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INDULGENCES health lab by jim zians, ph.d.


THE CONDOM CODE


What has happened to the condom code message? It is not just a Southern California issue; it appears to be the same in many gay communities across America. Health promotion outreach teams from UCSD’s EDGE Research Study and another area healthcare provider shared ideas at a recent brainstorming meeting. The HIV preven- tion outreach teams included staff on the frontline delivering health messages to gay/ bisexual men in public locations such as the park, community events, gay bars and other gay social venues. They report that the reception from many gay/bisexual men to condom code messages range from lukewarm, “thank yous” to “dude, I only need the lube.” Not always, but they do encounter some name calling, “Here’s the condom police again,” or “Are you the safe sex Gestapo?” One outreach worker stated that conversa- tions about the importance of using condoms seem as difficult as putting out a forest fire with a water bottle. On the other hand, the condom outreach guys in Southern California seem popular


with at least one target group, heterosexual women at gay bars who are partying with their gay friends. The outreach guys are met with hugs and inquiring conversation. These women then hand-pull the outreach guys across the bar, taking handfuls of condom packets and stuffing them into the pockets of their young friends. “You need these, use them,” the women caringly command. What has happened to the condom code among gay/bisexual men in our com-


munity? Does anyone notice a spotlight on this message? Other health messages appear to be resonating. Michelle Obama’s leadership spotlights childhood obesity and the value of good nutrition. Oprah—along with the Jonas Brothers—sound the alarm for texting-while-driving. Other health messages are present: the importance of regular exercise, reducing consumption of saturated fats, a low-salt diet, women’s an- nual mammograms and “don’t drink and drive!” Vegetarians and vegans were recently presented with a new message regarding possible risks related to “hexane” a toxin associated with consumption of too much tofu (Google it). Controlling one’s behavior, regardless of the health risks, is a very difficult task for


everyone. Anyone who has ever tried to lose weight, quit smoking, stop drinking or stick to an exercise program knows the challenges of behavior change. New health behaviors that also need to be maintained do not come easily. Consistent condom use surely tops this list of challenges. Within the LGBT community, something seems to have happened to the message of the condom code. There does not seem to be a clear, consistent, ever-present condom


“The condom code message surrounding HIV/AIDS is 29 years old. It suffers from fatigue and aging. If it appears, it seems hardly noticed, and in discussion with the target audience, messages resound like a mere echo of a traumatic past often deflected rather than heard.”


message. Gay/bisexual men still make up about 75 percent of the AIDS cases in San Diego County and in Long Beach and IV drug users who are also men-having-sex- with-men (MSM) make up an additional nine percent. 69 percent of AIDS cases are MSM-related in Los Angeles County. Each year young gay men continue seroconvert (become HIV positive) at unacceptable rates. These numbers appear stark in relation to other numbers, such as recent cuts


to prevention dollars in Southern California. San Diego County reports cut of 63 percent this year alone. Loses like these come as a blow to Southern California’s HIV healthcare agencies. Despite concern about budget cuts, the HIV-prevention outreach teams regionally


experienced some noteworthy successes such as addressing the syphilis outbreak and targeting prevention interventions for meth users. Crises seem to temporarily draw at- tention to the outreach teams’ condom message. Even against the odds, health teams have established a strong track record targeting high-risk groups via risk case manage- ment programs, delivering CDC-sponsored programs that are deemed effective to our younger adults such as the MPOWERMENT Project and IN THE MIX, and targeting health promotion interventions which ensure access to gay men of color. Coming up with the perfect, new, pop-culture condom message that will resonate well remains the wish of many in Southern California’s fight to reclaim the condom code. So where is the condom code message? What has happened? Health messages of childhood obesity and anti-text messaging while driving can perhaps be explained partially by their being relatively recent. Public health messages are very difficult to maintain over time and across many generations. Corporate advertising firms remain well aware of the limited shelf-life of a good ad/message campaign. This can be evidenced by the rise and fall of the infamous Taco Bell dog and in the new-versus-old GEICO commercials, switching from the “so easy a cave man can do it,” to “the piggy that goes wee wee all the way home” (Youtube it). The condom code message surrounding HIV/AIDS is 29 years old. It suffers from fatigue and aging. If it appears, it seems hardly noticed, and in discussion with the target audience, messages resound like a mere echo of a traumatic past often deflected rather than heard. What can we do about this?


Jim Zians, Ph.D. is the Project Director of the EDGE Research Study at UCSD. The EDGE Study continues to accept research participants who are HIV-positive, sexually active and have used methamphetamine during the past two months. Compensation is $305.


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RAGE monthly | SEPTEMBER 2010


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