The Grim Reaper TV advertisement has cast a shadow over the HIV response since it was first aired more than a quarter century ago. The original ad, with its foreboding “Always use a condom — always” tagline and grim predictions that AIDS could “kill more Australians than World War Two,” has often been credited with raising awareness of HIV in Australia. It’s also been rightly criticised for having the unintended consequence of increasing stigma around HIV and towards gay men.
Those surreal bowling reapers were supposed to represent death, but too many people read them as representing gay men, hurling a deadly virus at the innocent women and kids at the end of the alley. The ad fed into a climate of fear and hysteria and generated a great deal of hateful commentary towards gay men and those living with HIV, who were seen as the diseased vectors of a plague that at the time seemed certain to sweep through the ‘innocent victims’ of the heterosexual community.
Despite its many failings, we’ve never quite shaken off Mister Grim and his bowling buddies. The ad is so widely believed to have been a smashing success that barely a year has gone by in the last quarter century when some ill-informed government minister or pundit calls for a ‘new grim reaper campaign’ to scare people into behaving more sensibly. Luckily, to date those calls have been largely resisted.
All that changed this last weekend with the launch of We Shouldn’t Be Making This Advert, a new TV advertisement from the Queensland government, the first evidence we’ve seen of its new ‘in-house’ approach to HIV prevention following the shock de-funding of the Queensland Association for Healthy Communities. And there, proud as punch, is our old friend Grimsby, not looking a day older despite the intervening decades, ready to scare us all back into using condoms.
The slickly-made ad looks sort of alright at first glance, with messages like ‘we shouldn’t be having these conversations’ illustrating the pain of having to tell a loved one of your HIV diagnosis, all accompanied by sad-sounding plinky-plonky music. And of course no-one wants to go through that pain. But look at the ad through the eyes of someone who is HIV positive and the message is more ‘you shouldn’t have’ than ‘we shouldn’t’. The ad portrays HIV-positive gay men as failures for not preventing their own HIV diagnosis, as having let down their families and partners, and as responsible for the HIV epidemic they have found themselves caught up in.
For people who think they could be positive but haven’t been tested, or those who think they might be at risk, the ad reinforces stereotypes of HIV-positive people being less than their HIV-negative counterparts. For some people, this will discourage them from getting tested.
Numerous international studies have shown that people with unrecognised HIV are a major driver of HIV epidemics – almost universally, people who know they’re HIV+ take steps to avoid passing the virus on, but for those who don’t know they have it, they’re likely to persist in the sexual behaviours that put them at risk of HIV in the first place. Australian researchers have estimated that between 10 and 20 percent of people with HIV in Australia don’t know they are infected, and about half of all new infections are thought to come from this group. So encouraging testing is of paramount importance in the fight against HIV, especially now that we have increasing evidence that HIV treatments and undetectable viral load are as effective at preventing onward transmission as condoms alone. Obviously, if you haven’t been tested you can’t go on treatment, and if you don’t go on treatment you’re likely to be highly infectious.
Queensland’s new TV ad won’t encourage people to get tested – indeed, it shows the consequences of testing in such a ghastly light that it will actively discourage some of the people who need to get tested from doing so. It won’t make a speck of difference to HIV infections in Queensland, but it will stigmatise and blame positive people.
Australia’s success in combatting HIV has largely been the product of grounding the HIV prevention effort with community-based organisations, who understand these issues and have over the years become increasingly sophisticated and professional in what they do. They don’t always get it right but I don’t believe QAHC could ever have gotten things quite this wrong. Developing nuanced, meaningful, successful HIV prevention messages isn’t easy – that’s why it should be left to the experts.
I made the video below in response to the Queensland ad.