BTW, if as you say you don’t know what’s going on in NSW, you probably should – there’s some positive news to tell. It seems to me that there’s a general lack of gay media interest in examining what’s going on in gay men’s prevention in any detail and I think it’s a shame. I get that it’s not all that sexy and that media organisations are as cash-strapped as anyone else but still….

For what it’s worth, I’m all in favour of engaging, innovative prevention ads that give the facts in a clear, concise and effective way, but I don’t think that this ad does that. Sure, it’s designed to shock and get attention and it does that – unquestionably. I actually think that you’d probably get a bit of traction out of it for a few months – particularly among gay guys who are already morbidly fearful about HIV – until people realised that it’s dealing in worst case scenarios that probably won’t happen to them and then everyone would move on.

These ads surface from time to time in the US and then vanish without trace – of any evaluative impact, or cost benefit, or behaviour or notification rate change. To some extent they’re an artifact of – and a response to – the direct-to-patient advertising culture in the US where HIV Pharma companies run glossy ads featuring buff, ruddy-cheeked poz dudes scaling mountains on the great waves of life affirming energy offered by HIV antiretroviral therapy. They exaggerate the benefits of course but I don’t think that over-hyping the downside represents a significant improvement.

It seems to me that this is just the sort of ad you’d come up with if you thought that best way to resolve HIV transmission is for fags to keep their pants on and not get into that….stuff. The centrality of the graphically (deservedly?) diseased arse is surely not coincidental.

Rates of anal cancer are indeed around twice as high in poz gay men as they are in neg gay men (and of course poz gay men also tend to be an older, longer lived group which might have some bearing on that ) but it’s worth pointing out that rates in gay men generally – both poz and neg – are 2/3 times as high as they are in straight men. What sort of campaign approach might work here, I wonder?

The fact is that just about all sexually active gay men are infected with the HPV virus which leads to anal cancer but it’s by no means pre-determined or inevitable that any of us needs to develop it and with regular check ups and monitoring, most of us don’t and won’t.

And if young men were vaccinated against HPV, in the same way that young women now are, I reckon we’d see rates plummet pretty much in the future.

Rates of dementia are certainly higher also in PLHIV, but most people with HIV don’t and won’t have dementia – even those of my advanced years.

Ultimately I think this ad is just lazy. It’s an attempt to duck the undoubtedly harder ask that prevention now poses in an ever-evolving epidemic by reverting to the ‘magic bullet’ that diagnosis = death used to offer before effective therapy arrived on the scene.

But that moment has passed and it’s a good thing that it has. Prevention is more challenging in this environment but that’s the reality we have to deal with. We can’t wish it away.

No-one – least of all me – would deny that HIV is no picnic nor would I challenge the ad’s premise that HIV is often accompanied by a range of other co-morbidities. We do need to tell the truth about HIV but this ad doesn’t do that and spin is spin whichever way you play it.

If someone can show me some (in fact, any) evidence that this approach works effectively in gay men’s prevention – without further stigmatising or devaluing the lives of men who have fought bloody hard to have lives in many instances – then I’m happy to reconsider.

I do think though we need to lay the paternalistic bogey man to bed though, dear. Cutbacks under the Kennett govt etc shouldn’t really be all it takes for the floodgates to re-open in Victoria. Safe sex awareness and responsibility shouldn’t rely on a continuous flow of ever-updated posters and pamphlets from the health dept. The idea, as you suggest, that the moment they begin to dwindle gay men forget all about safe sex and hiv rates subsequently surge is more alarming than anything in the NY ad at the head of this article.

HIV is a health problem the community aims to prevent. And it is crucial to show why HIV should not be acquired. Otherwise, nobody will take the problem seriously.

And I’m a bit nonplussed at what seems to be the suggestion that protecting the sensibilities of people living with the virus are somehow more important that protecting another generation from getting infected in the first place.

Doug, that statement is beneath you. It not only trivialises the issue ( we are talking about people’s mental health and wellbeing not their delicate ‘sensibilities’) but it misrepresents my original point.

I have not said that stigma is ‘more important’ than prevention, but that they need to be balanced against each other, and in the absence of any evidence at all that a scare campaign would actually decrease HIV incidence, as you so earnestly seem to believe it will, there is no justification for stigmatising PLHIV further than they already are.

unbelievable idiocy. hasn’t there been an INCREASE in new infections over the past few years?

in any case, any new infection is a disaster, given the DECADES we’ve had to try and cram the safe sex basics through our thick gay skulls.

Australia’s big scare campaign, The Grim Reaper, is often said to have been a success, however, while it was memorable, it did not work in reducing new HIV infections among gay men; infections continued for years following that campaign at rates much higher than today. What worked was a comprehensive evidence-based prevention program, and responsible actions by gay men living with HIV.

In any case, HIV is already stigmatised by the media, and just about anywhere else you care to look, so even if you wanted a scare campaign, there is no need to spend taxpayer’s dollars on a glossy campaign!

There ARE indications that young gay men in Victoria are being more careless and having more unsafe sex, as the Burnett Institute recently reported . I’m not aware of any up to date reports in NSW so can’t comment on that.

The evidence has been there in the US and Europe for some time and now it’s showing up in Victoria, so I don’t think we can afford to wait around and be complacent and say ‘it’s not like it is in the US’.

And I’m a bit nonplussed at what seems to be the suggestion that protecting the sensibilities of people living with the virus are somehow more important that protecting another generation from getting infected in the first place.

What we do know for sure is that campaigns like this stigmatise people living with HIV, and they negatively impact the self-esteem and mental health of those of us living with the virus. That is an impact that we can be certain a campaign like this would have, and that means we need to be very sure that it would have a positive impact outweighing that negative effect before contemplating it.

Fear tactics won’t work because most gay men already understand that sex is never entirely risk free and they operate within a calculus of risk that balances risk with pleasure. As Garrett has pointed out, we don’t have the same epidemic in Australia as they do in New York and, frankly, lying to gay men by telling them their arses will rot off if they don’t practice safe sex is just insulting.

Why scare people? Instead, we should make them aware of the risks and provide them with the tools and support needed to make good decisions for themselves.

One of the problems as I see it is, ACON and other similar organisations straddle the fence on HIV and AIDS.

On the one hand they are taking a large sum from the government (and us the tax payers) to try to tell us that ‘HIV is bad and you don’t want to get it’…. but with the other hand they are taking a large sum of money from the government to look after people who have recently sero-converted and because of this they also have to say ‘HIV isn’t so bad’. Mixed messages if I’ve ever heard it.

One of the things I’ve learn’t working in advertising is, you need a strong, focused message. None of the campaigns I’ve seen in the last 10 years meet that criteria.

All of these organisations are just trying to ‘have their cake and eat it too’.

We need a whole of community approach, not just the gay glitterati community, but a WHOLE of community approach.

We need to engage and empower our young people, we need to make sure that we do not allow HIV/AIDS to take a foothold in our Aboriginal and Torres Strait Islander communities, that we work with sex workers and injecting drug users effectively.

The graphic imagery and advertisements used to promote smoking cessation and road safety have lost their lustre and people just switch off. This won’t work, it will just further demonise those infected.