Today is World AIDS Day and the 30th anniversary of HIV/AIDS prevention programs.

There’s good news: Young men are no longer attending funerals more than then their grandparents.

But while life-saving medicine hides the physical signs of AIDS, it also masks the ugliness of the politics, infighting and sanitised messages to appease constituents surrounding it. Meanwhile, HIV infections are up 8 per cent nationally.

AIDS Day is an initiative to remember the dead, to keep sunshine on the risk of infection and to support people living with HIV.

It sounds like a nice message of unity and collaboration. But it belies the reality.

An Australian coalition of AIDS organisations and others conceded in a July 2012 report that things are grim:

“The HIV partnership has been undermined by lack of certainty, limited investment, ineffective communication mechanisms and poor leadership.” It is uncertain.

Two years ago, high profile gay rights campaigner Gary Burns attacked the AIDS Council Of New South Wales (ACON).

He wanted it “demolished” for failing the community and wasting millions on wages and administration costs.

Premier Newman did his best to demolish the Queensland equivalent, gutting the Healthy Communities program of funding in his first 100 days and bringing HIV/AIDS prevention to the desk of his health minister.

In the late ‘80s journalist Randy Shilts penned a book And the Band Played On, chronicling the infighting, ego and politics during the initial discovery and spread of HIV. It’s 30 years on and his book is still hauntingly relevant here in Australia.

Take the polar opposite approaches of the campaigns of Queensland and New South Wales.

The northerners have a government run campaign, which in a paternalistic and preachy kind of way says “we shouldn’t be making this ad”.

Words like “shouldn’t” have been chosen to scold the players in HIV prevention for not doing enough. This is despite Queensland outperforming other states with over 8 per cent reduction in HIV infection for nearly two full years.

The ad also reprised the Grim Reaper, which was seen as being out of touch with today’s reality. The print advertisements that accompanied this campaign featured pretty coloured condoms but steered clear of any controversial messaging. The sexual health page on the Queensland government website only has heterosexual images.

Conversely in recent months ACON has gone down the path of a “Know Your Risk” approach which gets into the nitty gritty of who puts what, where. It isvery graphic.

This campaign is designed to help at risk people to make informed decisions. It also has its critics for straying from a strict prevention message of wearing a condom.

What is agreed is that ad campaigns are only a minor part of the total solution.

There is a hidden statistic too. According to the July 2012 comprehensive report by a coalition of AIDS Councils, sex workers and others, over 25 per cent of people infected with HIV do so from heterosexual contact. So this isn’t just a gay thing, but a community thing.

This is where things get rocky. The World Health Organisation promotes community led solutions to health problems. While not insisting, the WHO endorses impacted stakeholders take charge to manage the problem, as they are closest to it. This is known as being peer led.

The Queensland government’s intervention into HIV/AIDS prevention is not peer led. It has sent a shudder through other AIDS councils and community health groups.

Community health messaging needs to talk candidly to the people affected in a variety of ways, and it goes way deeper than advertising alone.

Once a government gets involved, they are at the hands of their constituents and their lobbyists. The super sanitised messaging out of the Queensland health minister’s office seems to play to that fear.

Conversely some AIDS councils are considered fat and wealthy. They get a bucket of cash from the taxpayer and then spend it on initiatives that can embarrass a government by their graphic content or by going off message into new areas.

HIV/AIDS is not likely to be an avenue for corporate sponsorship. It is hard to imagine a re-badged bottle of water like the pink breast cancer campaigns have executed so effectively.

One director of an AIDS council described it by saying “We are icky people. Who’s going to sponsor us?”.

This leaves the support of these groups in the hands of the government. If they don’t throw adequate resources to it, they will pay the price in increased health costs and social welfare.

Alternatively by following the WHO advice and outsourcing the response to peer led community groups, the government are no longer in control of the message.

If the peer led group goes off the reservation or embarrass the government, they are opening themselves up for flack from its constituents – making it a political problem.

This lack of cohesion is both understandable and unacceptable as people’s lives and quality of life are on the line.

AIDS Councils need to be able to show why their methods are successful and that they are spending your money wisely.

Governments need to avoid the temptation of making HIV/AIDS a political plaything. 30 years on and the band still plays on.

Follow Miles on Twitter: @mileshef

Comments on this post close at 8pm AEST.

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    • Fed Up says:

      05:13am | 01/12/12

      ” over 25 per cent of people infected with HIV do so from heterosexual contact. So this isn’t just a gay thing, but a community thing”.

      and we have the gay community to thank for it…..what…not a mention of all the hetros that have died due to contaminated blood?

      Morals have gone down the toilet and the tax payer has to pick up the bill.

      Either keep it zipped or practice safe sex….its as simple as that.

    • Dan says:

      08:28am | 01/12/12

      Keep it classy “Fed Up”

    • Carol says:

      10:07am | 01/12/12

      And in just one ignorance-filled comment, Fed Up demonstrates why HIV/AIDS awareness is still so important.

    • Mik says:

      11:46am | 01/12/12

      The West was at an advantage in that the disease came in through a relatively closed community, the American gay community, as this allowed the disease to be noticed relatively early and preventative actions put into place much more quickly. As Africa was becoming rampant with the disease as a disease of the heterosexual community, it was only a matter of time before it hit the West. Had it come in through the heterosexual community it may have taken a lot longer to be recognised due to population size and dispersal. For more information

      Those who recklessly endanger others, now that so much information is available, dishonour their partners, all those who have suffered and died from the disease, their communities and themselves.HIV which progresses on to AIDS is still a death sentence for the vast majority who suffer it around the world

    • Super D says:

      06:34am | 01/12/12

      Given that in 2012 you can only get aids through unprotected sex or intravenous drug use with shared needles anyone who catches Aids these days pretty much deserves it in the same way that we have no sympathy for smokers who get lung cancer.

    • Eyghon says:

      08:52am | 01/12/12

      Go back to bed Super D, clearly only your asshole side has woken up.

    • Tom says:

      07:50am | 01/12/12

      What a charming attitude.  You must be a genuinely lovely person.


      07:55am | 01/12/12

      Hi Miles,

      World Aids Day is all about a very good cause, indeed!  However is really enough to say that Australia is luckier than the world’s poorer nations such as China, Russia, India and some parts of the the Middle Eastern Region.  AIDS used to be called the silent killer which no one really liked to talk about.  I certainly believe than in this age of technology and jet setting AIDS virus could be spreading still around the globe very silently. For women of child bearing age, it is much more traumatic because it can also affect the health of the unborn baby as well. 

      It used to be a deadly disease but now thanks to affordable medication available to people with this virus can learn to live with this disease.  And unfortunately there is still a very strong stigma attached to the way we think about the very people suffering from this disease. We have to get over our prejudices and how we react to other nations’ suffering on a daily basis because they lack the very basic things such as medication, better health care with willing doctors and nurses to help them. 

      So no matter where we happen to be in this world, we have to make sure that especially the young generation make informed life style choices regarding their physical and mental health.  Because I am certain this particular disease can also mean isolation and loneliness for some patients. Learning to live with AIDS may be seen as one last option only, however being totally aware and making a conscious global effort for the prevention of this deadly and debilitating disease can be seen as the only intelligent choice for everyone on this planet. Kind regards.

    • David V. says:

      08:33am | 01/12/12

      New York and Washington DC have higher rates than some Third World countries, while India and Bangladesh have very low rates. That alone is quite disturbing.

    • bananabender56 says:

      08:41am | 01/12/12

      Could the relatively small (but still disturbing) rise be attributed to more or less people being tested?

    • Mouse says:

      08:51am | 01/12/12

      A good family friend’s daughter died of aids. They had been in a car accident 18 months before and she had had to have a blood transfusion.  12 months later she started getting sick all the time, respiratory infections, cuts taking ages to heal, terrible pallor, etc.  She got persistant chest infections and was always coughing. The doctors finally worked out that she had been given HIV infected blood in her transfusion and had deveoped AIDS. Anyway, she got pneumonia and she died.  It happened relatively quickly, which was a blessing. She was only 5 years old. We were all very angry for a long time.
      This all happened in the late 80s, I know that a lot has changed,  but people are still catching it. So why can’t the ads be brutal, it is a brutal disease and there is no cure. I remember the Reaper ads and thought they pretty much said it like is was. I really don’t care if some people’s sensibilities are offended. Mine certainly were as we watched that little girl die.

      Medicine may make this terrible disease livable now but it is still one that has no prejudices and no cure. As a community, we should be doing all we can in creating awarness, giving support to patients and families and removing the stigma that comes with it.
      ps I still get a bit angry over it!    :o(

    • Jay2 says:

      12:27pm | 01/12/12

      I’m sorry to hear about your friend’s daughter, that’s very sad. I couldn’t nurse kids, it really knocked me around when it was a terminal situation, I use to go home and sit in the bath and cry like a baby-not cut out for it.

      I use to think the same as you about brutal adverts, tell it how it is, but what I also realised that it’s a fine line between scaring people enough to get the message through and turning them off watching or taking in the message, pushing it out of their minds altogether, especially teenagers.

      I explained communicable diseases to my (grown up) kids like this during ‘the talk” much to their discomfort.

      “Anybody can catch a disease. The person may look immaculately dressed, clean and be a stand out human being, but that doesn’t make them immune. They could have only had one sexual partner and catch a disease, from their partner whom also might have only had one partner etc.  You don’t have to have multiple partners yourself to get HIV, hepatitis or any of the other STD’s. 
      You have three options that I would advise exploring:
      1)Abstain 2) Use protection, bearing in mind, that there is no absolute 100% guarantee, just a higher degree of protection 3) Both partners have tests done and a degree of trust that makes you both feel you can make an informed decision to have unprotected sex post test results.”

      Whether any of my kids followed my advice is unknown to me, but I can say I did try.

      @SuperD, I’ve nursed all sorts of people that have died from ‘preventable’ diseases, cancer, heart disease or accidents and if you actually saw what the patient and their families go through in the last weeks/days, I feel one would have to be a total sociopath to be devoid of any sympathy.
      You do understand though, that heart attacks; strokes, diabetes, even teeth can cause a myriad of problems and many forms of cancers etc can be attributed to poor lifestyle choices, whether it is not wearing sunscreen, eating too much starch,fat,sugar, not exercising adequately or even having a car accident by making a split second poor decision can all cause death. Anyway, death is the great equaliser, it doesn’t matter how rich or poor you are, how pious you are or what actually contributed to it, it comes for us all sooner or later.

    • pa_kelvin says:

      03:28pm | 01/12/12

      @Mouse… I think anything to do with young children affects us more than any other thing.. Try not to be angry, but to remember her for who she was..

      @Jay2.. I had similar conversations with my daughters… Must have gone over their heads as my youngest daughter was pregnant at 15…
      I like the rest of your posting..

    • stephen says:

      10:09am | 01/12/12

      It will be at least 20 years before there is a vaccine for Hep. C and AIDS, so I trust the AIDS Council be spend some of our money on changing the behaviour of the vulnerable.

    • Wurp says:

      02:15pm | 01/12/12

      Everyone has the right to life regardless of what personal factors such as age, race, gender, socioeconomic background and sexual practices. Whether one agrees with certain sexual practices is irrelevant as to whether a HIV infected person deserves to be treated. All diseased persons deserve to be treated for any disease. Human life should be of paramount importance and so the government should assist people to receive treatment for any disease. How the government does this is at their discretion.

    • Stan W says:

      03:50pm | 01/12/12

      So the Qld Health Minister defunds the only organisation that works with gay men and MSM (men who have sex with men - usually married men) and thinks him and his Ministerial Advisory Committee can reach the same demographic that Healthy Communities. Highly unlikely!  That is why Healthy Communities is there.  Previous governments have recognisef the important work they do and that is why they have been around for 28 years. The Minister nor his advisors have any idea what they are doing because they are clearly ignoring what the WHO recommends.  There was an 8% decrease in Qld last year and its obvious to me who is doing the job right and it’s not the Qld Government. Mr Springborg needs to give funding back to this organisation immediately or he will have to explain to the other HIV organizations why they don’t take on the recommendations of the WHO and work with community orgs that work with high risk sections of the community.  Peer education is what works!

    • Cremorne says:

      05:13pm | 01/12/12

      My best friend has had HIV for 27 years, she’s hetro and promiscuous but has never passed it on .. she is immune to it either through her Eastern Euro background or for other genetic reasons.
      27 years ago she was stuck with that grim reaper stigmaticism.
      These advertisers are all a bunch of assholes, she didn’t deserve this shit.

    • Hendo says:

      06:38pm | 01/12/12

      A perfect form of non discriminatory natural attrition of a species.
      How wonderfully politically correct, no one can complain when afflicted.


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