News Analysis: Aids: ignorance not sole challenge

Chris Smith's disclosure that he is HIV-positive has been hailed as a breakthrough for media treatment of the condition. But PROs are still striving to fight discrimination faced by those infected, as Richard Cann reports.

The horrifying 'tombstone' and 'iceberg' ads of the early 1980s shocked the public and raised awareness of HIV, but also sparked fears that HIV would engulf the UK.

Today, twenty-two years after HIV was identified as the cause of Aids, the communications challenge has shifted from raising general awareness of the condition to trying to improve the way the 50,000 British people who have HIV are treated.

Emma Bickerstaff, media officer at the National Aids Trust (NAT), the UK's principal HIV/Aids pressure group, says: 'The response to (former culture secretary) Chris Smith's announcement was fantastic. It shows people are moving on and getting over the blame mentality.'

Bickerstaff warns, however, that acceptance in the media has been a double-edged sword, breeding complacency and masking the fact that the public is unaware discrimination is still a major issue for those infected.

A 2002 Sigma Research survey of 1,821 HIV-positive people found 27 per cent had experienced problems in dealings with health professionals in the previous year, including refusal of treatment, removal from a GP's or dentist's list after disclosure of HIV status or the use of unnecessary protective equipment during treatment.

'Fault of the carrier'

As for public perceptions, an NOP survey carried out last year found that more than one in five believe it is 'peoples' own fault if they get HIV', while 23 per cent thought those infected through intravenous drug use should not get treatment on the NHS. Another 17 per cent agreed they would worry if their doctor treated patients with HIV.

'The stigma problem has improved since the 1980s, but there are still a lot of myths about transmission,' says Bickerstaff, who believes communications efforts are now focused on education. Information is now the prime need, she argues.

Although the Department of Health and the Terrence Higgins Trust charity both focus on providing services for HIV-positive people, NAT takes the lead on tackling discrimination. Its 'Are You HIV Prejudiced?' website (www.areyouhivprejudiced.org) has been redesigned this month in a bid to focus on two areas where it has identified the persistence of stigma - in the workplace and among healthcare workers. In each one, PR can focus on education without getting distracted by other, often linked, issues such as racism and homophobia.

NAT's PR activity is integrated with direct targeting of healthcare workers, especially those working outside HIV clinics such as dentists and GPs.

A healthcare resource pack commissioned by the Department of Health has been produced, and a second pack will target employers, few of which have any policies and procedures for catering for staff with HIV, according to Bickerstaff.

'Our communications work has always been quite targeted because we don't have the resources for huge marketing campaigns,' she explains.

NAT has established partnerships with drugs companies and condom manufacturers, but it is a challenge to attract support from corporations to help fund larger initiatives. 'It's never going to be the most popular of causes,' admits Bickerstaff.

The Coca-Cola Company, the largest private employer in Africa - home to 70 per cent of HIV-positive people - is one blue-chip company with an interest in breaking down the stigma and make prevention and treatment campaigns more effective.

Moral obligation

Coca-Cola Africa V-P public affairs and communications Robert Lindsay believes companies with strong community ties have a moral obligation to address the issue and are ideally placed to take the lead because they have comms structures in place. 'We already advertise everywhere - that's the unique thing we bring,' he says.

While much of Coca-Cola's effort is focused on getting simple educational messages out in Africa, Lindsay says people in the UK are aware of what their brands are doing globally.

Although HIV has a high profile in the mainstream media, a lack of English-language skills has excluded a large proportion of Britain's population from two decades of debate on the subject. Carlos Corredor, Latina co-ordinator at the NAZ Project - an NGO that provides sexual health support services to south Asian, Middle Eastern, African and Latin American communities - says foreign-language newspapers and radio stations for ethnic groups must be targeted.

'Sexual issues are often taboo for Latin Americans and people from other ethnic minorities,' he says. Corredor adds that the strong religious ties in such communities can bring a level of hypocrisy.

LANDMARK MEDIA MOMENTS

December 1981: First case of Aids in UK

4 July 1982: Aids-diagnosed Terrence Higgins dies. A trust is set up by his friends to personalise the condition

3 October 1985: Actor Rock Hudson is first major public figure known to have died of Aids

March 1986: The UK's first public information campaign on Aids launched

1987 'Tombstone' and 'Iceberg' ads; Aids benefit concert includes Elton John

April 1987: Diana, the Princess of Wales, shakes hands with an Aids patient, against Palace advice, as she opens the first specialist Aids ward at the Middlesex Hospital in London

1 December 1988: First World Aids Day

1992: EastEnders' Gill Fowler dies from Aids after infecting husband Mark; Queen singer Freddie Mercury dies of Aids-related illness and a tribute gig goes ahead in April

1994: Department of Health vetoes a £2m Aids campaign for being too explicit

March 1994: Tom Hanks wins Oscar for playing Aids victim in Philadelphia

2003: EastEnders' Mark Fowler killed off

6 January 2005: Nelson Mandela reveals that his son's death was Aids-related

30 January 2005: Former culture secretary Chris Smith reveals he has been HIV positive for 17 years.

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