There’s the dull sound of distant, thumping techno, as if there’s a party going on elsewhere in the house. A man and woman stumble into the dark room, strip their clothes off and start having sex; first she’s on top, then he is. The camera focuses on their bodies, but then the man raises his face. And it’s Hitler.

This was the shock-tactic safe sex campaign by German charity Rainbow that caused outrage across Europe last year. The message – “AIDS is a mass murderer; protect yourself!” – was condemned by other HIV/AIDS organisations as demonising people with the disease, rather than demonising the disease itself.
But Rainbow vociferously defended their ad, which was covered by media outlets the world over and clocked up millions of hits on YouTube. A spokesman said, “We want to give this terrible virus a face. This shock campaign is necessary to get people thinking again.”
Because it’s becoming increasingly clear that, when it comes to HIV and safe sex, there is a generation who aren’t thinking.
Research by Belgian scientists into the rise in new HIV infections, published last month, showed that transmission of the disease was “significantly associated with Caucasian origin, infection through homosexual contact and younger age” – that’s young, white, gay men in other words.
In Ireland in 2009, the number of new infections among men who have sex with men climbed by over 40% from the previous year. In total, 138 new cases were diagnosed in this group. The experts at the HSE’s Health Protection Surveillance Centre, who compile the national statistics on HIV, described the growing number of men who contracted the virus through sex with other men as “the key finding from this year’s report.”
“The majority (63%) of these men were born in Ireland and most likely acquired their infection in Ireland. Young men under the age of 30 years accounted for 35% of new diagnoses,” the report’s authors stated.
Needless to say, HIV is in no way confined to gay or bisexual men. Of the 395 new cases recorded last year, 39% (96 women and 60 men) contracted HIV through heterosexual sex; this was the single biggest group of new diagnoses. Only 9% of new HIV cases were injecting drug users.

Drug companies
Using a johnny isn’t rocket science – why isn’t the message about safe sex getting through?
Mary O’Shea of the Dublin Aids Alliance believes engrained myths about the “type” of person who contracts HIV are part of the problem, along with a new complacency about infection which seems to have developed apace of medical advances.
Antiretroviral drug treatment now means that people infected with HIV can live healthily for decades without developing full-blown AIDS. No-one under the age of 30 can remember the bad old days when diagnosis was followed, within a year or two, by death.
“There has been an upward trend in new diagnoses in the last few years. We need to keep it on the political agenda because there is a feeling that HIV has gone away, especially among young people who didn’t grow up in the ‘80s,” says O’Shea. “There is a complacency about it. People think HIV happens to other people, or to drug-users – but the figures don’t back that up at all. Anybody can pick up a sexually-transmitted infection. It’s not peculiar to any strata of society, that’s a myth.”
She is echoed by Brian Finnegan, editor of Gay Community News (GCN), who believes education on HIV has “lost its way.”
“When I was coming of age as a teenager in the 1980s, when AIDS first reared its ugly head, the education that was around was, ‘get this disease and you will die’,” says Finnegan. “The BBC campaigns had falling headstones, or an emaciated, dying man, surrounded by his family. Safe sex meant saving yourself from a terrible death.
“Now, with the rise of medication that elongates people’s lives and arrests the development of HIV being turned into AIDS, that image can’t be given out anymore – and it’s not politically correct anymore.
So the image associated with HIV comes from the drug companies in the 1990s, of carefree people running down beaches with no shirts on. The drug companies have a drug to sell, and they are selling health rather than death; they’re selling filled-out bodies rather than emaciated corpses.
“Gay magazines, especially in America, began to be filled with these images of healthy men living full lives. The message was, ‘you live with HIV’, not ‘you die of HIV’. That’s a very good message to give because there are a lot of HIV-positive people who need to hear that message and who need the world to move away from stigmatisation of HIV. But it’s not good for those who need information, and who weren’t there in the ‘80s. So there’s an in-between space that no-one knows how to tackle in educating young, gay men.”

Investment
Two years ago, the government published the ‘HIV and AIDS Education and Prevention Plan 2008 – 2012’, which made numerous recommendations in areas such as STI screening for young people, improving the availability of condoms, and promoting safe sex through the media and social media. Most of the report’s recommendations have not yet been implemented.
“We’re in a climate where no new initiatives are being invested in. But if we don’t, it will cost more to the exchequer in terms of public health. Prevention would save us a fortune on anti-retroviral drugs,” O’Shea argues. “We’ve been campaigning for free condoms to be available to people who need them. In the reception centres, like Mosney, for asylum seekers, people are getting €19.50 a week and they aren’t getting free condoms. The cost of condoms is very prohibitive to some people and it should be free,” she says.
O’Shea points out that investment in prevention has been proven to work – needle exchange has reduced the number of injecting drug users contracting HIV to a fraction of what it was.
“We have to grab people’s attention. The likes of the [€40 million] Road Safety campaign: that is very good and it is making a difference, but there are other things that need to be invested in. It is great that people are not dying anymore from HIV. The dramatic messages in the ‘80s were so dramatic that there was a large fear factor; that has changed and we need to come up with something to replace that.”
No-one wants a return to the fear-mongering public health campaigns of the past, like the 1987 Australian TV ad that showed men, women and children arranged like bowling pins, and the grim reaper emerging out of the gloom (and a lot of dry ice) to knock them down with his enormous bowling ball of death. In the UK, the ‘Don’t Die Of Ignorance’ campaign showed apocalyptic scenes of cliff-falls and volcanoes (cue more dry ice), followed by a massive gravestone inscribed with the word ‘AIDS’ falling over.
But for most people, the most shocking images of AIDS in the ‘80s and early ‘90s were those of young, emaciated men in hospital beds – this was certainly “a face for this terrible virus,” to use Rainbow’s language.
Finnegan believes that giving a new face to HIV – the face of someone living a normal, full life, but nevertheless a life that has been deeply affected by the condition – is the key to bridging the gulf between positive and negative messages about the virus.
“It is the HSE’s responsibility to give health education. Why put on a condom and have safe sex? Because you don’t want a virus you will never be able to get rid of. I think a proper campaign would have HIV-positive people speaking about safe sex, a HIV-positive person being photographed and interviewed and saying, ‘I’m HIV-positive and I live a full life – but I wish I wasn’t HIV-positive’.”