Mythful Thinking AIDS TREATMENT ADS SPIN A WEB OF FALSE HOPE by Daniel Goldsmith graphic courtesy of Glaxo Wellcome, Inc. There are 30 million people worldwide who are HIV positive. According to the World Health Organization, 8,000 more are infected every day. These people wake up each morning and face the realization that they may develop AIDS, die painfully, and face discrimination and misunderstanding in the meantime. Given the proliferation, seriousness, and painfulness of the disease, there has been a shameful and disgusting apathy among pharmaceutical companies about creating therapies for HIV. So when I opened an issue of Rolling Stone recently and found a two page advertisement boasting "something new for HIV," I was excited by the thought of mass development and distribution of treatments for HIV. Upon a full reading of the ad, however, I was shocked and concerned. The ad touts Combivir, a combination of two antiretroviral drugs, Epivir and Retrovir, and promises "the power of two and the simplicity of one." This is entirely misleading, however, because, as anyone familiar with them would know, combination treatments (or "cocktails") are far from simple. The interactions of drugs can be very complicated and dangerous (this is why Beam and crack don't mix). HIV pill regimens are complex, and failure to follow guidelines carefully can reduce effectiveness, and more, can lead to selection of viruses that are resistant to the therapy. HIV specialists advise that the decision to start any form of therapy be done with full knowledge of negative impacts. These include the risk of severe side effects and the change of lifestyle necessary for strict adherence. The ad for Combivir glosses over these aspects of therapy and attempts to sell the notion that treating HIV infection is simple and harmless. It does list frequent side effects such as "headache, fatigue, and runny nose," but fails to note the full danger. HIV therapies can have much worse side effects, including dramatic weight loss and full body rashes. By misrepresenting the true struggle, the ad trivializes the pain that HIV patients endure. Furthermore, most advertisements neglect the issue of cost. HIV treatments are expensive. The Johns Hopkins School of Public Health recently reported that the overall cost of drug therapy has more than doubled in the past year and that it currently averages 1,000 dollars a month. This price is out of reach for many low-income patients, and an HIV infection, through sickness or discrimination, often leads to unemployment. What makes the inaccuracies of advertisements like this so dangerous is the fact that they can skew public perception of the truths about HIV. There is a serious lack of HIV prevention ads in this nation, especially in poor urban areas. In the absence of prevention programs and other educational initiatives, drug ads can become the only source of information some people have about HIV. This can foster the notion that treating HIV is as easy as popping a pill. In an article that ran in the New England Journal of Medicine, drug researchers themselves acknowledged the fact that antiretroviral therapy, while beneficial, is only a simple step in treating HIV. At present, our only hopes for any real difference are prevention and perhaps eventually a vaccine. The most disturbing fact, however, is that the targets of many prevention campaigns, teenagers, are contracting the disease at an alarming rate. A recent survey of 13-18 year olds indicated that a majority of teenagers will have sex by the time they reach 18. In addition, 40 percent of those surveyed did not discuss disease prevention with their partners, and 58 percent reported that they did not use contraception regularly. Those are scary numbers when we consider the corresponding levels of promiscuity. Clearly the message of prevention is not being heard or it is not being stressed enough. Even though STDs can be prevented effectively, three million teenagers contract them annually, and 25 percent of Americans with HIV are under the age of 22. Adolescents are a major segment of Rolling Stone magazine's readership. Clearly, the ads for the sale of HIV treatments are targeting this young age group --the same ones failing to heed prevention warnings. The ad jeopardizes the fight to reduce the rates of unprotected sex among teenagers by overpowering the cry for prevention with promises of easy treatment. Teens are the most influenced by the media they cherish and since the ads contained in such media are so positive about infection, many teenagers may not internalize the very real facts about HIV's danger. This positive attitude also has adverse effects on the perception of needs for further awareness and investment. The ad has the ability to make the casual reader believe that "something new for HIV" means an effective treatment or even a cure. And if people aren't concerned, there will be a serious lack of urgency in the drive for further research, potentially delaying the development of new treatments. I must admit, however, that it is good to see drug companies taking an active approach toward the distribution of HIV treatments. It must be noted that pharmaceutical companies have invested billions in HIV therapies and have regained little. We must give them encouragement and provide incentive to do further research. It is unfortunate that companies feel the need to rely on such manipulative ads to elicit such a response. The Rolling Stone ad is completely irresponsible -- it gave a misleading and damaging spin to the current state of HIV treatments. And although one must be excited that the new drugs have reduced the number of deaths, they do nothing about infection rates. One cliché used by champions of the HIV fight is that "this is not the end, but only the beginning," and they are right. It appears that the smiling faces in ad graphics are celebrating too soon.

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