living carefree lives unimpeded by symptoms and side effects. For many (especially those without wealth, insurance and/or strong support networks), that's just not the reality. Ed T.

Posted by: circleinasquare at May 25, 2005 6:44 PM

Last I heard, you can't catch diabetes from unsafe sex.

Posted by: Norm at May 25, 2005 9:07 PM

I think Ed T. sums the point up nicely. How can we do anything about perceptions if every image that is seen nowadays is of buff boys who seems to have more energy, more muscles and are happier than all us drones? I have always hated ads for medicines, turning doctors into vending machines rather than practitioners of healthcare. Pharmaceuticals which require a prescription should never be advertised. In effect drug companies are aiding and abetting the rise in infections.

Posted by: copperred at May 26, 2005 2:50 PM