Risk of Negative Stigmatization of STIs in Public Safe Sex Campaigns

Introduction

The ‘could I have it’ campaign was developed by the WA Department of Health to highlight to the youth of WA (16-28) the importance of practicing safe sex and to promote regular testing for sexually transmitted infections (STI). The campaign was comprised of a television advertisement and an associated website. It is raising awareness of the seriousness of having sex without a condom and different diseases associated with unprotected sex (Elisa Janine Sobo, 1995). The website part of the campaign has many educational aspects including where to go for testing, symptoms of STIs (Kerrigan et al., 2006). The television ad is about 2 young heterosexual people about to engage in sexual activity and one of them taking responsibility to practice safe sex, through the use of a condom, and it has information about the importance of getting tested regularly for STI. The ’could I have it’ campaign was authorised by the Government of Western Australia, through the WA Department of Health. However, the campaign was created by the sexual health and blood-borne virus program and the communicable disease control directorate (Western Australian Government, 2019). This campaign targets the age range 16- 28 (Western Australian government, 2019), the campaign is inclusive to all sexual groups and aimed to those who are sexually active. Three key concepts in public health campaigns are used in this campaign. Healthism in this campaign targets the individual and the importance of maintaining ‘perfect’ sexual health. However, healthism creates a lot of negative stigma associated with contracting STIs (Crawford, 1980). The pre-emptive model is used as a scare tactic and to broadcast the risks about practicing safe sex. The negativity pre-emptive model does disturb the effectiveness of the campaign. The medicalisation of STIs has been essential for this public health campaign. Medicalisation reinforces the campaigns main messages however creates a negative stigma around STIs.

Pre-emptive model

Negative and fear inducing health campaigns fall under the concept of the ‘pre-emptive’ model. The pre-emptive model is when a situation occurs, it always ends in the most catastrophic outcome (Diprose, 2008). The pre-emptive model is used to instil fear and highlight the risk of the situation to the targeted demographic (Gagnon, Jacob and Holmes, 2010). In this campaign, the situation relies on unsafe sex and the likelihood of contracting a STI. The pre-emptive models risk defined by Gagnon as “about being pro-active in preparing for such a catastrophic threat” (Gagnon, et. al, 2010). In a campaign targeting unsafe sex, the campaign will attempt to instil fear of catching sexual transmitted infections (STI). In the campaign ‘could I have it’ the need for being proactive about unsafe sex is lost through the fear of the campaign.

In the campaign ‘could I have it’ the scare tactic used in this campaign is one major example of how STIs still has a huge negative stigma. This campaign is saying that if you have sex without a condom that you have a real chance of catching something and then be “diseased” it reinforces the already negative stigma around STIs. If the campaign took a less negative risk position associated with sex the stigma around STIs could significantly decrease (Gagnon, Jacob and Holmes, 2010). This is one of many oversights with this particular public health campaign, this oversight leads to the continuous stigmatisation of STIs.

The website and ad used for this public health campaign has the government logo plastered all over it and it is very obvious that it is a government endorsed ad. By making it well known that this campaign is government endorsed it is another part of the pre-emptive model because the government is associated with conservative and sensible behaviour (Diprose, 2008). However, by making this camping highly associated with the government it loses effectiveness because the targeted age demographic which is the youth of Western Australia are more than likely to rebel against the government (Gagnon, et. al, 2010). The over emphasis of governments involvement in a highly negative and risk campaign can reduce the effectiveness of the campaign. As a result of the campaign and particularly the ads being negative, the target audience will perceive that the campaign want to take the fun out of sex. By having all these negative conations and rules associated with sex the targeted audience will believe it takes the fun and pleasure out of sex. The campaigns negativity makes sex become rule bound and therefore subject to Government intervention.

In theory negative and fear sexually transmitted disease campaigns are designed to shock the risky target age group and dramatically change their unsafe sexual behaviours (Diprose, 2008). The “could I have it” campaign uses fear as a proactive way to convey their message. Fear was specifically to this campaign because of the targeted age group. The age group from 16-25 are considered to be the riskiest age demographic (Gagnon, Jacob and Holmes, 2010). In theory because of the age groups risky behaviour the campaign is attempting to shock and drastically change their sexual behaviour. The pre-emptive model highlights the severity of not getting regularly tested and how that can forever affect your life and or your sexual partners life or even possibly lead to AIDs. This campaign infers that if you’re having sex with someone your having sex with all off their other partners which is a scare tactic (Diprose, 2008). This scare tactic focuses on the extremity of what can happen if you don’t practice safe sex.

Healthism

Healthism is “Ascetic practices aimed at the achievement or maintain of appearance of health, fitness and youthfulness” (Ayo, 2012). Using healthism and putting pressure on the individual to get tested for STIs is vital for the campaign to be successful because “health consciousness has become deeply engrained within our social fabric” (Ayo, 2012). By society being so focused on being the healthiest you can be, healthism is a key factor which makes this campaign successful. It reinforces the needed to practice safe sex and to get tested often so that people can be socially accepted (Ayo, 2012). This campaign advocates for individuals to maintain a certain lifestyle which has be dubbed by society as the ‘ideal’ lifestyle.

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However, healthism is a major factor to why STIs are so highly stigmatized (Elisa Janine Sobo, 1995). As this campaign is addressed to the individual if someone was to contract an STI they would feel shame within themselves because of societies opinion on STIs. Not only would the person be judged by everyone else they would also judge themselves and could have guilt, anxiety or loathing towards themselves. The ‘could I have it campaign’ puts so much emphasis on the individual that if someone was to catch an STI they would “be punished through the mechanisms of self-surveillance” (Ayo, 2012). It’s the individuals need to get checked regularly and by getting tested you are achieving “perfect” sexual health. The “could I have it” campaign relies on the individual seeking regular tests to acquire perfect sexual health and people using condoms to preserve their already perfect sexual health. However, healthism has created a negative stigma associated with STIs.

The healthism concept is used in the ‘could I have it’ campaign because it addresses self-agency (Crawford, 1980). Healthism is the idea of perfect health on the individual and the need for individuals to maintain the perfect health. The wording of the campaign addresses the self-agency of having optimal sexual health. By using the word infection or “I” it is up to the individual to change their sexual behaviour and to get tested to make sure that their health is perfect. It’s the individuals need to get checked regularly and by getting tested you are achieving “perfect” sexual health. Healthism in this campaign showcases the importance to practice safe sex and the importance of using a condom. The video attached to the ‘could I have it campaign’ showcases the concept healthism because in the video, the main character who stops and reaches for the condom which makes the viewer realise that it’s up to the individual to make the right decision. This particular campaign is aimed at males, which differs from the usual campaigns that are aimed at women. This is a progressive campaign however girls are seen to be more responsible and concerned about their sexual health compared to males (Crawford, 1980).

Medicalisation

Medicalisation is when a ‘social’ problem becomes medicalised due to discourse and experience (Halfmann, 2011). Medical discourse and the patients experience are taken into account when the ‘illness is in the process of becoming medicalised (Crawford, 1980). Before STIs were medicalised they were rarely spoken about and they were just associated with having bad sex or having sex with someone promiscuous (Kerrigan et al., 2006). Before the medicalisation of STIs in the 90s (Halfmann, 2011) people were naive to the consequences of having unprotected sex. A phenomenon was occurring where people were getting weird pains and strange other symptoms after having sex and it was spreading fast (Conrad and Barker, 2010). The only disease linked to sex was AIDS which was in the 80s and was many people wrongly believed it was specific to gay men (Kerrigan et al., 2006). However as modern medicine advanced society became aware that there are many disease associated with unprotected sex and it’s not specific to any sexuality and or gender. STIs becoming medicalised was a massive step needed to control their outbreak (Kerrigan et al., 2006). In order to control the outbreak of STIs people needed to become educated about the importance of using a condom and to get regularly tested. The medicalisation of STIs lead to the opportunity for public health campaigns to promote safe sex and educate people of the risks associated with sex (Elisa Janine Sobo, 1995). The ‘could I have it’ campaign stems from the medicalisation of STIs. The “could I have it” campaign reinforces the medicalisation of STIs, the importance of being sexually healthy and the importance of seeking medical help regularly. The could I have it campaign uses the medicalisation of STIs in a positive light because it educates people the dangers of unprotected sex and the importance of having regular tested. At the end of the commercial a clear and calm voice tells the audience just how important it is to use a condom and to get regularly tested. By using a voice instead of just having text making people read it themselves it takes away from the stigma because someone is talking about it. The use of voiceover is one positive outcome of the ad because it’s saying that it’s okay to talk about STIs and sex (Davis and Manderson, 2014, chapter 5).

Stigma

There is a huge stigma around STIs which is due to human agency and the social norm (Gagnon, Jacob and Holmes, 2010). The ‘could I have it’ campaign creates huge stigma around STIs due to its heavy reliance on healthism and individuals needs to be at optimal health (Ayo, 2012). This campaign like many other STI campaign hasn’t been able to be successful in creating no stigma or even slightly less negative stigma around STIs (Davis and Manderson, 2014, p.chapter 5). This campaign takes a negative angle as it takes the enjoyment of sex away and rather sets in doubts about body image and sexual performance. By using other voices in the add and throughout the campaign continuously saying that you not just sleeping with one person your sleeping with all their sexual partners it brings concern to people about what people are going to say about what they’re doing. By this campaign continuously repeating those phrases it puts stigma on how many people you have slept with and how if you sleep with more people your more than likely to spread a disease regardless if you practice safe sex or not. By the campaign using these phrases your being persecuted for not only practicing unsafe sex but your being targeted even if your just having sex.

The stigma around STIs has had a major effect on the effectiveness of the ‘could I have it’ campaign. The stigma from this campaign makes people feel embarrassed about having an STI. This campaign also makes people fearful that they might have an STI and instead of getting tested find out they just don’t get tested because then they never know (Davis and Manderson, 2014, p.chapter 5). This is where the campaign attacking the individual didn’t recognize the experience of the person involved and the embarrassment of even having and STI.

Conclusion

It is evident that the campaign ‘could I have it’ explores the themes of healthism, pre-emptive model and medicalisation. Healthism targets the individual to have perfect sexual health but creates large negative stigma. The pre-emotive model uses risk to convey the message of the campaign but is unsuccessful. Medicalisation of STI reinforces the message of the campaign but has greater stigmatisation of STI. This campaign only reinforces stigma as a result and only engages a negative discourse.

References

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