Safe Words: How the prevention message disappeared from the public conversation about sex.

[Ed Barrow]

On Good Morning America in February, pop sensation Lady Gaga tested the limits of A.M. chatter by bringing up cavalier attitudes toward sex. Gaga (given name: Stefani Joanne Angelina Germanotta), was there with 1980s pop icon Cyndi Lauper to promote their lipsticks for MAC Cosmetics' Viva Glam line, whose proceeds go toward services for those living with HIV/AIDS. The two were dressed in sedate photo-negative outfits -- Lauper in a stiff, geometric black jacket and Gaga in a ruffled white dress. The chyron billed them as "Champions for Women's Health," but the two were focused on women's attitudes toward sex.

"I don't know if this is too much for morning TV," Gaga started. "Everyone has that ... phone call of 'Oh my gosh, you won't believe what I did last night. I was so stupid I didn't use a condom,' and there's all this laughter on the phone. ... I've gotten those phone calls, and it's our job as friends to one another to say, 'I don't know why you're laughing because it's very serious.' I really don't feel there's enough women who are educated about AIDS, how quickly it's spreading, how dangerous it really is, how many people really have it."

The 24-year-old pop star's rapid rise to fame and outrageous fashion choices (a bodysuit encased in a cloud of clear plastic bubbles for the cover of Rolling Stone, a bondage-inspired red latex gown to meet the Queen of England) have earned her comparisons to Madonna. "I want to make it fashionable to have safe sex," Gaga told the London Sun on a visit to an HIV support center in Manchester, England, last year. Of course, Madonna was spreading a similar message in the 1990s, but today it's rare to hear megastars lauding the virtues of condom use. Has safe sex really fallen so far off the radar?

In the nearly 30 years the United States has grappled with HIV/AIDS, public and private groups have struggled with how to best spread the message of prevention. Despite more than 100 years of public-health campaigns about sexually transmitted infections (STIs), the message of how to prevent them -- talking openly with your partner, using a condom properly, getting tested regularly -- still hasn't stuck. Condom use, particularly among teens, has increased over the past decade, but between 2004 and 2007, the time period of the most recent data available, diagnoses of HIV increased 15 percent, and STIs are on the rise. "Our HIV rates are appalling, given that we know how to prevent infection," says Ellen Friedrichs, a sex educator in Brooklyn.

What happened? Federal efforts to ensure public-school students receive accurate education about HIV/AIDS and other STIs have been chronically underfunded, when they have existed at all. Funding for HIV/AIDS prevention campaigns has shrunk to less than half of what it was in the mid-1990s, as the federal government adopted the counterproductive policy of funding abstinence-only curricula. The discovery of effective antiretrovirals, along with widespread understanding of how HIV/AIDS was transmitted, minimized the threat in many people's minds. Even celebrities largely stopped pushing the message that safety is sexy. (While many stars are involved in efforts like Product RED -- the consumer campaign launched by U2's Bono whose proceeds go to fight AIDS in Africa -- very few make a point of telling Americans to "wrap it up.")

The result is that both the general population and specific demographics where HIV infection rates are the highest have had limited exposure to safe-sex messaging over the last decade. The number of Americans who reported hearing about the HIV epidemic in the past year dropped (from 70 percent in 2004 to 45 percent in 2009) as did the percentage of those concerned with getting infected. "A lot of people, they don't see AIDS as a contemporary problem; it isn't seen as the serious threat that it once was," Friedrichs says.

Gaga's comments on Good Morning America sounded straight out of the early 1990s because that was the last time having a frank, national conversation about safe sex seemed not just possible but popular.



http://www.prospect.org/cs/articles?article=safe_words