The HIV Prevention Debate: To Scare or Not To Scare

By now we've all heard about the controversial New York City HIV prevention Public Service Announcement (PSA). If you haven't seen it, take a look here -- just be forewarned that it is very graphic.

There has been a ton of coverage and debate surrounding this controversial PSA, including two previous posts here on Change.org.  The saying goes, there's no such thing as bad publicity, and this is Exhibit A. As I mentioned in my original post, whether you agree or disagree with the PSA, it gets people talking, and that's a big success.

The New York Times recently did a piece highlighting the sharp divide this campaign has caused among HIV/AIDS activists. Some advocates are highly in favor of this strategy, and some are severely against it. In a blog featured on POZ, the real issue is captured with these words: "The debate over these ads has largely been amongst people who have devoted much of their lives to combating the epidemic, which makes me hesitant to write in terms of the different 'sides' of the issue.  Everyone is on the side of finding the best ways to reduce HIV transmission, but we have differing thoughts on whether this particular campaign will help reach that goal."

The prevention campaign and the aftermath that has followed have been symbolic of the overall evolution of the AIDS epidemic and the world's response to it. In the beginning, there was fear and outrage within the gay community since they were the scapegoats for AIDS. There was denial and outward abuse from the rest of the world, especially those with power politically and medically. As the virus evolved and the world became more educated and aware of what it means to be HIV-positive and what it takes to care for and prevent this disease, the silence was broken and more lives were saved. Yet the anger and outrage remained and fueled much of the advocacy efforts during that time.

Then it seems the world got complacent. Medical advances evolved HIV to a chronic disease. Now HIV could be better controlled and prevented, so it must not be an issue anymore, right? Wrong. This is the "Catch 22" of the HIV epidemic. HIV positive individuals are living long, healthy lives thanks to these major advances in medications and treatments. At the same time, HIV is still a devastating disease that cannot be taken lightly. If a person does not have access to these advances or if there are other issues involved, HIV and AIDS can still be life-threatening.

Today, HIV rates are climbing again, especially among young men who have sex with men. The outrage has returned. Of course Larry Kramer is angry. He and others worked tirelessly to curb the spread of this disease and to combat the myths and stereotypes. Now he is witnessing a resurgence of HIV within his community. As someone who one might call the Grandfather of the HIV movement, his anger is justified.

Many others in this fight share his frustration. As written in the POZ blog: "It is profoundly frustrating, disempowering and, quite frankly, depressing to see so many one-time activists, caring friends and neighbors, concerned journalists, political and public policy leaders disappear like a puff of smoke once combination therapy brought a relative cure to those with the privilege of healthcare access. As the epidemic settled into communities of poverty, communities of color and amongst the young, the milieu that once made combating AIDS their priority has acquired a collective amnesia. Nowhere do we feel that frustration more than when we see young gay and bisexual men put themselves at risk, either unknowing or uncaring about the consequences."

We need to continue to fight and make it clear just how dangerous this disease is. This is true. At the same time, we continue to assert that fear tactics are not the answer. We cannot stigmatize HIV in the name of HIV prevention. Both "sides" of this debate are justified. There truly is no right or wrong. Both are true and we can embrace both messages in a more caring, compassionate and effective way.

HIV has evolved. HIV will continue to evolve. We need to unite and work together to evolve our messages to more adequately capture the heart of this epidemic and create prevention messages that better reflect this evolution.

Photo Credit: Rich Lombino