Issue:  Vol. 48 / No. 12 / 22 March 2018

HIV ads to be scrutinized in 2007


Better World's Les Pappas. Photo: Rick Gerharter
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The billboard above Cafe Flore in San Francisco's gay district last year carried a New Year's resolution message. An unidentified person, presumably a gay man, pledged he wouldn't infect anyone with HIV in 2006.

The HIV prevention message was part of the long-running HIV Stops With Me campaign, begun in San Francisco and created by the locally owned Better World Advertising firm. The social marketing message sparked outrage in one gay man in his 20s, Trevor Hoppe, a newly arrived resident.

Hoppe wrote in a guest opinion published in the Bay Area Reporter last February that the seemingly innocuous message actually had "an insidious subtext." Hoppe found fault with the advertisement because it implied that "positive men, invisible to the naked eye, are apparently on the prowl – purposefully infecting unsuspecting HIV-negative youngsters. Hide your children!" he wrote.

It would be just the first HIV prevention campaign developed by Better World to spark outrage last year. Another of the firm's campaigns, the "HIV is a gay disease" ads paid for by the LA Gay and Lesbian Center, sparked widespread condemnation and outrage after it appeared in October.

The criticism of his agency's work had Better World owner Les Pappas on the defensive, telling the B.A.R. in November that such campaigns are needed in order to stop the spread of HIV.

Responding to critics who complain his campaigns only focus on negative behavior, Pappas said, "I think some people want to believe that everybody is doing the right thing and behaving properly and taking care of each other, but that's not what's happening. I don't see the benefit of sugar-coating and glossing over problems."

Opponents of what they see as "fear-driven campaigns" counter that gay men are taking care of themselves, pointing to recent declines in both HIV rates and syphilis in San Francisco's gay male population. They have called for a two-year moratorium on all social marketing campaigns in order to dialogue with gay men on what types of messages should be directed at the community.

AIDS activist Michael Petrelis, one of the main proponents for the moratorium, said that after 25 years of living with the AIDS epidemic and countless HIV prevention messages "there is diminishing community buy-in to the campaigns."

The debate about HIV prevention messages will receive even more scrutiny this year, when the city's HIV Prevention Planning Council is expected to discuss concerns about the campaigns at either its February or March meeting.

Tracey Packer, interim HIV prevention director at the San Francisco Department of Public Health, said the HPPC's steering committee has already discussed the issue and she intends to have the entire council address what HIV prevention messages members feel are appropriate.

Packer said some of the questions that came up during the committee meeting were: what are the standards for social marketing; and, should there be a group to monitor the messages that are produced?

"How can we be creative in HIV prevention campaigns? How can we ensure there are positive messages? It might be an interesting conversation," Packer said.

Packer has overseen the HIV prevention section since December 2005, and in that time, has launched one new campaign called the Disclosure Initiative, produced by Pappas's firm. The campaign has sparked controversy not so much for its advertisements but for recognizing serosorting – where men seek out sex partners of the same HIV status – as a valid HIV prevention tool.

The campaign's aim is to support gay men in disclosing their HIV status to each other, and it is not done in a demonizing way, said Packer.

"First of all, I would not say we have done a negative message. Our goal is to support community norms around disclosure," she said. "We think it is really important people talk to each other about their status, know what it is and talk about it."

Supervisor Bevan Dufty said he endorses having a community-wide discussion about the tone of HIV prevention ads. He said he intends to bring his concerns to the HPPC at its January meeting.

"Rather than act autonomously, I am going to go to public comment at the first meeting in January and ask them how we can work together – whether it is a summit or whatever – to evaluate prevention campaigns, look at what the messages are, what the campaigns are, and what the public thinks about new ways that can be considered," said Dufty.

He said that the best approach to take in HIV prevention messaging is a complicated question to address.

"At one level you want to try to penetrate and grab peoples' attention. At times the campaigns are so harsh you turn people off," said Dufty.

Jimmy Loyce, deputy director of the AIDS Office, defended the health department's and AIDS agencies' developing the controversial campaigns. He said it is to be expected that an HIV prevention message will upset someone in the community.

"To assume the community monolithically supports any HIV prevention message we put out is silly. That is not going to happen," he said. "We have to des

SFAF's Mark Cloutier. Photo: Rick Gerharter
ign provocative messages and have people looking at who they are and looking at where they are in relation to their risk."

Campaigns shift

Yet in San Francisco the largest AIDS agencies have either moved away entirely from producing social marketing campaigns or are no longer targeting gay men with their messages. The Stop AIDS Project, long a producer of controversial HIV ads, has not launched a new HIV-specific campaign since its  "HIV is no picnic" ads appeared in 2002.

Over the last four years the agency has instead focused its advertising on combating speed use among gay men and reorganized its HIV prevention work to focus on specific areas gay men congregate or communities they belong to such as gyms, bars, the Internet, or the leather community.

Robert McMullin, the agency's executive director, said the switch in approach is partly due to funding constraints and partly due to using alternative methods to engage gay men in talking about HIV.

"We can't afford to do great big billboards like other people do. Our outreach is more focused on sexual networks, so our social marketing is more focused on social networks," he said. "It focuses on communities most at risk instead of a generally scattershot type of approach. They may not be as big and visible as social marketing campaigns."

The Asian and Pacific Islander Wellness Center has also retooled its advertising focus away from gay men and more toward their support networks. Its two-year-old Banyan Tree Project aims to reduce HIV stigma in the API community by targeting messages to parents, grandparents, siblings, and friends of gay men.

"It is because we have known a lot of the epidemic in our communities comes from beliefs that are carried within families and within communities there are deeper seated prejudices and stigma around HIV," explained Lance Toma, the center's new executive director. "That ultimately has the power to affect how gay men and high-risk members can change their behavior. It is the influence of the family or normalizing it in families to make it okay for the gay men in our community and other at-risk groups to access services."

While he supports social marketing, Toma said he is not surprised to see less HIV prevention campaigns being produced.

"I think social marketing campaigns are vital. What we struggle with is we have seen less and less money from the federal government to support social marketing campaigns," he said.

The San Francisco AIDS Foundation does have the resources to launch a campaign targeted at a wide audience of gay men. The agency had been expected to roll out such a campaign highlighting serosorting and other prevention methods last summer, but creative differences between foundation staff and Pappas, whose firm had been hired to design the ads, kept pushing its launch back.

SFAF Executive Director Mark Cloutier said both he and foundation deputy director Steven Tierney "felt the prototypes were not communicating what we wanted to communicate."

Once the agency learned that Pappas's firm was also working on the city's disclosure campaign and it would include messaging about serosorting, Cloutier said he decided to scrap the foundation's campaign since there was no need to waste money on duplicative efforts.

The foundation's contract with Pappas ends in six months and at this time, Cloutier said, "he is on hold." Pappas could not be reached for comment this week.

Cloutier has since hired Amon Rappaport, formerly with the Marin Institute, as a full-time staffer to develop the foundation's marketing in-house. Rappaport started December 4 and will be paid $125,000 annually. Cloutier first met Rappaport in September when he interviewed him for the foundation's director of communication position.

"He had an interesting take on social marketing and cause-related marketing," said Cloutier. "He said he woke up in the night with the thought AIDS = endemicity and that it sounds like AIDS = Ends in My City. I thought it was very clever."

He said the task he has given Rappaport is to design a campaign that can assist gay men in taking care of one another and that speaks to them in a positive manner.

"Many campaigns don't seem to necessarily identify with the positive motivations that gay men have in taking care of themselves and others. They often start with a frame of 'You are doing something wrong' and using a social marketing campaign to start a conversation about it," said Cloutier. "The question I have is how do we supply information and align campaigns with the deeper intentions of gay men to take care of themselves and their partners to continue to drive the infection rates down?"

Cloutier said he hopes to launch the foundation's new ads this spring.

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