A public service announcement produced by the New York City Health Department promoting condom use to prevent HIV/AIDS has horrified advocacy groups, who say it demonizes and frightens gays and those living with the disease.
The video, which aired on such cable networks as the gay and lesbian channel Logo, Bravo and the Travel Channel, chides, "When you get HIV, it's never just HIV. You're at a higher risk for dozens of diseases even if you take medications, like osteoporosis, dementia, and anal cancer."
Gay advocacy groups and blogs were barraged by complaints after viewing the video on YouTube.
"This video bothers me," wrote JT, a reader on Steve Rothaus' Gay South Florida on the Miami Herald's website.
"Not in the way that it's supposed to though," he wrote. "I think they are trying to alienate people who already have HIV... I don't think this will help anyone to remember to wear a condom, but it will maybe get them to look down at HIV+ people as a lost cause."
The Gay and Lesbian Alliance Against Defamation (GLAAD) and the Gay Men's Health Crisis in New York (GMHC) are demanding the video be withdrawn, saying that "scare tactics" do not work and that the PSA is stigmatizing.
"While it's extremely important that we continue to educate New Yorkers about HIV/AIDS prevention, the sensationalized nature of the commercial, including its tabloid-like fear tactics, misses the mark in fairly and accurately representing what it's like to live with HIV/AIDS," said GLAAD President Jarrett Barrios.
"It's our hope that the department will work with us to create a PSA that promotes safety and solutions, rather than stigma and stereotype."
Some described the ad as "gross," as the voice-over warns that those who get HIV/AIDS -- even those who are being treated -- are at higher risk for bone loss through osteoporosis, and "permanent memory loss" because of dementia. It says HIV carriers are 28 times more likely to get anal cancer.
"Always use a condom," said the PSA, with scary music in the background.
GMHC, which has in the past worked with New York's health department, said it was not consulted and was "surprised" and "alarmed" to see the ad.
The agency received numerous calls from the public, objecting to the PSA.
But the city health department is standing its ground, insisting it "has no intention of pulling the ad or dropping the campaign."
"The PSA is meant to raise awareness that HIV/AIDS no longer a death sentence, but it's a serious disease with serious consequences, even with medication," said Dr. Monica Sweeney, assistant commissioner for New York's Bureau of HIV/AIDS Prevention and Control.
The ad was modeled on successful anti-smoking PSAs that depict sensational images of sick patients. One shows a man with lung cancer with a hole in his neck, who died shortly after filming. Another reveals a woman's hand with blackened fingers that were amputated after years of smoking.
The campaigns were lauded for being hard-hitting and had prompted hundreds of people wanting to quit to call the health department and ask for nicotine patches.
"Whatever it takes to use condoms and to prevent HIV infections is a good thing," said Sweeney, a physician who has worked with the AIDS community since the disease was first identified in New York City in 1979.
New York's HIV Rates Three Times National Average
There, HIV diagnoses have risen 50 percent among "men who have sex with men" -- a term used because "not all men who have sex with men identify as gay or bisexual," she said.
The city has been the "hardest hit" by the crisis with an HIV diagnosis rate that is three times the national average and the largest concentration of those living with the disease in the country.
An estimated 56,300 Americans were newly infected with HIV in 2006, the most recent year for which data are available, according to the Centers for Disease Control and Prevention. More than half of these new infections occurred in gay and bisexual men. African American men and women had a rate seven times that of whites.
Culturally, many African American and Latino men who have sex with other men do not identify themselves as gay. One of the groups that support the city's ad campaign is the advocacy group Gay Men of African Descent.
"Not saying 'gay,' we are hoping to have a broader reach," said Sweeney. "A lot of men who have sex with men don't identify as gay and if you use the word, they may not listen to the message, whatever they call themselves."
The city has had success with campaigns making syringes available, in mother-to-child transmission and giving out 40 million condoms last year.
But HIV/AIDS rates have begun to climb again, despite public education. Experts say the main reason is that the disease is no longer a death sentence.
"When we did focus groups among those 18 to 30, blacks and Latinos who had sex with men, they said we needed to do something to counteract the stereotype on TV that if you take one pill you are fine," said Sweeney. "We did screenings with them, we went to opinion leaders and the majority of them said, 'Go for it.'"
The PSA merely states scientific evidence, she said. "We say it without judgment."
But groups like GMHC say they are worried about the negative portrayal of gay men, especially in light of recent suicide attempts among young gays who were bullied.
The dark PSA makes a gay person "feel like a perpetrator or like a victim," said Francisco Roque, GMHC's director of community health. "You feel disempowered overall and feel like walking away and not taking care of myself."
Also troubling, he said is the ads suggest that partners might be able to "see" HIV/AIDS and assume if a sex partner "doesn't look bad," they are not infected.
New York City Runs a Dark PSA on HIV/AIDS
"We think it does more harm than good," said Roque. "It depicts gay men in a really terrible light and is gloomy in nature -- men in a dark setting with eerie horror music. It demonized them for their behavior, rather than shifting the behavior."
"Young people seeing this, the impact it will have is not the message we want, to take care of yourself," he said. "It makes them feel terrible about themselves."
Campaigns that focus on strengths of the gay community, with its contributions to culture, music and the arts, are more effective, according to Roque.
When gay men feel more positive about their sexuality, they will make healthier choices when it comes to safe sex, he said.
"We could model what it's like to use a condom, to have a dialogue with your partner, to have support and the desired behavior," said Roque. "It's marketing 101 – prescriptive approaches that talk down to people are not as effective. You value your audience and you lift them up."