'It's bad enough that people are dying of AIDS, but no one should die of ignorance' - Elizabeth Taylor (actress)

Roslyn Cochrane (n8289247)Tutor: Judith MeiklejohnARTEFACT


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This advertisement was a part of the Rip and Roll safe sex campaign developed on behalf of the Queensland Association for Healthy Communities (QAHC). It was displayed on billboards and bus stations at 45 locations around Brisbane in June 2011. The advertisement was displayed by both Goa Billboards and Adshel (Baumgart, 2011). After 47 complaints, most of which allegedly stemmed from the Australian Christian Lobby (ACL), Adshel removed the advertisements without consulting the QAHC (Baumgart, 2011). The ads were reinstated the following day after a Facebook campaign and significant media attention. Additionally, Adshel's actions prompted the other advertising company involved, Goa Billboards, to launch a campaign on their digit billboards that said, "OUR GOD LOVES EVERYONE: GAY & STRAIGHT" (Baumgart, 2011). Read some of the complaints lodged about this advertisement here.

PUBLIC HEALTH ISSUE
As a current public health issue, increasing HIV/AIDS diagnoses statistics among young people in Australia is a major focus of concern, not only because of the physical consequences of the disease, but because of the social and emotional changes that result from a positive diagnosis. Research has shown that HIV status can have significant effects on employment, poverty and
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mental health (Ezzy, De Visser & Bartos, 1999). In 2009 an estimated 20,171 Australians were living with an HIV positive diagnosis (AVERT, 2009). This same year marked the largest number of new HIV/AIDS cases reported in Australia since 1993 (AVERT, 2009). Although in 65% of these cases HIV positive patients reported engaging in male-male sex, this public health issue does not only effect gay men (AVERT, 2009). In considering the reasons for the re-emergence of such a dangerous and devastating disease, population attitudes towards HIV/AIDS; whether knowledge about HIV/AIDS effects sexual risk taking behaviours; and the use of sexual protective measures among Generation Y will be examined in the literature below.

LITERATURE REVIEW

After peaking in 1987 the rate of HIV diagnosis in Australia went into twelve years of decline. However, after 1998, the rates began to increase again with the latest statistics revealing that 1,050 new cases were diagnosed in 2009 (AVERT, 2009). While early research concerning HIV/AIDS centred on the pathophysiology of the disease and its spread, more recently HIV/AIDS research has focused on attitudes and sex risk behaviours surrounding HIV/AIDS.
Recent evidence suggests that the development of new treatment options and shifts in the perceived risk of contracting HIV/AIDS and other STIs have had an effect on young people's attitudes and their sexual practices. For example, MacKellar, Hou, Whalen, Samuelsen, Valleroy et al (2011) examined the sex risk behaviours and attitudes towards HIV/AIDS in the two to four years following the widespread availability of Highly Active Antiretroviral Therapy (HAART). HAART slows the progression of HIV to AIDS by suppressing HIV replication, and means that an HIV positive diagnosis is no longer a death sentence (MacKellar et al, 2011). The study found that since the introduction of HAART the perceived severity of HIV/AIDS has decreased among young people. This study was conducted among 23-29 year old men who have sex with men (MSM) in six cities across the US and showed a negative correlation between concern over HIV and sexually risky behaviour; and susceptibility to an HIV positive status (MacKellar et al, 2011). This means that those who were less concerned about the severity of HIV/AIDS were more likely to engage in risky behaviour and more likely to become HIV positive. This finding was confirmed in 11 of the 13 studies examined by the authors and similar rates were discovered for younger age groups, indicating the presence of the trend throughout the Gen Y population (MacKellar et al, 2011).
Opt and Loffredo (2004) conducted a study at Florida Southern College, a private church affiliated college. 315 mostly Caucasian (82%), female (61%), heterosexual (90%) 18-21 year olds (79%) were tested for the perceived AIDS risks to their age group and their safe sexual practices. The study found that whilst students were knowledgeable when it came to HIV/AIDS transmission and protection methods, it rarely deterred from engaging in risky sexual behaviours (Opt, & Loffredo, 2004). 54% had never been tested for AIDS, only 21% said that unprotected sex or sleeping with a risky partner might motivate them to be tested, and 10% said that nothing would motivate them to be tested (Opt, & Loffredo, 2004). Only 35% of the participants reported always using a condom (Opt, & Loffredo, 2004). The small sample diversity and religious affiliation of the College are limiting factors of this study. However, the study does reflect similarly low levels of testing and protective measures in Australia (Marie Stopes International, 2008).
Marie Stopes International (2008) researchers have reported that more than half of all sexually active Australians have not been tested for STIs and that 90% of them have had sex without a condom. This is also confirmed by rising STI rates and, in particular, the high rates of other STIs amongst the Gen Y cohort. For example, 61,000 people were diagnosed with Chlamydia in 2009, this is up from 17,000 in 2000 (Benson, 2010). In 2011 of the 62,494 total recorded case of Chlamydia Infection in Australia 50,972 cases were between the ages of 15 and 29 (Benson, 2010). An Australian study found Gen Y's average age of sexual activity to be 15.7 years for both males and females, a younger age than past generations (Marie Stopes International, 2008). This may provide one explanation for the increases in STI prevalence because if people are engaging in sexual activity at a younger age, they have more opportunity for sexual partners than those who engage in sexual activity at a later age (Robinson, & Rogstad, 2002). Younger age groups are also more susceptible to peer pressure, less likely to initiate sexual health checks, and less educated when it comes to sexual health (Robinson, & Rogstad, 2002).
Cassell, Mercer, Imrie, Copas and Johnson (2006) confirmed these results when they reviewed condom usage amongst all UK populations with two national probability sample surveys. The surveys were conducted in 1990 and 2000, and showed that, over the ten year period condom use had increased on the whole rising from 43.3% in 1990 to 51.4% in 2000 amongst men and 30.6% in 1990 to 39.1% in 2000 amongst women (Cassell et al, 2006). The trend of increased condom usage was especially evident within the Generation Y 16-24 year old range. Condom use increased with the amount of partners reported in the previous year, but fell significantly if the person had been with their partner for six months or more (Cassell et al, 2006). Those who had reported having a previous STI diagnosis were less likely to have used a condom during their last sexual encounter and the majority of male-female condom use was motivated by pregnancy prevention concerns (Cassell et al, 2006). However among the 16-24 year old age group, STI and HIV prevention were also a strong motivator (Cassell et al, 2006). Consistent condom use was also an important factor, with almost two thirds of those who had at least two partners in the past four weeks reporting inconsistent or no condom use. Interestingly, this study proposes that condom use is a marker of "high risk" sexual encounters, and that the protective benefits of condom use may encourage sex with more high risk partners such as those with current STIs and HIV positive statuses (Cassell et al, 2006). The study targets inconsistent condom use as one of the major problems facing STI and HIV prevention groups today and warns that the Generation Y age group is most at risk because of their higher rates of new partners and serial monogamy than older generations (Cassell et al, 2006). This study is useful because of the changes that can be seen across time in population condom use, and because of the scale and consistency of the data across surveys. It is however limited in that, although it does report on prevalence of usage, it does not account for incorrect usage and condom breakage.

CULTURAL AND SOCIAL ANALYSIS

It can be argued that recent increases in HIV/AIDS diagnosis rates and the incidence STIs stem from the cultural and societal factors. The current structures of our country and our communities have been shaped by the past social movements of the time. For example, in the decades since the AIDS first appeared in Australia, public opinion has moved away from the perception of biomedical 'causes' of homosexuality and has focused instead on homosexuality as an expression of social rights and political freedoms. Homosexuality is now more openly acknowledged, accepted and practiced than it was in previous generations (Robinson, & Rogstad, 2002).
This is important because not everyone is affected equally by this issue. As has been discussed above, men who have sex with men are one of the most significant groups at risk of contracting HIV/AIDS (Clark, 2008). One of the other vulnerable groups is migrant populations from developing countries, as their rates have been proven to be higher than that of non-migrant Australians (AVERT, 2009). Although awareness of this issue is generally quite good, prevention strategies are clearly failing, as can be seen by the increasing diagnosis rates (Opt, & Loffredo, 2004). Some experts have attributed this to a decreased perception in the severity of this disease, because of new treatment options, as was highlighted in the literature review (MacKellar et al, 2011). Because certain populations are vulnerable to it, they should be targeted for prevention strategies.
The increasing rates of HIV diagnosis are such a concern because they indicate that the safe sex message is not getting through to young people. More than half of all HIV new infections in the US occur in the under 25 age group (Opt, & Loffredo, 2004). The majority of these infection occur as a result of sexual activity (Opt, & Loffredo, 2004). Generation Y is the second largest group when it comes to new HIV infections in NSW (ACON, 2011). As Cassell et al (2006) indicated, sexual health is not always a priority with young people. An Australian study by GlaxoSmithKline (2010) found that the top three reasons for not using a condom amongst young people included preferring the sensation without protection, being too horny, or being too drunk.
It is interesting to note the influence of media and advertising in the case of HIV/AIDS prevention. Lately, Australian researchers and leaders have been voicing their concerns about the rise of 'raunch culture' (Toy, 2010). Although it is a highly contested issue, some researchers are arguing that saturation of public spaces with sexualised media imagery is one contributing factor to the pre-sexualisation of young Quote2.pngAustralians (Clark, 2008). They offer 'sexting' as an example of the way young people are expressing themselves sexually, they argue that young people are not being pressured into this behaviour but do it because of the normalisation of sex in our culture (Toy, 2010). Recent reports have argued that sex has been normalised to such a degree that Gen Y women feel they are expected to give oral sex. A survey by Family Planning NSW (2011) reported that half of women aged 16-24 who participated in the survey had been pressured into giving oral sex, and felt that the men they were with expected it. It is not surprising that this sort of cultural environment may encourage younger generations into serial sexual encounters.
Additionally, Facebook and social networking have added to the debate. Many commentators on the Rip and Roll ad debate which is the artefact of this page, commented that pressure from new media, such as the Facebook campaign against Adshel, overpowered the traditional billboard methods (Baumgart, 2011). Furthermore, organisations like ACON (2011), which advocates the health of GLBT Australians are turning towards more interactive marketing methods that engage Gen Y's tech-savvy nature. Strategies that they have used include 'Horizon', and online GLBT soap opera, and an interactive condom game, because they have found that when looking for information and making decisions Gen Y do not respond to traditional media, but focus on peer information and the internet (ACON, 2011).

LEARNING REFLECTIONS

The artefact I have chosen is such a good 'case in point' for this public health issue because it highlights some very important and interesting aspects of the HIV/AIDS problem in Australia. Not only does the ad demonstrate the growing problem of HIV/AIDS in Australia, but it highlights one of the most vulnerable groups in identifying the GLBT community, and shows that HIV/AIDS is not only a disease for older people, but can also affect Gen Y. Furthermore, the circumstances surrounding the implementation of the media campaign also highlight other issues that contribute to this problem. The public debate that it sparked amongst the population, especially amongst the Christian community, and the continuing debate about advertising in public places (including the fact that all advertising should be G-rated to stop early sexualisation of children) highlights the topical and far-reaching nature of this issue. Finally, the dichotomy of old and new technology, billboards and Facebook, shows how Gen Y's interactions with their world are very different from generations before them.
For me, this project has been a steep learning curve. When I first started this assignment, I was under the impression that HIV/AIDS in Australia was an almost eradicated disease, like Polio. I found it hard to keep to my word constraints, and not diverge too much from the topic at hand, because once I started looking, I found that so much of our everyday culture is a factor in what we do and how we act. I hope that I can carry that with me when I approach future learning topics, but also when I approach aspects of my everyday life.

REFERENCES

ACON. (2011). Promoting safe sex among Gen Y with Web 2.0 [Brochure]. Retrieved from http://pag.aids2010.org/PDF/12005.pdf
AVERT. (2009). Australia HIV & AIDS Statistics. Retrieved from http://www.avert.org/aids-hiv-australia.htm
Baumgart, S. (2011, July 11). Rip and Roll campaign draws most complaints. The Brisbane Times. Retrieved from http://www.brisbanetimes.com.au/queensland/rip-and-roll-campaign-draws-most-complaints-20110711-1hafi.html
Benson, K. (2010, January 13). Tripling in sexual infection prompts demand for national testing. WA Today. Retrieved from http://www.watoday.com.au/lifestyle/diet-and-fitness/tripling-in-sexual-infection-prompts-demand-for-national-testing-20100112-m4tm.html
Cassell, J. A., Mercer, C. H., Imrie, J., Copas, A. J., Johnson, A. M. (2006). Sexually Transmitted Infections, 82, 467-473.
Clark, S. (2008, July 3). Sexual infections rise among Gen Y. The Sydney Morning Herald. Retrieved from http://www.smh.com.au/lifestyle/diet-and-fitness/sexual-infections-rise-among-gen-y-20090407-9xy5.html
Ezzy, D., De Visser, R., & Bartos, M. (1999). Poverty, disease progression and employment among people living with HIV/AIDS in Australia. Aids Care, 11(4), 405-414.
Family Planning NSW. (2011). Oral Sex & Young People - survey report summary. Retrieved from http://www.fpnsw.org.au/606255_12.html
GlaxoSmithKline. (2010). Young Australians risk sexual health. Retrieved from http://pag.aids2010.org/PDF/12005.pdf
MacKellar, D. A., Hou, S., Whalen, C. C., Samuelsen, K., Valleroy, L. A., Secura, G. M., Behel, S., Bingham, T., Celentano, D. D., Koblin, B. A., LaLota, M., Shehan, D., Thiede, H., & Torian, L. V. (2010). A Plausible Casual Model of HAART-Efficacy Beliefs, HIV/AIDS Complacency, and HIC-Acquisition Risk Behaviour Among Young Men Who Have Sex with Men. AIDS and Behaviour, 15(4), 788-804. doi: 10.1007/s10461-010-9813-x
Marie Stopes International. (2008). Sex - telling it like it is: a parent and teen insight. Retrieved from http://www.mariestopes.org.au/images/stories/resource-files/Sex-telling-it-like-it-is-Oct-08.pdf
Opt, S. K., & Loffredo, D. A. (2004). College Students and HIV/AIDS: More Insights on Knowledge, Testing, and Sexual Practices. The Journal of Psychology, 138(5), 389-402.
Opt, S. K., & Loffredo, D. A. (2004). College Students and HIV/AIDS: More Insight on Knowledge, Testing and Sexual Practices. The Journal of Psychology, 138(5), 389-402.
Robinson, A. J., & Rogstad, K. (2002). Adolescence: a time of risk taking.Sexually Transmitted Infections, 78, 314-315. doi:10.1136/sti.78.5.314
Toy, M-A. (2010, April 19). Gen Y women facing pressure to have sex. The Age. Retrieved from http://www.theage.com.au/lifestyle/life/gen-y-women-facing-pressure-to-have-sex-20100418-smm2.html

REFLECTIONS
http://healthculturesociety.wikispaces.com/message/list/%27You+are+not+a+beautiful+and+unique+snowflake%2C+you+are+the+same+decaying+organic+matter+as+everyone+else%27+Gen+Y%27s+craving+for+individuality+and+consumerism
http://healthculturesociety.wikispaces.com/message/list/%27Seriously%2C+R+U+OK%3F%27