Just five weeks after launching an $800,000 campaign featuring explicit ads on condom use, the lead federal agency for AIDS prevention is backing away from TV and radio commercials and looking for additional ways of getting out the safe-sex message.
The Centers for Disease Control and Prevention began exploratory discussions with communications experts yesterday about how to incorporate AIDS-prevention messages in prime-time television shows.
Agreeing with an advisory panel, the CDC now acknowledges that public-service spots, no matter how frank, have minimal impact on sexual behavior. Instead, the agency now feels, a few lines of dialogue in a prime-time sitcom may accomplish far more.
The condom commercials will continue to appear, at the discretion of networks and local TV stations. But the ads won't anchor the CDC's prevention efforts against the virus that causes AIDS.
"Public service announcements have a useful but limited role," says Vicki Freimuth, a communications professor at the University of Maryland College Park and principal consultant to the CDC's advisory panel.
Such ads "are most effective in increasing awareness of an issue, bringing up the topic," she says. "But they are not going to result in behavior changes by themselves."
Many activists in the fight against acquired immune deficiency syndrome (AIDS) praised the commercials for providing information about use of condoms.
But the National Conference of Catholic Bishops and conservative lobby groups, such as the Traditional Values Coalition and the Family Research Council, criticized them for being too explicit. One of the commercials features an animated condom package that dances under the bedclothes covering a couple. In another, a man and woman kiss, their silhouette visible against a darkened doorway. She unbuttons his shirt. He takes vTC off her earring. She asks, "Did you bring it?"
"Uh-oh . . . I forgot it!" he says.
L The woman says, "Then, forget it," and clicks on the lights.
Yesterday, at CDC headquarters in Atlanta, agency officials began three days of discussions with communications specialists and representatives of the entertainment industry.
The CDC's goal is to include AIDS-prevention information in the scripts of a wide range of prime-time and daytime television programs.
This approach was used successfully in the late 1980s to promote the concept of having a "designated driver." That initiative by the Harvard University School of Public Health called for one person to accept the responsibility of acting as chauffeur -- and of remaining sober.
Communications specialists say the concept caught on because the message was repeated on prime-time TV programs, including "The Cosby Show" and "Cheers."
The CDC's advisory panel -- which began its work last year -- included people with AIDS as well as public health and behavioral specialists.
Though a final report won't be out until March, "there are some things that we recognized needed to be changed more immediately," says Dr. James Curran, associate director of the agency's AIDS program.
The revamped strategy also puts added emphasis on hot lines, community-based counseling programs and on placing information in magazines and newspapers, he says.
The CDC was impressed by a Swiss campaign that included commercials, print ads and "extensive community efforts," says Dr. Curran. "Condom usage among young adults went from 8 percent to over 52 percent with no significant increase in the number of adolescents having sex."
In the past, public-service ads have pushed everything from seat belts ("Buckle up for safety") to staying clear of drugs ("Just say ,, no"). Communications specialists believe that such messages often get public attention but seldom change behavior.
Consider the federal government's seat belt campaign, says Neil Alperstein, advertising professor at Loyola College. For years, public-service ads warned about the dangers of not buckling up.
Also for years, most people in Maryland and across the nation ignored the advice.
Only after buckling up was required by state law did use of seat belts increase significantly. "After all the years of advertisements . . . what changed behavior was legislation," says Dr. Alperstein.
Research shows that many people will not change a certain behavior even when they know it is dangerous or deadly, says David Vlahov, an AIDS researcher at the Johns Hopkins University School of Public Health.
For example, a 1988 Hopkins survey of intravenous drug users found that though 98 percent of the respondents knew that the human immunodeficiency virus (HIV) can be transmitted by needles, 70 percent reported sharing needles during the previous six months.
Also, though 98 percent were aware that condoms could prevent infection by the AIDS virus, 66 percent said they never, ever, used a condom.