Anti-Syphilis Campaign Toned Down

A smiling cartoon penis will star in a syphilis awareness campaign to be unveiled this week in San Francisco to stem sharp increases in the sexually transmitted disease among gay men.

But the “Healthy Penis 2002” campaign--and its motto, “Making every penis a healthy penis”--has been rejected in Los Angeles County because health officials say it is too racy, demeaning to the gay community and potentially offensive to others.

In its place, the county and a coalition of community groups launched a less explicit anti-syphilis campaign last week, using the theme “Stop the Sores.” Although the campaign doesn’t feature a penis, it has its own cartoon character, a fierce-looking red sore nicknamed Phil. (Sores are one of the telltale signs of early syphilis.)

The dueling approaches by the state’s two largest health departments show how cultural differences between Northern and Southern California surface even in safe-sex campaigns. San Francisco often embraces the risque; Los Angeles tends to be more cautious.

“How can you have a campaign talking about syphilis and not talk about where the sores show up--on the penis?” said Steven Gibson, program manager of Castroguys, a gay men’s health project in San Francisco. “Penis is not a vulgar word.”

Les Pappas, creative director of Better World Advertising, which designed both “Healthy Penis” and “Stop the Sores,” said Los Angeles officials place a high importance on “not rocking the boat, on protecting their jobs, avoiding controversy almost at any cost.”

“The result is that it’s very hard, close to impossible, to do really meaningful stuff, because it requires challenging the norms and ... talking about sex in ways that will captivate people’s attention and interest and be relevant to them,” Pappas said. “The county has pretty much said that they can’t handle that.”

Officials at the Los Angeles County Department of Health Services said the “Healthy Penis” theme stigmatized gay men. They also were concerned that the campaign might offend people who are not gay.

“We decided that, on balance, the likely benefit in terms of reaching the population we’re trying to reach didn’t outweigh the downside of those people that would find this objectionable,” said John Schunhoff, chief of public health operations for the agency.

Concern About Gay Men

Schunhoff also said that some officials feared that “the penis actually sort of objectified gay men as penises, which was a concern.”

Instead, the county settled on Phil, a bumpy red creature with silver shoes and an earring. The Los Angeles County campaign includes ads in gay publications, 40,000 squeezable three-inch Phil toys and two life-size mascots of the character that will make appearances throughout Los Angeles.

Los Angeles AIDS service groups say the county, which is spending $394,000 on this syphilis campaign, is afraid to take chances. The “Healthy Penis” proposal was endorsed by a coalition of six gay and AIDS organizations.

“We saw this as an effective way to shock people into paying attention, but it was also a very playful campaign and a very positive campaign,” said Terri Ford, director of prevention programs for the AIDS Healthcare Foundation in Los Angeles. “This campaign was supposed to be driven by the community, and the community is not getting what it wants.”

Ford also criticized the county for waiting eight months to approve funding for the campaign after identifying syphilis awareness as a priority last August. County officials acknowledge the wait was too long.

Dr. Jeffrey Klausner, director of sexually transmitted disease control in San Francisco, said his office favored the “Healthy Penis” campaign, which will cost his agency about $50,000, because its messages are “fun.”

“We clearly heard from the community that it’s time to stop focusing on negative aspects of health and start promoting healthy behavior,” Klausner said.

Without mentioning Los Angeles County, he also criticized government agencies that “don’t listen to their communities and don’t respond to what the community is asking for.”

Even in San Francisco, however, not everyone is embracing the cartoon penis image. Viacom Outdoor objected to using the penis image on bus shelter advertisements, but has allowed the slogan “Healthy Penis 2002” to appear in the ads that went up this week in five bus shelters in the Castro area.

“I just said, tone it down to what I felt would be acceptable to the public in that area,” said Patrick Roche, vice president and regional manager for Viacom Outdoor.

San Francisco AIDS groups, meanwhile, have drawn scrutiny from federal officials, some of whom think their promotions cross the line of decency. At least one Bay Area group has been audited by the U.S. Department of Health and Human Services, and additional audits are expected. Los Angeles hopes to avoid such scrutiny.

Earlier this year, Los Angeles health officials rejected a billboard featuring a bare-chested man and the slogan “I believe in sex” that was to be included in the “HIV Stops With Me” campaign.

San Francisco officials endorsed a federally funded television commercial whose opening line, “I believe in sex,” was uttered by a shirtless model.

Terry Leftgoff, 43, who was featured on the banned billboard, said Los Angeles County “injected moral judgment into public health. They have become responsible for increasing the risky behaviors that they have been charged with helping reduce.”

Ad Called Inappropriate

Charles Henry, director of the county’s Office of AIDS Programs and Policy, said the billboard did not meet federal standards and was inappropriate for the neighborhoods in which it was slated to run.

“I was not convinced that the ‘I believe in sex’ component was sufficiently educational,” he said. “I felt it was more titillating than educating.”

Though syphilis is treatable with antibiotics, health officials are worried because its sores greatly facilitate the spread of HIV. Both Los Angeles and San Francisco have seen substantial increases in syphilis cases, and both have been searching for solutions. As of Friday, Los Angeles County had reported 209 early syphilis cases, of which 122 were among gay or bisexual men. Cases are up 37% from last year at this time. From January to May, San Francisco reported 180 cases of early syphilis, of which 141 were among gay or bisexual men.