Try to remember where we were 30 years ago ...
We start the focus groups we run on our social messaging campaigns with this request. We ask our participants, who are 55 to 70 years old, to think back to when they were three decades younger -- when they were at their sexual peak and first heard about the catastrophic damage AIDS was causing across the country.
What they learned about AIDS at that time often defines what they think about it today, especially among heterosexuals. It is remarkable that even 30 years later, many older adults in New York City still think HIV is a concern only for gay men, drug users, and sex workers. This lack of knowledge is the main cause of new infections in older adults -- not only HIV but other STDs as well.
That's the reason we've created five different social messaging campaigns about sexual health that target people over 50 of all sexual orientations. We need to inform them that accurate information, safer sex, and regular testing are the key tools to maintaining their health.
As consultants for ACRIA, we've created a new "Age is Not a Condom" campaign each year for the last five years. These campaigns consist of 12 to 17 different posters -- half in Spanish -- that appear on bus shelters in New York City, online at ageisnotacondom.org, and on Facebook, Twitter, and Pinterest.
As consultants, we bring our own expertise, but we do not do it alone. Effective social messaging campaigns are not created on computers in isolated offices. They are created by the audience they are intended for. In small meetings, older adults of all backgrounds shape the look, message, and tone of each ACRIA campaign by honestly, and sometimes forcefully, expressing their opinions.
Creating a Campaign
Our work starts with some simple ideas for a campaign. We come up with a few different ideas, using images and content from brainstorming meetings with ACRIA staff and from earlier research. We then arrange and meet with focus groups, by teaming with organizations that work with older adults and selecting people who are similar in age, race, and where they live. HIV status is not asked nor disclosed in the groups.
We start by warming them up with a conversation about growing older, finding relationships, and, of course, having sex. We spend quite some time on that, asking if they are sexually active, how much they know about safer sex, and how much they share with their doctors about their sex lives. Finally, we show them our ideas and just listen. The participants are always very engaged, strong-minded people, and their ideas and opinions really make a difference in taking our original sketches to the final product that appears on the street. We update the graphics and content based on the group's suggestions, narrow the campaigns down to one, and then finalize the models, photography, and graphic design.
Over the years, the opinions of our focus group participants have left their own stamp on each campaign. In 2011, we were halfway into a meeting with a group of older Latinas when we noticed a common concern among some participants. Turns out they were heterosexual women with HIV who all recalled being infected by their partners or husbands. Rosa, a 62-year-old Puerto Rican, said:
Growing up, we learned from our mothers that a good husband is one who always provides for his family and comes home every night. Mine was a good husband under those principles. I just didn't know I could get HIV from him.
Rosa's statement defined our first campaign, titled "I Didn't Know", in which we presented Rosa's story along with five more from other older adults who didn't know they needed to protect themselves from HIV and other STDs.
Sometimes we faced rejection when putting the groups together. Last year, we were starting a group at OATS (Older Adults Technical Services), an organization that helps older adults improve their computer skills. When we gave out a questionnaire, a white man about 60 years old stood up and said:
Oh, sorry -- I just read here that this group is about AIDS. I'm leaving because I am not interested.
But this man was exactly the kind of person we wanted in the group! We need to meet people, especially heterosexual men and women who don't often think about HIV, and talk about their sexual health and safer sex practices. Unfortunately, many have built up thick barriers that prevent any new information from getting through.
I honestly can't believe that people over 50 don't have the information they need to practice safer sex. Everybody knows the rules! For God's sake, it's been over thirty years!
That was the statement of a 55-year-old white man who had worked in HIV agencies for years. We were amazed to learn that people working in HIV often think that everyone knows and accepts information designed to change prejudices like "only gays, sex workers, and drug addicts are in risk for HIV." Through our groups, we've learned that's often not the case.
Hell no! I don't want to see grandma naked on a poster. We are too old to show that much skin.
We were shocked to hear this from a 52-year-old AIDS activist when we showed images of people over 50 who appeared to be nude. They looked proud of themselves, healthy, and sexy. This reaction -- which we considered a little discriminatory toward older women -- only made us more determined to portray models in suggested nudity, looking proudly at the camera and delivering the clear message, "If you have sex. ... Age is not a condom." Using controversial elements can sometimes be very effective. It's better to get a negative reaction that none at all.
The groups also allowed people to discuss the effect HIV has had on their sex lives and the difficulties they face discussing that with their doctors. Omar, a 62-year-old gay man with HIV, shared this story:
I was trying to talk to my doctor about sex and ways to prevent infecting others. He looked at me and said, "You just need to make sure you take your meds and take care of your health. At your age there is no time to think about sex."
Stories like that taught us that our campaigns need to speak not only to people with and at risk for HIV, but also to their health care and social service providers.
What We've Learned
Over time, valuable facts that make these campaigns more effective have become clear. Our participants have expressed loudly and clearly that they want to see themselves in the pictures we take, to make sure we are effectively targeting their peers in the campaign.
They want to see regular men and women over 50, not professional models -- images they can relate to. For this reason, we've done our own photo shoots for the last three years, carefully casting men and women who represent our audience. It's very rewarding to see these regular folks in high-quality images.
We've used photos of gay and straight couples in order to target all communities. And we've also learned the value of using an image of one person and broadening the written message to include all sexual orientations. That way, we can reach all of our target audiences without excluding anyone's sexual behaviors.
These are not big-budget campaigns. Since our target audience is scattered around the city, we use bus shelters in all five boroughs of New York City as the main outlet to display our posters. This allows us to target everyone who rides buses throughout the city, as well as the pedestrians who walk by them. We can also determine the demographics of the area in which each bus shelter is located to ensure that we find the best location for each poster.
All our campaigns remain up at ageisnotacondom.org long after the bus shelter posters are gone. Please visit us there, like us on Facebook, or follow us on Twitter and Pinterest -- search for ageisnotacondom. Help us spread the word that older adults have great sex and so need to learn how to protect themselves.
Sammy Jurado is an independent consultant in New York City, specializing in social messaging, social media, and digital marketing.