Graphic HIV/AIDS Video Horrifies Gay Community

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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

Advocates say ads that scare may have an immediate impact, but do not work in the long run, citing studies from Sigma Research and Yale University.

"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."

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