Ottawa Public Health Needs to Come “Clean”

Michael Orsini and Marilou Gagnon criticize Ottawa Public Health’s recent sexual health campaign.

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Public health folks are normally on the right side of things, but sometimes they get it colossally wrong.

Ottawa Public Health recently apologized for creating a banner ad that featured the caption “Was he lying when he said he was clean?” which was featured in Xtra, a popular lesbian and gay newspaper. The ad was part of the Public Health unit’s Sex it Smart campaign, which began several years ago to encourage condom use among youth aged 15-29 and address the growing tide of chlamydia and gonorrhea cases.

NQbqEuz0.jpg-large While the ad has since been pulled following an outcry from some members of the HIV community, serious questions remain.

First, how could Ottawa Public Health, which has patted itself on the back for creating public health programs that are creative, technology-savvy and responsive to the demands of a weary public, be so out of touch with the HIV community? You do not have to be an HIV expert to appreciate that more than three decades into the epidemic, HIV-positive people remain the objects of stigma and fear, and that this stigma has real consequences for their lives. AIDS activists and researchers have worked long and hard to combat stigma and discrimination, which was a defining feature of the epidemic when it unfolded in the early 1980s.

Ottawa Public Health’s half-hearted response to the controversy was to suggest that it sought input from the youth advisory committee about this particular ad, and that the committee suggested that they go ahead despite some of the concerns raised. And that’s exactly what Ottawa Public Health did. As AIDS activist Michael Burtch argued in Xtra, Ottawa Public Health’s defense amounts to throwing these youth “under the bus.” It’s not our fault: our youth advisory committee made us do it!

In its defense, an Ottawa Public Health official told Xtra that the ad was never intended to address HIV, which is puzzling given that it targeted a publication read widely by members of the LGBT community. Gay men continue to constitute the majority of HIV infections so it is hard to believe that Ottawa Public Health assumed that the offending ad would nudge readers to think about gonorrhea or chlamydia, and not HIV.

Second, why create a banner ad that is directed to folks who are presumably “clean”? Why ignore those individuals who are HIV positive or have other sexually transmitted infections? The ad is premised on the idea that the only person worth appealing to is the “clean” person. Isn’t sexual decision a shared responsibility?

The idea that some individuals are “clean” suggests that people living with HIV are somehow “dirty.” There has been a wide community response to the idea of labeling people as “clean” or “dirty,” including the most recent social media phenomenon #weareALLclean. In addition, the ad and its core message are seriously misleading and out of touch with the science, which reminds us that HIV transmission is more complex, fluid, and complicated than one might think. Presuming that some people are “clean” ignores the fact that even people who test negative have to redo the test three months later because of what is known as the “window period.” In the world of public health, this is 101 stuff.

Third, why focus on lying and deception? This neglects what is painfully obvious to many who work in HIV/AIDS prevention. A person’s decision to disclose their HIV status to sexual partners is complex and messy. Presuming that people living with HIV are motivated primarily by a desire to deceive others and lie to their sexual partners is a dangerous public health message. Given that Canada is a ‘hot-spot’ for the criminalization of HIV non-disclosure, this message is irresponsible and potentially harmful to people living with HIV. There is plenty of research and evidence – because public health folks want evidence, of course – to demonstrate that people living with HIV are concerned about HIV transmission and knowledgeable about how to prevent this from happening. There is also plenty of evidence that the risk of transmission of HIV approaches zero when people know their status and can access proper HIV care (including HIV treatment).

This recent controversy is a reminder that well-intentioned campaigns are not enough. Public health campaigns can be clever tools to exhort individuals to challenge dominantly held views, but they can also resurrect tired ideas about good and bad ways to contract HIV or other sexually transmitted infections.

Here is hoping that the next time a public health campaign wants to engage sexually active youth in the LGBT community, it should start by combating stigma, not reinforcing it.

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Michael Orsini is Director of the Institute of Feminist and Gender Studies and Associate Professor in the School of Political Studies at the University of Ottawa. @OrsiniMichael

Marilou Gagnon is Associate Professor in the School of Nursing at the University of Ottawa. @mlgagnon_XVII

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