“Aids is not only a medical crisis on an unparalleled scale, it involves a crisis of representation itself, a crisis over the entire framing knowledge about the human body and its capacities for sexual pleasure.”- Simon Watney
The New York City Department of Health created the PSA It’s Never Just HIV which began airing on television about one week ago. The department’s website states that in New York City the AIDS rate is 3 times the US average and that HIV is the third leading cause of death for NYC residents aged 35-54. These are sobering statistics which when coupled with the evidence that many gay men under 30 are contracting HIV at a greater rate than their older peers believing perhaps that with the new drug therapies the disease has become merely a chronic condition. Or perhaps they feel that a cure is just around the corner. Either way the context of the disease now is vastly different from the early days of the epidemic when contracting HIV more likely meant suffering and death.
Against these facts, I assume, the Department of Health felt the need for a very strong PSA to urge people to practice safe sex, use condoms and realize that HIV even when treated with medications can cause many other health problems. Yet, the form of this PSA which only features men of various ethnicities and seems clearly targeted to gay men alone is a shocking display of terror and fear. It attempts to scare the viewer into safer sexual behavior by graphically relating the potential complications of HIV. It states that dozens of diseases can occur with HIV and no matter if you are on a drug therapy. It focuses on three that you could contract: osteoporosis, dementia and anal cancer.
In the osteoporosis section of the PSA there is a split second image of men dancing; you only see their legs while the voice over describes the disease as a dissolution of bone accompanied by an x-ray image of bone full of holes and then another x-ray of a leg in which the thigh bone cracks and brakes. The brief dancing segment seems to reference gay nightlife and suggests rather ignorantly that such nightlife always leads to unprotected sex and HIV infection.
The dementia portion of the ad depicts a man holding his head and looking confused and then the image of his head dissolves into a cat scan of apparently his brain that suddenly atrophies and looks shredded.
The final section about the contraction of anal cancer is the most graphic and gruesome. A cat scan reveals tumors in the anus. And then a split second image of a diseased, reddened anus with hideous black stitches appears. This sequence reminded me of Leo Bersani’s famous article, “Is the Rectum a Grave"?” Clearly in the PSA the rectum (of gay men) is a place of disease and pain rather than pleasure and sexual gratification.
And here is why I am angry. This PSA seems to revive old representations which appeared in the early years of the AIDS crisis in which gay men were conflated completely with the disease. To be gay was to be a contagious threat to the rest of the population. This paradigmatic representation changed as the nature of AIDS itself shifted with effective drug therapies that allowed people to live longer and healthier lives. But this ad shows gay men seemingly healthy but when their insides are revealed through technology only disease is present.
And while I am angry at this PSA for its terror tactics and its casting of gay men as some sort of new millennium monsters, I am also ambivalent because I realize that there exists a degree of complacency about HIV as if it is simply a chronic and manageable condition. Of course, it contributes to other health problems, but shock and awe scare tactics do not seem to be the way to reach gay men about changing their sexual behavior. The content is important, but its form is dangerous.
A recent study in The Journal of Acquired Immune Deficiency Syndromes found that gay men newly infected with HIV change their sexual behavior only in the short term, only to resort to previous unsafe practices in the long run. In this context (whether this study is accurate or merely anecdotal) it doesn’t seem that the new PSA can truly be effective for its target audience. Instead what it does rather insidiously, is confirm for the wider heterosexual world that gay men are vessels of disease with the founding disease being HIV.
The PSA ends with an image of a man in a hospital bed visited by his lover or husband or friend as if this is the fate of all gay men whether HIV+ or not…same-sex desire equals death.