Fear and HIV Prevention Shouldn't Mix

Think one part The Walking Dead, one part CSI and a dash of any anti-gay public service announcement (PSA) from the 1950s, and that pretty much sums up "It's Never Just HIV," the New York City Department of Health and Mental Hygiene (NYC DOHMH)'s newest PSA. In an attempt to raise HIV awareness among young men who have sex with men (MSM), this eerie and explicit PSA stresses that having HIV can make one more susceptible to developing bone loss, dementia and anal cancer.

View the PSA below:

Since its Dec. 7 television debut, "It's Never Just HIV" instantly polarized the HIV and LGBT (lesbian, gay, bisexual and transgender) communities. High profile advocates -- including Larry Kramer and Gay Men of African Descent (GMAD)'s Tokes Osubu -- have hailed this as a much-needed wake-up call for gay men. Kramer wrote, in a blog for ACT UP's Web site, "It's about time. This ad is honest and true and scary, all of which it should be. HIV is scary and all attempts to curtail it via lily-livered nicey-nicey 'prevention' tactics have failed." Osubu told NBC New York, "We're getting to the point where HIV is becoming the norm. It's okay, you can just take one pill and it will disappear. But that's not the reality."

Others are calling it a serious prevention failure. On Dec. 13, New York City's Gay Men's Health Crisis (GMHC) and the media advocacy organization Gay & Lesbian Alliance Against Defamation (GLAAD) called for the ad to be pulled from television because it is "counterproductive" and "sensationalistic." The NYC DOHMH refused GMHC and GLAAD's request and plans on playing the ad throughout the month of December and into mid-January. When asked about NYC DOHMH's decision, Monica Sweeney, M.D., the assistant commissioner for the NYC DOHMH's Bureau of HIV/AIDS Prevention and Control told FishbowlNY, "Silence is no solution."

The use of fear is not new when it comes to HIV prevention, and when looking at how far (or not far) we have come in the past 30 years, I can definitely understand why the NYC DOHMH may have relied on scare tactics to grab people's attention. New HIV diagnosis rates among MSM under the age of 30 are up 50 percent in the past eight years. Yes, that's a serious problem.

I also understand that a lot has changed since the disease was once called GRID (gay-related immunodeficiency disease): AIDS doesn't deplete social circles anymore thanks to antiretrovirals; the face of the disease has become more inclusive over the years; and Big Pharma markets living with HIV as painless and as easy as popping a pill every day. And despite everything we know about this disease and how to prevent it, we are still seeing naive and nonchalant attitudes among young men when it comes to HIV. Clearly, we have a lot more work to do.

But many of the large, national LGBT organizations -- the ones that have the most visibility, influence and funding -- need to take some responsibility for why HIV has fallen off their own community's radar as well. While some of these groups will occasionally lend a hand to HIV/AIDS organizations when it's convenient, they essentially have turned their backs on the epidemic and have taken up more "relatable" platform issues, such as marriage equality, adoption and "Don't Ask, Don't Tell." And while I understand that the stigma of the early days has helped shape homophobia and misconceptions about gay people, now is the time for LGBT people to let go of that hang-up and re-own this epidemic as if it's 1985. HIV is still a gay disease.

But even if the kids just don't get it and would rather remain fixated on Lady Gaga and Beyoncé, or even if Gay Inc. is too busy playing respectability politics with straight America, that doesn't justify what the NYC DOHMH has done.

This PSA is not the answer. Not even close.

First, it's misleading. The ad simplifies the science around the association between HIV and developing other ailments, such as dementia and osteoporosis, by making it seem as if these things are a definite and will happen immediately after being diagnosed. These are diseases that may not happen at all and if they do, most likely they will occur much later in life. It's not that plausible that a 28-year-old, HIV-positive man will go dancing at Splash on a Wednesday night and look down to see that his femur has snapped in half. Not to mention, this could actually deter people from wanting to get tested since the ad claims that antiretrovirals don't necessarily stop one from developing these diseases. Ignorance for many is bliss, especially if it seems as if modern medicine won't stop one's anus from being riddled with bloody sores or one's brain from rotting.