Gay men and bisexual men still represent a disproportionate number of HIV cases in the United States (CDC). In addition, African-American and Latino men are significantly more likely than white men to be diagnosed with HIV and die from AIDS-related illnesses. Numerous HIV prevention campaigns are thus aimed at these populations.
It’s important to try to reduce the HIV among these populations, but we also need to think critically about how prevention strategies reinforce stigmatization.
For example, this ad from a western Massachusetts clinic uses the phrase “man up, get tested” — taking care of yourself by getting tested for HIV is linked to your masculinity. What’s interesting is that by including only men of color in the photo, the ad suggests that black and Latino men are particularly obsessed with their masculinity, more so, perhaps, than white men. It also potentially reinforces stereotypes about black men as hyper-sexualized and Latino men as machismo.
Second, a New York City campaign released in late 2010 uses fear to reach young gay men who are often thought to be complacent about the consequences of HIV disease now that life-saving medications are widely available in the U.S. and people can live with the virus for decades. Gay and bisexual men are encouraged to use condoms through a commercial that reminds viewers “it’s never just HIV” by featuring a close-up photo of anal cancer among other (potential) HIV/AIDS related illnesses. The video was applauded for its frank depiction of risk in the face of public apathy about the dangers of HIV/AIDS while simultaneously condemned for sensationalizing and stigmatizing gay sex:
In the face of stark HIV/AIDS inequalities among gay men and people of color, it’s clear that new prevention strategies are needed. At the same, however, we also need to think about how we reinforce damaging and stigmatizing ideas about race, gender, and sexuality.
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Christie Barcelos is a doctoral student in Public Health/Community Health Education at the University of Massachusetts Amherst.
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Comments 17
Anonymous — October 14, 2011
"What’s interesting is that by including only men of color in the photo, the ad suggests that black and Latino men are particularly obsessed with their masculinity, more so, perhaps, than white men. It also potentially reinforces stereotypes about black men as hyper-sexualized and Latino men as machismo."
These are legitimate concerns, but I think the attitude that the ad is trying to combat is that admitting to being gay or bisexual, admitting that you are vulnerable to disease, or actually going to get screened for STDs/STIs are all seen (by some people) is detrimental to one's masculinity and/or reputation of masculinity. I don't know the degree to which black gay men are pressured to "keep it on the DL" vs. a decade or so ago, but it certainly has been an issue in the past, and contributed to occurrences of closeted gay men giving their wives HIV.
We always have to be vigilant about accidentally reinforcing stereotypes, but I think there is a legitimate need for someone to say, "You can be manly/strong/sexual/etc. and admit you might be HIV-positive."
Slaven Hrvatin — October 14, 2011
If a campain only includes men of color, it doesn't mean it's sexist. This segment of population frequently has higher rates of HIV infection compared to whites. That would make the decision to include only black and hispanic men completely justified.
Kat — October 14, 2011
"It also potentially reinforces stereotypes about black men as hyper-sexualized and Latino men as machismo."
I disagree with you. Be that as it may: How would you have wanted the campaign?
Andrew — October 14, 2011
Christie, I wish I sill had a copy of a study I did in 1999 on media coverage of HIV infection rates to share here. In summary, I found that nearly all outlets reported heavily on the correlation between race and HIV, but only one mentioned the factor that had far more statistically valid weight, which was class.
The exception was the relatively obscure Medical Anthropology Quarterly, which had some exhaustive research into how factors of poverty (which disproportionately affects blacks and Latinos in the US) increases the risk of exposure to HIV and of being diagnosed after one has exposed other sex partners to it. Every major variable - access to health care, level of education completed, time spent in prison, time spent as a sex worker - led us back to the fact that low-income people were both likelier to contract HIV and likelier to maintain a highly infectious viral load due to lack of medical care. Race did overlap with some of those details - particularly time spent in prison, which is drastically higher for black men than other groups - but it was never the whole story.
The media of the time, just as now, did an enormous disservice to the science by artificially detaching race from class. Some outlets even went so far as to speculate on the reasons for a spike in black infection rates (all of which were based on stereotypes, such as the idea of black promiscuity, that did not correspond with any available data on sexual behavior). Inadvertently, one thing they did accomplish was deepening the AIDS stigma within some minority communities, to the extent that some of the people we interviewed avoiding condom use out of fear that their partners would think that meant they had HIV.
Hearing this coming out of the mouths of young people without health insurance was heartbreaking.
I don't necessarily object to the strategies attempted by the campaigns cited above, but I don't find people in AIDS charities to be in any way delusional about what they're up against. They know that universal health care access, more affordable antiretrovirals, better sex education, and economic strategies to lift more people out of poverty would achieve far better results across the board in public health. But these are broad systemic failures far beyond the capacity of small nonprofits to deal with. The best they can really do is try to target minority groups as persuasively as possible without a Madison Avenue budget or the full support of a government that has always dragged its feet on HIV/AIDS and neglected the health impact of the vast and growing income gap.
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Maeghan — October 14, 2011
I have been reading Elizabeth Pisani's "The Wisdom of Whores," about AIDS. Based on that (I don't have a lot of knowledge on the topic), I do not see anything wrong with the commercial. At all, really.
Blix — October 15, 2011
Sexually transmitted disease would be minimized, if not eradicated in one generation if monogamy was practiced.
JonCarter — October 15, 2011
This comment from the post could not be more wrong: "we also need to think about how we reinforce damaging and stigmatizing ideas about race, gender, and sexuality." Public health officials when communicating about deadly diseases should communicate in a way that WORKS and should pay no mind at all to these other issues. If the public health professionals wish to speak to a segment of the population they should just do it and damn the touchy feely foolishness.
Kvanderm — October 17, 2011
These kinds of social marketing campaigns are usually designed around very careful formative research -- I don't think the campaigns above are a representation of how "elites" view their target populations, but the outcomes of specific research designed to change behavior.
allreb — October 17, 2011
If it's of interest, one of my coworkers wrote a fairly long editorial on the "It's Never Just HIV" PSA last winter -- http://www.thebody.com/content/art59938.html .
Admin — October 19, 2011
Dear Christie,
I would suggest you first look at how gay-orientated media and gay-targetting ads reinforces existing stereotypes. They do that because it works and thought I see many problems with re-inforcing stereotypes to the point it becomes sickening reading a gay mag, if in this case it comes with a benefit, this is something we could live with.
But for sure, PC campaigns are doomed to fail as they will not appaal to those they are supposed to reach.
vb
roger
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