No Fear in HIV Prevention
posted: 09/11/2010
Using fear as a tool for HIV prevention, like in the 1980s British AIDS tombstone and icebergs campaigns, causes more harm than good, according to a recent review of the evidence.
The idea behind the AIDS tombstones and icebergs was that making people fear death would encourage self preservation by using condoms. Similar fear approaches to HIV prevention were used in the United States, and in Australia (with images of the Grim Reaper).
Following the success of HIV treatments, fear arousing campaigns have picked out some unwanted treatment side effects (for example, facial wasting and diarrhoea).
Attention Grabbing, but does fear work?
Campaigns arousing fear are good at grabbing public attention by using graphic imagery, simplistic language and shocking statements. Fear campaigns are often very memorable.
Recently the use of fear has increased in other health promotion campaigns highlighting the harm from smoking, excess alcohol use, and drug use. The public has great faith in the use of fear to change behaviour.
Frustration
The media, including the gay press, have been calling for more emphasis on harm from sexual risks. The public and campaigners are frustrated at high rates of HIV and STI infection in the UK and the lack of progress in reducing these. That is often behind the calls for what seems to be an ‘obvious solution’.
Does using fear of HIV work?
Would using more fear in HIV prevention work? The role of fear in HIV prevention is written as a guide for gay men’s HIV prevention workers, but many other people, including people with HIV, are very interested in this and have strong views about it. It is an interesting and informative read in four illustrated pages.
It looks at the scientific evidence for whether fear works or not, considers the ideas behind it, and looks into the unforeseen consequences and risks of using fear in HIV campaigns.
Fear is for the Fearless
Fear only works with people who are not frightened by HIV. But 98% of gay men say (in Gay Men’s Sex Survey, 2008) they agree or agree strongly that “HIV is still a very serious medical condition.” So almost every single gay and bi man is already fearful of HIV. Perversely, adding to that fear can make things worse for the men at more risk of HIV.
As Adam Bourne says: “It will remain a constant challenge for those promoting sexual health and well-being to attract the attention of their target audience among the many other advertisements that compete for their attention.
“The temptation is to produce shocking or explicit imagery, which may stand a better chance of being noticed or being remembered.
“However, it is doubtful whether it will actually be successful at influencing behavioural choices.
“Most gay men and other men who have sex with men are already motivated to avoid HIV, but some still lack the knowledge or the power to do so.”
“Inducing fear is not an effective way to promote previous HIV relevant learning or condom use either immediately following the intervention, or later on.
However, HIV counselling and testing can provide an outlet for previous HIV-related anxiety and, subsequently, gains in both knowledge and behaviour change immediately and longitudinally.”
Earl & Albarracin, 2007
Read The role of fear in HIV prevention, Adam Bourne, 2010, Sigma Research Briefing no.1 for the CHAPS gay and bi men’s HIV prevention partnership
Permalink