The case for condoms, part two

Published 20, Dec, 2012

In “A Flawed campaign from Top to Bottom” Christopher Banks continues his critique of the Australian Top2Bottom gay men’s HIV prevention campaign which details risk reduction strategies and which he suggests does not adequately support using condoms

Con – not a smart arse, but a silly bugger.

In my previous article, I asked whether the designers of VAC’s Top2Bottom campaign were guilty of either falsely assuming there’s an immovable category of gay men who don’t use condoms, failing to use their imagination to design creative, challenging and compelling arguments to men who currently don’t use condoms, or afraid of challenging gay men who disagree with condom use.

Based on their response to that blog, which you can read in full here, I am forced to conclude that the answer is all three.

First up, VAC acknowledge that some men are already not using condoms:

There is growing evidence in social and epidemiological research that indicates that men who do not consistently use condoms and water based lube as a prevention method are adopting different risk reduction strategies to minimise their level of HIV risk in sexual activity with casual and regular partners…

Based upon the research indicating that these risk reduction strategies are already being used by gay and bisexual men in certain settings, it was important that a new campaign be developed that spoke to men for whom condom use was not a regular option, in an effort to generate community discussion about the increasing complexity in HIV prevention, and provide up to date and accurate information about what the evidence says about risk reduction strategies so that people may make informed decisions about what risk they are willing to take when it comes to sex and HIV. (emphasis mine)

This is akin to a company finding the sales of its product plummeting because of increased options from their competitors and deciding that the best way to get people to buy their product again is to develop a campaign that tells people all about their competitors.

Make sense to you?

The rise of tablets and mobile devices has completely changed the landscape of the computer market.  Microsoft in particular was badly hit, with sales of desktop PCs vanishing quicker than a sausage at a den night.  Their (eventual) response was to adjust their product to make it more appealing to the market, not to spend money on an advertising campaign telling you all about iPads and Galaxy smartphones.

Of course, if Microsoft were to do this, there would only be money at stake, and the survival of the company.  In the case of HIV, there are lives on the line.

If your job is to prevent HIV, and you know that condoms and lube is the best method to do this, then your job is to convince those people who don’t currently do this to change their behaviour, not to provide them with information about “risk reduction” strategies, particularly when – as VAC painstakingly enunciate in their briefing paper – every single one of these strategies is flawed.

The second problem is in targeting: how do you ensure you’re only targeting the men who don’t regularly use condoms currently?  There is certainly nothing in the campaign messaging to indicate this is the intention.

I am a condoms-every-time guy, and yet I see the Top 2 Bottom ads appear on my Facebook every day.  When I visit the site, all I see is a large amount of information about ways I can have unsafe sex, backed up by social proof that everyone else is doing it anyway.

You want to target men who aren’t regularly using condoms?  Then say so.

Lead your campaign with the line: “Not using condoms when you fuck?  Then there’s some stuff you need to know.”

Clearly outline why other methods don’t work, and provide examples of men who have rejected these strategies and remained HIV negative.  Tell people what you want them TO do, not what you want them NOT to do.  Negative campaigning has been proven not to work.

But VAC’s stated objective is not to change behaviour, it’s to create discussion. That strategic choice is fatal in terms of HIV prevention.  They conclude their briefing paper like this:

“We are pleased to see that Top2Bottom has elicited great community discussion and debate around the topic of risk reduction strategies for HIV prevention, and hope that this will continue to foster helpful discussion around what strategies men are using to help minimise their risk of picking up or passing on HIV.”

Anyone feel like we’re going in a circle here?  VAC have already told us they know what strategies men are using.  And they’ve also told us they know that there is only one strategy that works effectively to prevent HIV – condom use for anal sex.

Hiding behind the mantra of “increasing complexity” is not going to stop gay men becoming infected with HIV.  In social marketing and health promotion, your job is to make complicated things easy to understand for a mass audience.

At any rate, “increasing complexity” is a misnomer.  There is one method that works effectively to prevent HIV for sexually active gay men, and loads that don’t.

The question is not what pseudo-scientific methods gay men are choosing to avoid HIV, but WHY they are doing it.  Once you have these answers, you will begin to be able to devise ways of steering gay men back to the one method that works.

Does VAC have the balls to do this?  Or will it continue to concede ground and muddy the waters?

This article originally appeared on Christopher’s own blog BiPolar Bear here