Media sources of HIV/AIDS information in injecting drug users Michael W. Ross National Centre in HIV Social Research Unit, University of New South Wales
Simon Chapman Department of Community Medicine, University of Sydney
Alex Wodak Alcohol and Drug Seruice, St Vincent's Hospital, Sydney
Me1 Miller Directorate of the Drug Oflensive, North Sydney
Julian Gold Albion Street (AIDS) Centre, Sydney
Abstract:We report on media habits of 797 members of a sample of 1245 injecting drug users interviewed in Sydney, Australia. While preferred hours of television viewing and radio listening were similar to those of the general population, the preferred channels and stations were different. These findings could assist in targeting injecting drug users with information about HIV/AIDS prevention. However as the self-regulatory advertising process has constrained broadcast and publication of overt messages directed at homosexual and bisexual men, similar restrictions may prevent optimal mass media approaches to educating this other important group at risk of HIV infection. (Awl J Public Health 1992; 16: 324-7) roviding informative and motivational messages a b o u t prevention of human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) to people who are injecting drug users and who may share needles with others is a critical component of any comprehensive approach to controlling the spread of this infection. I A national study in 1986 found that injecting drug users were unexceptional in their use of information on AIDS, except that compared to the general population, they considered personal sources of information more effective.' In Sydney, Australia, there are several widely available and read gay newspapers and magazines, gay information radio programs, extensive contact networks in the form of clubs, social groups and newsletters, and a concentration of gay bars, businesses and meeting places in an inner city area and in several other centres. These overt and highly accessible channels of communication have been used extensively by both the gay community and government agencies since the advent of AIDS to publicise preventive information about HIV/AIDS and to foster new norms of safer sexual behaviour.
P
Correspondence to Dr Michael Ross, National Centre in HIV Social Research Unit, 345 Crown Street, Surly Hills, NSW 2010
324
AUSTRALIAN JOURNAL
By contrast, injecting drug users are involved in illegal activities (sale, possession and selfadministration of illicit drugs) and so injecting drug user subculture is far less overt; there are no masscirculation magazines explicitly designed for drug users, meeting places cannot be advertised and injecting drug users are often harassed by the police. In contrast with the highly developed efforts to promote solidarity of concern about HIV/AIDS in the gay community, personal relations among injecting drug users are often characterised by suspiciousness, mistrust and a caveat emptor overlay. Injecting drug users often (but not always) live in poor social conditions, have limited education, are unemployed and have difficult relationships with parents, sexual partners and children. However injecting drug users do have extensive and active networks which are used for propagating information about the quality, price and availability of illicit drugs. These networks have been used creatively for disseminating HIV prevention messages in San Francisco. These factors, together with the scarcity of overt communication channels for the population of injecting drug users, create major difficulties for HIV/AIDS educational efforts. Most educational efforts have been concentrated in offers of counselling to those in contact with treatment services and in modestly funded attempts at outreach via Streetwise comics and newsletters to the partners and associates
OF PUBLIC HEALTH 1992
VOL. 16 NO.
3
MEDIA SOURCES OF HIV INFORMATION
of those injecting drug users known to health workers. In 1989, a network of government-funded state and federal organisations of injecting drug users was established to expand peer-based education. The Department of Community Services and Health has devised several mass media campaigns concerning injecting drug users and HIV/AIDS, with the most recent (1990) consisting of television, radio and print media advertisements presenting the possibility that potential sexual partners may have shared needles and become infected with HIV. This paper reports data on the media habits of a sub-sample (n= 797) selected from 1 245 injecting drug users interviewed in Sydney in 1989.
Method Respondents were obtained in three ways. First, cards describing the study were distributed to known injecting drug users and their associates by health workers. The cards gave the telephone and address of the interview site, and explained that injecting drug users would be paid $A20 for an anonymous interview. Secondly, advertisements with the same message were placed in employment and social security offices, needle exchanges and pharmacies which sold syringes. Thirdly, the same advertisement was placed in a popular, free, central-city magazine. While we have no data on the proportions recruited by each method, t.he interviewers report that a majority heard of the study by contact with other injecting drug users. Interviews took place between May and December 1989 in an unmarked building several blocks from the centre of the drug-using subculture in the Kings Cross-Darlinghurst area of Sydney. The interviews were conducted in a private cubicle by interviewers who had extensive personal or professional experience in the area of injecting drug use. A receptionist took initials of first and surnames and date of birth and where respondents were suspected or recognised as having attended previously, these data were checked to ensure that there was no double interviewing. In addition, interviews were conducted by one interviewer in the western suburbs of Sydney to obtain a broader geographical distribution of injecting drug users; these interviews were conducted at a community health centre under the same conditions. All data were entered on the interview schedule by the interviewer and subsequently analyzed using the SPSS-X package. Statistics used included Spearman’s rank difference correlation coefficient between males and females, and older and younger respondents, and on sources of medical and preventive information on HIV/AIDS. The interview schedule had previously been tested on over 100 injecting drug users and modified as a result. A core section covered demographics, drug use behaviour, use of new equipment or re-use of own equipment, social context of injecting drug use, sexual history, knowledge and attitudes about HIV/ AIDS, sources of information, and antibody testing. Additional modules on treatment, use in prison and on media use were administered to sub-samples.
Response possibilities ranged from closed options to open-ended questions, and all response possibilities were provided on show-cards where appropriate. A copy of the full 36-page interview schedule is available from the first author on request. The interview took an average of one hour to complete. A full description of the methodology has been published elsewhere3. Sample characteristics A total of 1245 respondents were interviewed: these included 908 males, 331 females, and six male to female transexuals. Respondents with birthdates between January and August inclusive (n= 797) were administered the module of questions on media habits. Selected characteristics of the sample are described in Table 1. Mean age for males was 28, females 26. As not all respondents answered all questions, there is some variation in the numbers reported.
Results Respondents were asked to name their preferred sources of information: What sources have you found to be most useful in providing you with information about the medical aspects of AIDSabout how to avoid catching AIDS/where to get needles and syringes etc?
A list of media sources was shown to respondents and they were asked to nominate their preferred sources of information on medical and preventive issues. Table 2 shows those responses where five per cent or more nominated a particular source. There were minimal differences in sources of medical and preventive AIDS information between males and females (Spearman’s p = 0.95 for both medical and preventive information) and between younger and older respondents (p = 0.88). Respondents were also asked to state which mass medium they thought was the most effective through which to deliver education about AIDS to injecting drug users. Of those who answered this question, 77 per cent named television, 12 per cent radio and 6 per cent either newspapers or magazines. Most respondents watched television (88 per cent) and listened to radio (85 per cent), with 81 per cent having a television and 90 per cent a radio in Table 1 : Characteristics of the sample of injecting drug users interviewed about media sources of information
Characteristic Some high school education O n social security benefits Employed full-time Unemployed Australian-born Ever in drug treatment Currently on methadone Ever in prison Intravenous drug use within hours of interview Intravenous drug use within days of interview
AUSTRALIAN JOURNAL OF PUBLIC HEALTH
1992 VOL.16 NO. 3
Percentage of males
Percentage of females
(n=582)
(n=215)
50 53 13 20 80 57 53 43
55 56
16
19
33
31
a
14 82 54 50 20
325
their households. The preferred television channel and radio stations are given in Table 3, and most popular viewing and listening times in Table 4. About half the sample (56 per cent) read newspapers daily, and a further 37 per cent read them weekly. Only 13 per cent read magazines daily, and a further 56 per cent read them weekly. The most popular newspapers were the Sydney Morning Herald (30 per cent), the Daily Telegraph (24 per cent) and the Mirror (18 per cent), with only four magazines reported by more than 5 per cent of respondents as being ‘commonly read’-People (1 0 per cent), Rolling Stone (seven per cent), On the Street (six per cent), and Time (five per cent). Less than one-third of respondents (32 per cent) said that they would be willing to distribute pamphlets about the risks of HIV/AIDS and injecting drug use to other injecting drug users.
Discussion These results must be read with the caveat that they are based on self-report data and cannot be validated. However, interviewers reported that there was no suggestion that a socially desirable report of media use was operating. These data indicate that any assumption that injecting drug users are somehow so disengaged from ordinary life as to not listen to radio, watch television or read newspapers and magazines is misconceived. Like the general population, most injecting drug users prefer to listen to the radio in the morning and watch television at night. However, the stations and channels preferred by injecting drug users differ from those preferred by the general population; while radio 2JJJ had an audience share of only three per cent of the Sydney radio audience in 1989, 32 per cent of the injecting drug user sample named it as their station of choice. Similarly, ABC television in Sydney had an average 11.7 percent of the Sydney television audience in 1989, whereas 34 percent of the injecting drug user sample named the ABC as their preferred station. Unlike commercial radio and television stations in Australia, the ABC frequently broadcasts lengthy, serious documentaries on social issues, including AIDS. Television documentaries were named as the preferred source of information about prevention and medical aspects of HIV/AIDS. This confluence of the injecting drug user sample’s media Table 2: Preferred sources of AIDS information Source
Medical ( n = 78 1 1
Television documentaries Pamphlets AIDS workers Television news Doctors Friends Magazines Otherso
29 18 9 9 8 7 6 14
Preventive ( n = 782)
16 24 12 7 8 8 4
21
Note: la)Television advertisements, radio news, documentaries and advertisements. newspaper news and features, prostitutes, posters, telephone information
326
preferences, their stated preference for television documentaries as a source of information and the documentary broadcasting policy of the ABC suggests that AIDS education directed toward injecting drug users could exploit this nexus. In the recent past, the self-regulatory advertising process in Australia has prevented the broadcast and publication of certain explicit imagery and information about prevention of HIV transmission. For example, over 90 per cent of cases of AIDS reported in Australia by 1990 have been attributed to male homosexual or bisexual contact.* Many gay and bisexual men have little or no contact with overt gay culture5. This suggests that the mass media have an important potential role in the education of men who have sex with other men but who do not identify themselves as homosexual. However, the 1988 Beds national AIDS television advertisement depicted only heterosexual couples in sexual embrace. The selfregulatory body, the Federation of Australian Commercial Television Stations (FACTS) through its Commercial Acceptance Division, refused to accept any advertisement that depicted homosexual men in bed for reasons of taste and decency. Similarly, the Advertising Standards Council ruled in September 1990 that its media members should not publish a Victorian AIDS Council safe sex advertisement that showed two men embracing6 In fact, since television advertisements were first commissioned in Australia in 1987, no large-budget, mass-reach radio or television advertisement explicitly addressing homosexual or bisexual men has been broadcast. Since 1987, some explicit messages about not sharing injecting equipment have been broadcast through a variety of mass media in Australia. Although these messages have been sporadic, possibly lessening their effectiveness, budgetary constraints rather than sensitivity about content were the major factors for this. In 1990, the Department of Community Services and Health in association with the Australian National Council on AIDS targeted the sexual partners of injecting drug users concerning the potential for sexual transmission of HIV. However, there have been few mainstream media campaigns directly relevant to injecting drug users, such as on needle decontamination or needle exchange. It is possible that any attempts to mount such campaigns in the future could invoke objections as did the advertisement showing homosexual men in bed. Despite the not uncommon depiction of male Table 3: Television and radio stations preferred by injecting drug users Television channel
Percentage preferring (n=613)
Radio station
Percentage preferring ( n = 670)
2 9 10 7 SBS
34 27 18 15 6
2JJJ 2MMM 2DAY Skid Row 2SER
32 28 9 5 5 19
AUSTRALIAN JOURNAL OF PUBLIC HEALTH 1992
others
VOL. 16 NO.
3
MEDIA SOURCES OF HIV INFORMATION
homosexuality on television in films, drama and news, in September 1990 the Advertising Standards Council ruled on the Victorian AIDS Council advertisement, stating: whilst ostensibly promoting the use of condoms for safe (or safer) sex, [the advertisement] also advocated a course of behaviour not regarded by the general community as raticinal and which, in certain forms and circumstances, still constitutes an offence under the law. . . the overall tenor of the advertisement . . . was such as to be likely to cause serious offence to a significant section of the community.
This reasoning suggests that any explicit depiction of injecting drug use and especially of the means to render the practice less dangerous would be similarly blocked by the self-regulatory process for advertising. More encouraging, it is well to recall that the source of information most preferred by the sample was television documentaries.. These are not subject to the same constraints that may operate in advertising. Documentaries also do not suffer from the narrow constraints in which advertising messages are confined. Radio 2JJJ (FM), the station preferred by one in three of the injecting drug user sample, is predominantly a music broadcaster, although contemporary social issues like AIDS are regularly included in news and current affairs. 2JJJ has fewer editorial policy constraints as it is not a member of the Federation of Australian Radio Broadcasters, the radio self-regulatory group. From time to time 2JJJ has commendably covered AIDS and injecting drug user issues in considerable depth. However, for the two-thirds of the sample who preferred radio and television stations other than the ABC (and possibly
those injecting drug users who were missed by our sampling procedure), the sanitised and evasive portrayals in national AIDS-control advertising afford little confidence that these media are being used effectively. Of the other stations, 2MMM (FM) plays popular and dance music for a younger audience, and 2DAY (FM) is similar but with more old favorites for an older audience; 2 Skid Row broadcasts from a basement in the inner city and is associated with ex-prisoners, and 2SER is a community station in the inner city with alternative interviews and dance music. These data describe useful media avenues and times to reach injecting drug users, and suggest that the approach of using documentaries might be better than advertising to disseminate information on HIV/ AIDS transmission risk reduction. References 1. Commonwealth of Australia. National HIV/AIDS strategy. Canberra: Australian Government Publishing Service, 1989. 2. Ross MW, Carson JA. Effectiveness of distribution of information on AIDS. A national study of six media in Australia. N Y Slate J Med 1988; 88: 239-4 1. 3. Ross MW, Gold J, Wodak A, Miller ME. STDs in injecting drug users. Genilounn Med 1991; 67: 32-6. 4. Australian HIV Surveillance Report. Canberra: National Centre in HIV Epidemiology and Clinical Research. July 1990; 6(Suppl): 5. 5. Bennett G, Chapman S, Bray F. Sexual practices and ‘beats’: AIDS-related sexual practices in a sample of homosexual and bisexual men in the western area of Sydney. Med J Am1 1989; 151: 309-14. 6. Health S. Advertising watchdog bans AIDS Council’s gay ad. The Age 27 September 1990: 17
AUSTRALIAN JOURNAL OF PUBLIC HEALTH
1992
VOL. 16 NO. 3
327
Simon Chapman Department of Community Medicine, University of Sydney
Alex Wodak Alcohol and Drug Seruice, St Vincent's Hospital, Sydney
Me1 Miller Directorate of the Drug Oflensive, North Sydney
Julian Gold Albion Street (AIDS) Centre, Sydney
Abstract:We report on media habits of 797 members of a sample of 1245 injecting drug users interviewed in Sydney, Australia. While preferred hours of television viewing and radio listening were similar to those of the general population, the preferred channels and stations were different. These findings could assist in targeting injecting drug users with information about HIV/AIDS prevention. However as the self-regulatory advertising process has constrained broadcast and publication of overt messages directed at homosexual and bisexual men, similar restrictions may prevent optimal mass media approaches to educating this other important group at risk of HIV infection. (Awl J Public Health 1992; 16: 324-7) roviding informative and motivational messages a b o u t prevention of human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) to people who are injecting drug users and who may share needles with others is a critical component of any comprehensive approach to controlling the spread of this infection. I A national study in 1986 found that injecting drug users were unexceptional in their use of information on AIDS, except that compared to the general population, they considered personal sources of information more effective.' In Sydney, Australia, there are several widely available and read gay newspapers and magazines, gay information radio programs, extensive contact networks in the form of clubs, social groups and newsletters, and a concentration of gay bars, businesses and meeting places in an inner city area and in several other centres. These overt and highly accessible channels of communication have been used extensively by both the gay community and government agencies since the advent of AIDS to publicise preventive information about HIV/AIDS and to foster new norms of safer sexual behaviour.
P
Correspondence to Dr Michael Ross, National Centre in HIV Social Research Unit, 345 Crown Street, Surly Hills, NSW 2010
324
AUSTRALIAN JOURNAL
By contrast, injecting drug users are involved in illegal activities (sale, possession and selfadministration of illicit drugs) and so injecting drug user subculture is far less overt; there are no masscirculation magazines explicitly designed for drug users, meeting places cannot be advertised and injecting drug users are often harassed by the police. In contrast with the highly developed efforts to promote solidarity of concern about HIV/AIDS in the gay community, personal relations among injecting drug users are often characterised by suspiciousness, mistrust and a caveat emptor overlay. Injecting drug users often (but not always) live in poor social conditions, have limited education, are unemployed and have difficult relationships with parents, sexual partners and children. However injecting drug users do have extensive and active networks which are used for propagating information about the quality, price and availability of illicit drugs. These networks have been used creatively for disseminating HIV prevention messages in San Francisco. These factors, together with the scarcity of overt communication channels for the population of injecting drug users, create major difficulties for HIV/AIDS educational efforts. Most educational efforts have been concentrated in offers of counselling to those in contact with treatment services and in modestly funded attempts at outreach via Streetwise comics and newsletters to the partners and associates
OF PUBLIC HEALTH 1992
VOL. 16 NO.
3
MEDIA SOURCES OF HIV INFORMATION
of those injecting drug users known to health workers. In 1989, a network of government-funded state and federal organisations of injecting drug users was established to expand peer-based education. The Department of Community Services and Health has devised several mass media campaigns concerning injecting drug users and HIV/AIDS, with the most recent (1990) consisting of television, radio and print media advertisements presenting the possibility that potential sexual partners may have shared needles and become infected with HIV. This paper reports data on the media habits of a sub-sample (n= 797) selected from 1 245 injecting drug users interviewed in Sydney in 1989.
Method Respondents were obtained in three ways. First, cards describing the study were distributed to known injecting drug users and their associates by health workers. The cards gave the telephone and address of the interview site, and explained that injecting drug users would be paid $A20 for an anonymous interview. Secondly, advertisements with the same message were placed in employment and social security offices, needle exchanges and pharmacies which sold syringes. Thirdly, the same advertisement was placed in a popular, free, central-city magazine. While we have no data on the proportions recruited by each method, t.he interviewers report that a majority heard of the study by contact with other injecting drug users. Interviews took place between May and December 1989 in an unmarked building several blocks from the centre of the drug-using subculture in the Kings Cross-Darlinghurst area of Sydney. The interviews were conducted in a private cubicle by interviewers who had extensive personal or professional experience in the area of injecting drug use. A receptionist took initials of first and surnames and date of birth and where respondents were suspected or recognised as having attended previously, these data were checked to ensure that there was no double interviewing. In addition, interviews were conducted by one interviewer in the western suburbs of Sydney to obtain a broader geographical distribution of injecting drug users; these interviews were conducted at a community health centre under the same conditions. All data were entered on the interview schedule by the interviewer and subsequently analyzed using the SPSS-X package. Statistics used included Spearman’s rank difference correlation coefficient between males and females, and older and younger respondents, and on sources of medical and preventive information on HIV/AIDS. The interview schedule had previously been tested on over 100 injecting drug users and modified as a result. A core section covered demographics, drug use behaviour, use of new equipment or re-use of own equipment, social context of injecting drug use, sexual history, knowledge and attitudes about HIV/ AIDS, sources of information, and antibody testing. Additional modules on treatment, use in prison and on media use were administered to sub-samples.
Response possibilities ranged from closed options to open-ended questions, and all response possibilities were provided on show-cards where appropriate. A copy of the full 36-page interview schedule is available from the first author on request. The interview took an average of one hour to complete. A full description of the methodology has been published elsewhere3. Sample characteristics A total of 1245 respondents were interviewed: these included 908 males, 331 females, and six male to female transexuals. Respondents with birthdates between January and August inclusive (n= 797) were administered the module of questions on media habits. Selected characteristics of the sample are described in Table 1. Mean age for males was 28, females 26. As not all respondents answered all questions, there is some variation in the numbers reported.
Results Respondents were asked to name their preferred sources of information: What sources have you found to be most useful in providing you with information about the medical aspects of AIDSabout how to avoid catching AIDS/where to get needles and syringes etc?
A list of media sources was shown to respondents and they were asked to nominate their preferred sources of information on medical and preventive issues. Table 2 shows those responses where five per cent or more nominated a particular source. There were minimal differences in sources of medical and preventive AIDS information between males and females (Spearman’s p = 0.95 for both medical and preventive information) and between younger and older respondents (p = 0.88). Respondents were also asked to state which mass medium they thought was the most effective through which to deliver education about AIDS to injecting drug users. Of those who answered this question, 77 per cent named television, 12 per cent radio and 6 per cent either newspapers or magazines. Most respondents watched television (88 per cent) and listened to radio (85 per cent), with 81 per cent having a television and 90 per cent a radio in Table 1 : Characteristics of the sample of injecting drug users interviewed about media sources of information
Characteristic Some high school education O n social security benefits Employed full-time Unemployed Australian-born Ever in drug treatment Currently on methadone Ever in prison Intravenous drug use within hours of interview Intravenous drug use within days of interview
AUSTRALIAN JOURNAL OF PUBLIC HEALTH
1992 VOL.16 NO. 3
Percentage of males
Percentage of females
(n=582)
(n=215)
50 53 13 20 80 57 53 43
55 56
16
19
33
31
a
14 82 54 50 20
325
their households. The preferred television channel and radio stations are given in Table 3, and most popular viewing and listening times in Table 4. About half the sample (56 per cent) read newspapers daily, and a further 37 per cent read them weekly. Only 13 per cent read magazines daily, and a further 56 per cent read them weekly. The most popular newspapers were the Sydney Morning Herald (30 per cent), the Daily Telegraph (24 per cent) and the Mirror (18 per cent), with only four magazines reported by more than 5 per cent of respondents as being ‘commonly read’-People (1 0 per cent), Rolling Stone (seven per cent), On the Street (six per cent), and Time (five per cent). Less than one-third of respondents (32 per cent) said that they would be willing to distribute pamphlets about the risks of HIV/AIDS and injecting drug use to other injecting drug users.
Discussion These results must be read with the caveat that they are based on self-report data and cannot be validated. However, interviewers reported that there was no suggestion that a socially desirable report of media use was operating. These data indicate that any assumption that injecting drug users are somehow so disengaged from ordinary life as to not listen to radio, watch television or read newspapers and magazines is misconceived. Like the general population, most injecting drug users prefer to listen to the radio in the morning and watch television at night. However, the stations and channels preferred by injecting drug users differ from those preferred by the general population; while radio 2JJJ had an audience share of only three per cent of the Sydney radio audience in 1989, 32 per cent of the injecting drug user sample named it as their station of choice. Similarly, ABC television in Sydney had an average 11.7 percent of the Sydney television audience in 1989, whereas 34 percent of the injecting drug user sample named the ABC as their preferred station. Unlike commercial radio and television stations in Australia, the ABC frequently broadcasts lengthy, serious documentaries on social issues, including AIDS. Television documentaries were named as the preferred source of information about prevention and medical aspects of HIV/AIDS. This confluence of the injecting drug user sample’s media Table 2: Preferred sources of AIDS information Source
Medical ( n = 78 1 1
Television documentaries Pamphlets AIDS workers Television news Doctors Friends Magazines Otherso
29 18 9 9 8 7 6 14
Preventive ( n = 782)
16 24 12 7 8 8 4
21
Note: la)Television advertisements, radio news, documentaries and advertisements. newspaper news and features, prostitutes, posters, telephone information
326
preferences, their stated preference for television documentaries as a source of information and the documentary broadcasting policy of the ABC suggests that AIDS education directed toward injecting drug users could exploit this nexus. In the recent past, the self-regulatory advertising process in Australia has prevented the broadcast and publication of certain explicit imagery and information about prevention of HIV transmission. For example, over 90 per cent of cases of AIDS reported in Australia by 1990 have been attributed to male homosexual or bisexual contact.* Many gay and bisexual men have little or no contact with overt gay culture5. This suggests that the mass media have an important potential role in the education of men who have sex with other men but who do not identify themselves as homosexual. However, the 1988 Beds national AIDS television advertisement depicted only heterosexual couples in sexual embrace. The selfregulatory body, the Federation of Australian Commercial Television Stations (FACTS) through its Commercial Acceptance Division, refused to accept any advertisement that depicted homosexual men in bed for reasons of taste and decency. Similarly, the Advertising Standards Council ruled in September 1990 that its media members should not publish a Victorian AIDS Council safe sex advertisement that showed two men embracing6 In fact, since television advertisements were first commissioned in Australia in 1987, no large-budget, mass-reach radio or television advertisement explicitly addressing homosexual or bisexual men has been broadcast. Since 1987, some explicit messages about not sharing injecting equipment have been broadcast through a variety of mass media in Australia. Although these messages have been sporadic, possibly lessening their effectiveness, budgetary constraints rather than sensitivity about content were the major factors for this. In 1990, the Department of Community Services and Health in association with the Australian National Council on AIDS targeted the sexual partners of injecting drug users concerning the potential for sexual transmission of HIV. However, there have been few mainstream media campaigns directly relevant to injecting drug users, such as on needle decontamination or needle exchange. It is possible that any attempts to mount such campaigns in the future could invoke objections as did the advertisement showing homosexual men in bed. Despite the not uncommon depiction of male Table 3: Television and radio stations preferred by injecting drug users Television channel
Percentage preferring (n=613)
Radio station
Percentage preferring ( n = 670)
2 9 10 7 SBS
34 27 18 15 6
2JJJ 2MMM 2DAY Skid Row 2SER
32 28 9 5 5 19
AUSTRALIAN JOURNAL OF PUBLIC HEALTH 1992
others
VOL. 16 NO.
3
MEDIA SOURCES OF HIV INFORMATION
homosexuality on television in films, drama and news, in September 1990 the Advertising Standards Council ruled on the Victorian AIDS Council advertisement, stating: whilst ostensibly promoting the use of condoms for safe (or safer) sex, [the advertisement] also advocated a course of behaviour not regarded by the general community as raticinal and which, in certain forms and circumstances, still constitutes an offence under the law. . . the overall tenor of the advertisement . . . was such as to be likely to cause serious offence to a significant section of the community.
This reasoning suggests that any explicit depiction of injecting drug use and especially of the means to render the practice less dangerous would be similarly blocked by the self-regulatory process for advertising. More encouraging, it is well to recall that the source of information most preferred by the sample was television documentaries.. These are not subject to the same constraints that may operate in advertising. Documentaries also do not suffer from the narrow constraints in which advertising messages are confined. Radio 2JJJ (FM), the station preferred by one in three of the injecting drug user sample, is predominantly a music broadcaster, although contemporary social issues like AIDS are regularly included in news and current affairs. 2JJJ has fewer editorial policy constraints as it is not a member of the Federation of Australian Radio Broadcasters, the radio self-regulatory group. From time to time 2JJJ has commendably covered AIDS and injecting drug user issues in considerable depth. However, for the two-thirds of the sample who preferred radio and television stations other than the ABC (and possibly
those injecting drug users who were missed by our sampling procedure), the sanitised and evasive portrayals in national AIDS-control advertising afford little confidence that these media are being used effectively. Of the other stations, 2MMM (FM) plays popular and dance music for a younger audience, and 2DAY (FM) is similar but with more old favorites for an older audience; 2 Skid Row broadcasts from a basement in the inner city and is associated with ex-prisoners, and 2SER is a community station in the inner city with alternative interviews and dance music. These data describe useful media avenues and times to reach injecting drug users, and suggest that the approach of using documentaries might be better than advertising to disseminate information on HIV/ AIDS transmission risk reduction. References 1. Commonwealth of Australia. National HIV/AIDS strategy. Canberra: Australian Government Publishing Service, 1989. 2. Ross MW, Carson JA. Effectiveness of distribution of information on AIDS. A national study of six media in Australia. N Y Slate J Med 1988; 88: 239-4 1. 3. Ross MW, Gold J, Wodak A, Miller ME. STDs in injecting drug users. Genilounn Med 1991; 67: 32-6. 4. Australian HIV Surveillance Report. Canberra: National Centre in HIV Epidemiology and Clinical Research. July 1990; 6(Suppl): 5. 5. Bennett G, Chapman S, Bray F. Sexual practices and ‘beats’: AIDS-related sexual practices in a sample of homosexual and bisexual men in the western area of Sydney. Med J Am1 1989; 151: 309-14. 6. Health S. Advertising watchdog bans AIDS Council’s gay ad. The Age 27 September 1990: 17
AUSTRALIAN JOURNAL OF PUBLIC HEALTH
1992
VOL. 16 NO. 3
327
