‘It is estimated that over 30 million people worldwide live with HIV leading to around 2 million deaths per year. In the UK HIV is one of the fastest growing illnesses and as of June 2010 there has been 26,262 new cases of AIDS diagnosis with over 19,000 HIV related deaths”. [i] 

Despite various health and government campaigns designed to inform the public of HIV transmission and prevention in the UK; rates of diagnosis of the disease still continue to rise.

This essays aims to understand if media campaigns are effective to induce a change in both prevention and the number of individuals who are willing to undergo testing? If this is not the case then what factors contribute to its current stigma? Finally, has the media been effective enough to change the publics perception to the disease in today’s society compared to when it first hit the headlines? Through these arguments, conclusions and recommendations for future effective awareness and media techniques can be drawn.

The History of AIDS in the media

The media is considered to be the most influential tool having a direct ability to influence mass target audiences. This was made more powerful through the invention of the internet where information could be broadcast worldwide, allowing more people than ever to access information.

Throughout the years, portrayal of HIV and AIDS through newspapers, television, radio, posters, leaflets and educational advertisements have had a direct effect on the way the disease is perceived by the general public.

For example, when AIDS first hit the global headlines in the early 1980’s it was displayed by the media as being a new, unknown disease with a direct link to individuals only involved in homosexual activity. This reflected a time where same sex relationships were frowned upon and how this ‘taboo’ was seen to result in death.

There were also cases of how infected blood transfusion products acted as a transmission route, this led to terms such as “killer blood” [ii] and labelling AIDS as a “gay plaque” [iii] . The early perception of the disease is shown through newspapers including influential and renounced broadsheets like The Daily Telegraph in 1983 with their main headline of “Gay Plague May Lead to Blood Ban on Homosexuals”. This was a paper which was targeted at many affluent people with a high degree of social status and education.

In 1982 The Terrence Higgins Trust was formed, the first campaign of its kind. This charity group was dedicated in supporting, preventing and campaigning for greater public understanding of HIV. Through this new slant of providing a support frame work for infected individuals, charities started to focus on prevention, education and aiding the families of those affected. Through the growth of science and research more understanding was obtained about the disease and it was no longer a ‘fear of the unknown’ but more focus on how transmission of the disease can be prevented. Hence this lead to government campaigns in the new millennia, educating the general population rather than inducing fear.

The perception and stigma of HIV

Today there is still a wide stigma which surrounds many cultures, religious and ethic groups.

“Landlords have evicted individuals with AIDS” and “the Social Security Administration is interviewing patients by phone rather than face to face.” [iv] Dr David Spencer, Commisioner of Health, New York City

The question lies in whether the media has been effective enough to overcome stigmatisation within the associated groups.

An eye opening story of how AIDS has been portrayed through the media and its direct influence on discrimination and prejudice was shown by the case of Ryan White, a haemophiliac who became infected in 1984. As HIV was poorly understood at the time, many parents and teachers protested against his attendance, signing petitions to exclude him from campus even though scientists at the time knew that HIV was not transmittable through any form of casual contact. He worked as a paperboy and many people along his route cancelled their subscriptions in fear that the disease was contractible through newsprint. This shows the extent of how HIV was perceived and the fear of contraction, which instigated threats of violence and legal cases towards the family. When White was allowed to return to school in 1986 he was deeply unhappy. He had few friends and school policy required him to eat with disposable utensils, have a separate bathroom and his requirement to attend gym class was dismissed. However, the most shocking event came about when a bullet was fired through the Whites’ front room window and the family decided it was time to leave. He was later enrolled into another school and was greeted by the superintendent and a handful of students who were educated about the disease and who were not afraid to shake his hand. This shows the detrimental difference that education makes towards public perception and how prejudice and discrimination can be limited. [v] 

Hence through the array of inaccurate information, the fear of prejudice and discrimination has lead to stigmatisation. This has had an effect on the willingness of individuals to acquire HIV testing, and be open about a positive status despite the reduced visibility of the symptoms of the disease such as skin and muscle wastage.

The Disability Discrimination Act 1995 has made discrimination within the workplace illegal for people associated with HIV and AIDS. However this does not combat the prejudice and stigmatisation an individual may encounter from their colleagues. Hence subtle discrimination is more common as it is difficult to tackle in comparison to open discrimination.

These are the reasons why people choose not to disclose their HIV status, as for many people living with the disease the most hurtful prejudice that they may face comes from those to who

they would normally turn to for support. Close family, friends and partners have been known to turn

their back on people diagnosed with HIV. In addition, the sense of belonging that being part of a

community provides can quickly disappear when that community appears to discriminate against

you simply because of its own prejudice against HIV, this often leads to financial and further social difficulties.

The media is therefore faced with the difficult task of changing peoples’ perceptions, of which there have been a few successful outcomes. EastEnders a popular UK television soap explored the issues of HIV and AIDS with regards to antiretroviral drugs, safe sex, prejudice and the difficulties that can occur in a relationship. The producers worked closely with The Terrence Higgins Trust throughout the story and it was found that after the character’s positive diagnosis in 1991 this correlated with the highest peak in HIV testing requests [vi] . This was influential as the soap showed someone living with HIV as opposed to dying with the disease, and the storyline was so successful in raising awareness that a 1999 survey conducted by the National AIDS Trust found teenagers got most of their information about HIV from the soap. [vii] When the character died in 2004 campaigners suggested that he was killed too early as advancements in drugs were helping people live much longer and was not reflective of what was happening at the time. Lisa Power, head of policy at the Terrence Higgins Trust, stated ‘…that, one decent soap episode is worth a thousand leaflets in schools. That is why we would always go out of our way to help scriptwriters. TV and films can be very powerful.” [viii]  

How the media has changed the perception of HIV /AIDS

Horizon produced a BBC documentary ‘Killer in the Village’ which showed the perception that the media had of HIV and AIDS back in 1983. Terms such as “killer disease” highlighted the fear of the disease by “gay men who walk in its shadow”. Even though the programme’s aim was to provide information on this ‘new cancer’ the way that the issue was dealt with showed the prejudice that even health care workers and politicians who tried to shed light on the subject held. [ix] 

Advertisements were steamed on TV warning viewers about contracting the disease which would lead to death. They were not based on educating the public but mostly warning of the dangers of the disease, this was perhaps due to the lack of understanding of the topic. This is clearly shown in one of the earlier T.V advertisements produced in Australia in 1987. [x] Here we see that AIDS has been given the face of the grim reaper, a metaphoric analogy showing that AIDS equals death. He is seen to throw a bowling bowl at his target the general public and they are seen to fall which is a symbol of death. Another advert produced in the US in the same year shows a vulnerable child lying in bed with the disease and with his last breathe reaches out to the public with the message ‘DONT GET IT!’. [xi] 

The later HIV and AIDS television campaigns have become the main source of education for the general public with information commercials showing links to help lines for more information. Marketers feel in order to sell their products to the teenage target audience they have to use sex to appeal to them, this is shown though clothing and perfume lines. Therefore it is evident to get teenagers attention about the dangers of unprotected sex, advertisements have had to be made more graphical and ‘explicit’. This is made apparent through later television campaigns as such produced by MTV in 1999 [xii] where couples are seen to engage in intercourse in a relatable fashion and then the newly infected partner is shot by the infected one. This would have seen to be too controversial back in the 1980s. However towards the end of the commercial it shows a bullet being stopped by a condom, this analogy of how death can be stopped by wearing a condom adds a powerful element in getting the message across.

A recent advertisement campaign produced by the NHS in 2009 [xiii] again showed couples engaging in risky sexual behaviour. Names of STI’s such as chlamydia and gonorrhoea were shown throughout the commercial however notably there was no mention of HIV or AIDS. For what possible reason has HIV and AIDS, which a significant cause of morbidity and mortality worldwide appear to have been forgotten in recent campaigns? Perhaps the predominance of HIV transmission in the media in previous years had overshadowed more s ‘common’ and ‘less serious’ STI’s, decreasing their awareness and allowing them to rise significantly. As a result, government and health authorities could be trying to draw greater focus to these, meanwhile dangerously oversighting the significant risk of HIV transmission in today’s young population.

In more recent times, the media has tried to make HIV and AIDS more relatable to the general public by using celebrities and figure heads. Celebrities with HIV and AIDS are not shown in a bad light but more of a lesson to be learned from. They have been seen as individuals who people look up to as role models and leaders, where people form an identification with them hence they can relate to these individuals including famous people such as Rock Hudson and Freddy Mercury who lost their lives to AIDS.

One significant change that aadvertising has provided is promoting the use of condoms with slogans such as “stay safe, use a condom” [xiv] , highlighting condoms as an important factor in the prevention pathway. In March 2009, during the Pope’s visit to Africa the Pope denounced the use of condoms saying that the best way to be free of the disease was through abstinence. However, in November he changed his statement saying that “the use of condoms to reduce the risk of infection is a first step on the road to a more human sexuality, rather than not to use it and risk the lives of others.” [xv] 

The change in the perception of both the media and the public can be seen through the introduction of HIV dating websites and international conferences held for journalists to provide them with the latest statistics and different ways of educating the public.

Conclusions and Recommendations

HIV is on the increase and still continues to rise regardless of media attention. A press release from NAT (a UK charity designed to change society’s view on HIV/AIDS) in November 2010 revealed that in the UK the number of HIV transmissions being diagnosed still remains high with no hint of a decline when compared to previous years. The HPA (Health Protection Agency) has revealed that although overall rates of diagnoses have shown a decline, this is largely due to fewer diagnosis been made in those infected overseas. Therefore greater intervention other than media is required to make people more aware of the disease.

The stigmatisation surrounding HIV and AIDS still continues and this also acts as barrier for people to willingly undergo testing. They believe a diagnosis could have a knock on effect amongst their social, religious and cultural group if anyone found out about their positive status, therefore by not being tested traps them into a false sense of security which acts as a source of denial. Therefore in order to overcome this barrier stigmatisation needs to be removed, the only reason why this is difficult is because people see it as a punishment for immoral behaviour and still associate the disease with drug use and homosexual behaviour whereas currently it is heterosexual women who have seen the biggest rise in new infection over the last decade with 4,220 cases acquired heterosexually in 2008 in comparison to only 2,760 acquired homosexually. [xvi] 

In today’s society, the majority of young people see contraception’s main function as protection against pregnancy, not against diseases. Especially since the first hormonal contraceptive pill was approved by the FDA in 1960. [xvii] It is readily available and free of charge to young girls, therefore the use of condom is deemed unnecessary in some young peoples eyes. Therefore the use of a condom should be deemed as essential in sexual activity, not to prevent pregnancy, but to prevent a fatal disease.

A further reason for the increased spread of HIV in the UK, is ’18-30’s holidays’. These holidays, promoted through advertisement in the media, encourage binge drinking and sex. It is seen as one of the main attraction of the holiday. However, a combination of these results in a high risk of HIV transmission. Being under the influence of alcoholic hugely affects ones perception of safety and decreases the probability of remembering, or caring, if a condom is used. This alone would increase the spread of HIV. One of the most popular countries for these types of holidays is Greece. Over the last decade, Greece has experienced an influx of migrants from countries in South Eastern Europe, the Middle East, Asia and Africa. Studies show that 12% of new infections between the years 1989 and 2003 occurred in immigrants. [xviii] 

“the results suggest an increasing trend of HIV-seropositive migrants in Greece during recent years.” [xix] 

Therefore, these alcohol -fuelled holidays can result in people from the UK becoming infected with the virus and increasing the spread once returning to the UK.

Recommendations

A. Research should be undertaken to map the current prevalence of HIV prejudice and types of HIV

discrimination experienced in the UK, and Terrence Higgins Trust should establish a database of case

studies.

B. The Department of Health should ensure that their concerns about the role of stigma in HIV

transmission and illness be met by, amongst other strategies suggested here, supporting projects to

aid people with HIV in challenging prejudice and discrimination through positive role models,

speaker and media work and support networks.

C. The Government should enact agreed proposals to extend the Disability Discrimination Act to cover medical conditions from the point of diagnosis, rather than the onset of illness, in the next

legislative session.

D. Health promotion agencies producing information on sexual health and HIV should include, as

appropriate, messages countering prejudice and discrimination both in the general population and

within targeted communities.

E. In addition to the Codes of Practice produced by the Disability Rights Commission offering guidance to the providers of goods and services about their legal obligations, the Government should legislate to tackle the discrimination encountered by people with HIV and other medical conditions when they access goods and services.

F. HIV prevention information targeting Africans, Black people and/or asylum seekers should be

produced but their messages and formats need to take into account the concerns of these

communities around potential prejudice.

G. HIV information providers to African people in the UK should produce materials which make clear

their medical and legal rights if diagnosed with HIV

In conclusion the requirement of good HIV information through TV, wind-up radios (e.g. in Africa), HIV issues in soap-operas which are most influential, accessible HIV tests, expensive counselling for those proving positive, safe-sex promotion, fewer sexual partners, decreased alcohol use to avoid risky behaviour, and good trials found circumcision helps prevent HIV transmission is necessary to continue and increase prevention campaigns thus providing further education about the disease process, its transmission and how it can be prevented.

Hence the mainstay of management relies on education including promotion of safe sex, needle exchange programmes, screening of blood transfusion products and public awareness campaigns. Therefore the only real way of getting rid of any associated stigma is to find a cure for HIV.