Evolution of an Epidemic: 25 Years of HIV/AIDS Media Campaigns in the U.S.

This report focuses on how national media campaigns on HIV/AIDS have evolved over the last 25 years in the United States, reflecting the changing nature of the disease as awareness and treatment have progressed. It also provides insight on the approaches, historical context and impact of leading national public education campaigns. The report documents some of the shifting organisations and interests behind advertising related to HIV/AIDS, from government-sponsored efforts to campaigns developed by non-profit and non-governmental groups to messages developed by or through partnerships with the media industry itself.

The report is divided into five time periods.

• 1981 - 1985: A New Threat and Activist Response - During the early years of the epidemic, people were fearful and there was limited information about HIV/AIDS. The dominant form of public communication about the disease was in news reporting. During these early years, activists took the lead in responding to AIDS, especially in major urban areas like New York City and San Francisco, through community education projects and local campaigns that employed informational materials and advertising including billboards, broadsides, buttons and leaflets. New organisations emerged to fill the gap in information and services for communities impacted by AIDS.
• 1986 - 1989: The HIV/AIDS PSA is Born - The first national campaigns using television and print advertising emerged in the late 1980s after the U.S. Surgeon General had outlined a set of HIV prevention guidelines. The American Red Cross partnered with the Ad Council to launch the first national campaign to address AIDS-related stigma and misinformation about the disease. Public opinion data from 1985 revealed that many Americans were afraid of people living with HIV/AIDS. Nearly half (47%) said they would “avoid” someone who had tested positive. Many were concerned and often confused about how the disease was transmitted. A series of television public service announcements (PSAs) were created using celebrities and other personalities to deliver messages debunking some of these commonly held myths. The tagline of the campaign was: “Rumors are spreading faster than AIDS.” The 1986-1987 Rumors television campaign directly challenged beliefs held by many in the United States and encouraged viewers to seek out the facts by writing to the Red Cross for more information. The America Responds to AIDS campaign took a long-view approach to the issue and relied on a combination of communications strategies included media relations, organisational relationship development, and direct-to consumer materials, as well as traditional advertising to get out information about HIV/AIDS. The goal was to initiate a public dialogue about HIV/AIDS to reduce fear and dispel myths. A decade after it had launched, the original message of the CDC’s America Responds to AIDS - that “anyone can get HIV/AIDS” - was sharply criticised by some in the AIDS community as having misrepresented the true scope of the epidemic at the time. The emphasis on the “broad reach of the disease,” it was argued, failed in connecting with some of those at highest risk: gay men having unprotected sex, injection drug users and their sexual partners.
• 1990 - 1995: Reaching Communities at Risk - Heading into the mid 1990s, the U.S. public was becoming more knowledgeable about HIV/AIDS. The major campaigns during this period began to hone their messages. In 1990, America Responds to AIDS reached out to “adult infuencers,” in particular parents, encouraging them to talk with their children about AIDS. The next year, the campaign focused on testing and treatment. The campaign’s first ad about condom use did not air until 1993, along with messaging around abstinence and monogamy. In the 1990s, the campaign focused on audiences disproportionately affected by HIV/AIDS, including African Americans and Latinos, employing similar strategies as it had with the general population, using “real people” delivering messages about the increased risk among communities of color. Many national campaigns had shifted from general awareness and information to communicating about prevention, testing and treatment. Successive years of the effort over the last decade have included community outreach, local social marketing designed for women, adolescents and gay, bisexual, and transgendered men, as well as cable television PSA placement.
• 1996 - 2000: HAART Brings Hope. But is AIDS Over? - By the mid-1990s, a new combination HIV treatment regimen known as “highly active antiretroviral therapy” (HAART) contributed to a plummeting AIDS death rate in the U.S. Many even hoped HARRT might lead to an end of the epidemic; unfortunately, reality would be much more complicated. Print and outdoor advertising intended to build a sense of hope around research and a possible cure, while providing a realistic impression of the challenges of those using HAART.
• 2001 - 2006: Global AIDS - During the latter half of the 1990s, perhaps in part due to the perception that HIV/AIDS in the U.S. was under control, there was a growing focus on the global epidemic, with HIV/AIDS increasingly seen as a problem occurring elsewhere. In the U.S. a new message was beginning to gain ground in media campaigns - the impact of HIV/AIDS around the world. Several media efforts addressing the global epidemic emerged. The strategy was to confront the growing complacency many in the United States seemed to be feeling about AIDS, and to link the experience of children in the U.S. with that of millions of AIDS orphans in areas of the world devastated by the disease. Celebrities became an important part of this global messaging.

Short summaries of each campaign profile can be found in the report's appendix.