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The Swiss Aids Prevention Campaign 1998
PREVENTION IS BETTER THAN THERAPY

GENEVA, SWITZERLAND. -- Delegates to the 12th World Aids Conference, to be held in Geneva from 28 June to 3 July, are to be the target of a special poster display by the Swiss STOP AIDS campaign. The old saying "An apple a day keeps the doctor away" has now become "A condom a day keeps the doctor away". The aim of this new STOP AIDS campaign is to draw the attention of delegates, most of whom are doctors and health care professionals, to the continuing importance of the work of HIV prevention. In view of the improved prospects in Aids treatment, emphasis on the importance of HIV prevention appears to have dwindled somewhat in some areas of health policy. Nevertheless, the condom remains the only known method of preventing infection during intercourse. And prevention is better than cure, to quote another old saying. This is why, for the past ten years, the Swiss Federal Office of Public Health and the Swiss Aids Federation have consistently advocated prevention. We now present this year's campaign.

The STOP AIDS campaign theme - a risky affair
The theme of the STOP AIDS campaign for Summer 1998 on posters and TV advertisements is the risk attached to an affair. This taboo-breaking campaign therefore takes another step forward, audaciously announcing to the entire population of Switzerland: "No cheating without a condom". Since 1986 the STOP AIDS campaign has been providing information to heterosexuals, with posters, TV advertisements and in the press, on the risks of HIV and the ways of avoiding it. This has always tended to touch on taboo areas. This summer again, in its selection of cheating as a topic, the campaign has adopted a theme which is both a social reality and a delicate area.

Why this theme?
From the point of view of HIV prevention, is there any need to bring up the subject of casual affairs? Indeed, the epidemiological data suggest that there is ¹. For some years, there has been a continuous increase in the proportion of cases of HIV infection caused by heterosexual contact, which passed the 50% mark for the first time at the end of 1997. New infections attributable to i.v. drug use have decreased (15% at the end of 1997), while those attributed to homosexual contact remained relatively constant (27%).

Sex, lies and relationships
Of course, not all new infections in heterosexuals are attributable to fleeting contacts outside of permanent relationships. However, since it is indisputable that affairs happen and since condoms are not always used in these situations, this behaviour definitely carries a risk of HIV infection. According to a telephone survey conducted by the Institute for Social and Preventive Medicine of the University of Lausanne in 1994 ², around 6% of married men had had at least one sexual contact in the previous six months with a casual partner, whether male or female. The proportion was almost as high for unmarried men living with a female partner (5.5%). For men in a permanent relationship but not living with their partner, as many as 15.2% confirmed at least one casual sexual contact within the previous six months. Studies by social scientists in other countries have shown similar results ³: married individuals in all age groups are more likely to have had sexual contact with only one partner (their spouse), within the particular period of investigation, than those living in stable relationships. A particularly clear difference is seen between married persons and those who have a permanent relationship but do not live together.

Trust, safety and silence
In general, however, the affair is not mentioned to the permanent partner. In fact, within fixed relationships, sexual contacts with third parties are mostly taboo. It seems, paradoxically, that even those who cheat on their partners clearly subscribe to the notion that this would result in the destruction of love and trust. Under these conditions, a fleeting sexual contact outside an existing relationship is seen as a betrayal of love, even by the cheating partner. In order to come to terms with this betrayal, the fleeting sexual contact is dismissed as being of no importance. It is then difficult to make the connection between an event regarded as inconsequential and something as serious as the risk of HIV infection. Therefore, the HIV risk associated with casual sexual contacts is frequently denied.

Raising the level of risk awareness in men
The intention of those responsible for the STOP AIDS campaign is to highlight the fact that an unprotected affair does present an HIV risk. They are aware that this will give rise to heated social controversy. But after all, it is the task of an HIV prevention campaign to face the hard facts about sex and to promote discussion on aspects of relationships which men and women find it difficult to address. In the summer of 1998, men who are married or living within a permanent partnership will be encouraged, if they must have an affair at all, to do what so many don't: use a condom. At the same time, the campaign seeks to support women in their request that a condom should be used. Posters with slogans which translate roughly as "NO FUN WITHOUT ONE," "YOU'RE THE GREATEST, BUT NOT THE LATEST," "DON'T FREE WILLY WITHOUT ONE," will be displayed in 3,500 sites all over the country from 15 June 1998. The poster campaign will be accompanied by TV advertisements also dealing with the topic of the affair. These will be broadcast from 16 June and will also be screened in cinemas from July 1998. The intention of the STOP AIDS campaign is not to prick the conscience of men who have affairs or to make light of the affair. The aim is to raise their awareness of the risk involved and to reinforce their sense of responsibility to themselves and to their partners.

Information campaign or clients of prostitutes
To supplement the STOP AIDS campaign, the Swiss Aids Federation will also run an information campaign for the clients of prostitutes. Starting in autumn 1998, adult magazines will urge these men to play their part in prevention and not merely to leave that responsibility to there female partners.

Conclusion of a representative survey of STOP AIDS 1997
STOP AIDS campaigns are on the right track. They are backed by a broad spectrum of the population. STOP AIDS publicity is best received when it arouses curiosity, is witty, provocative and honest; when it makes the point quickly and concisely, is immediately comprehensible and eye-catching. The more these characteristics are fulfilled, the greater the public response. RGS Motiv- und Marktanalysen GmbH, Zurich

REFERENCES

1 Swiss Federal Office of Public Health, HIV and AIDS in Switzerland at the end of 1997, Bulletin BAG 1998, no. 5, p. 19-22

2 Institut de médecine sociale et préventive de l'Université de Lausanne, Enquête téléphonique population générale 1994, F.Dubois-Arber et al., Evaluation de la stratégie de prévention du sida en Suisse sur mandat de l'OFSP. 5e rapport de synthèse 1993-1995, Lausanne, IUMSP, 1997

3 E.O.Laumann, J.H.Gagnon, R.T.Michael, and S.Michaels, The Social Organization of Sexuality - Sexual Practices in the United States, The University of Chicago Press, Chicago, 1994

A.M.Johnson, J.Wadsworth, K.Wellings, and J.Field, Sexual Attitudes and
Lifestyles, Blackwell Scientific Publications, Oxford, 1994

A.Spira et al., Les comportements sexuels en France, Rapport au ministre dela Recherche et de l'Espace, La documentation française, Paris, 1993

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