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Culture War Roundup for the week of January 2, 2023

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Every once in a while I'll get random YouTube pre-rolls for very vague pharmaceutical ads that are generally targeted at LGBTQ communities. Entire ad campaigns that are purely aspirational and don't even mention what the drug is supposed to do. I'm thinking there might be a bit of an info bubble where people in those communities have a decent idea about the different drugs as products and it's more about establishing brand identity. More recently at my office in the break area where all manner of magazines are left lying around I noticed a full page advertisement in a similar vein (Men's Health May-June 2022 issue, pg41 so not that old). Effectively the same as the first page of this brochure.

While it was at least more straightforward about the purpose of the drug, the ad campaign slogan "detect this" and the 2017 "U=U" (Undetectable = Untransmissible) campaign (bonus CW, Fauci is apparently a big promoter) both seem to have a similar info bubble. In this case slightly different. I can understand how for people who are very aware of HIV and fret about things like detectable viral load then the messaging of undetectable being functionally untransmissible is more along the lines of "X rights are human rights" slogan.

But did anyone involved consider how a normie might parse "undetectable" in conjunction with HIV? That it might convey a sense of other people not being able to find out about the infection, even when those "other people" include partners? Which is not some hypothetical, the pull quotes from an article about a paywalled research article. Meanwhile an AMA Journal of Ethics article looking at the merits and drawbacks (reads like a position paper but apparently it merits peer review) didn't even consider whether or not attitudes about disclosure could be a drawback. Of course duty to disclose is itself an ethical question, so whether or not a campaign affects whether or not people fulfill it can be sidelined by not considering either of those questions relevant.

Not my circus, not my monkeys but from the outside I feel like the possible implication of encouraging sneaky fuckers who cannot be caught because they cannot be detected (especially since consent and disclosure get heavily emphasized in other areas of sexual ethics) might be a bad thing. And I'm sure there have been heated conversations about it internally but the polished, pharma+government+activist PR campaigns present a rather unified picture and criticism is hard to find (U=U also has terrible SEO and typed out is equally generic). From the U=U campaign presser I linked, here is how the opposition is presented:

But what about the naysayers? Those who donā€™t believe in U=U or have concerns? Some were contacted and declined to comment. However, Gina Brown, an activist from New Orleans who is living with HIV, says, ā€œIn the beginning I had some reservations about this message. I wasnā€™t really sure how it worked. To me it was almost too good to be true. I didnā€™t want to give PLHIV the wrong information or information that could get them into trouble. [Editor's Note: Louisiana is a state that criminalizes the intentional exposure of another person to HIV/ AIDS through sexual contact. But, despite the language in the statute, Louisiana courts have found that neither the intent to transmit HIV nor actual transmission is required. See hivlawandpolicy.org/states/louisiana]. You would think that Iā€™d be an initial believer; after all, I had a daughter who was proof that treatment works. I was on 076 [the study demonstrating that giving AZT to pregnant moms and babies cut the risk of transmission by two-thirds], plus the fact Iā€™d been in a relationship where we made a conscious decision to not use barriers and the guy never acquired HIV. I was undetectable during that time, as I am now. I happened to meet Bruce Richman in Florida at USCA [the U.S. Conference on AIDS] and we had an in-depth conversation about U=U. He told me where I could find credible information that would spell U=U out clearly. I devoured this information, joined the U=U Facebook page and became a member of the U=U Steering Committee. I am a true believer that if a PLHIV is undetectable they cannot transmit the virus. Thatā€™s why itā€™s important that every PLHIV have access to this information and the medications that makes U=U a possibility in their lives!ā€

But did anyone involved consider how a normie might parse "undetectable" in conjunction with HIV?

There are some different connotations inside the community that are easy to forget, but I don't think that's the problem.

Unfortunately, in this case as with a lot of HIV-adjacent stuff, it's the FDA's circus and the FDA's barrels of monkeys. If there's one thing that's more powerful than the general progressive interest in fixing linguistic problems or 'problems', it's a health and safety bureaucrat who has thirty forms requiring that you spell out "Yes" instead of putting down a "Y". So a lot of the various linguistic hoops and acronymization is some marketing monkey trying to turn a sow's ear into a silk purse, and often not doing a terribly good job.

((It could be worse; the other common term of art was 'suppressed', for low-but-above-threshold results, and I invite you to think of as many amongus memes as possible for the counterfactual world where they tripped over that. This isn't specific to this matter: compare condoms in general and 'female' condoms in specific for an area with a ton of available optimizations, which you might as well try to flap your arms to fly.))

That raises other concerns -- it's very unlikely that the traditional detection envelop is also coincidentally the exact place where rates of transmission plummet -- but that falls into the general class of "FDA makes people search under lampposts" problem.

That it might convey a sense of other people not being able to find out about the infection, even when those "other people" include partners?

That's true, but I'm not sure it's very well-connected to the specific marketing here: if various IRBs prohibited the initial studies being used to justify U=U to such a point the marketing never got dreamt up to begin with, it's not like someone taking a discrete blood sample from a deceptive sexual partner would have returned a different result. And it's not like any level of sugarcoating things for HIV-suppressing drugs would have made it harder to guess: maintaining a good idea of what amount of HIV is floating around in the blood is kinda important for making sure the dose and utilization is right to start with.

[Editor's Note: Louisiana is a state that criminalizes the intentional exposure of another person to HIV/ AIDS through sexual contact. But, despite the language in the statute, Louisiana courts have found that neither the intent to transmit HIV nor actual transmission is required. See hivlawandpolicy.org/states/louisiana]

That's some activist-speak. Actually follow through the various links, and you'll find that they're referencing this case (cw: violent rape), which held law prohibiting intentional exposure only requires intent to commit an act which exposed someone to HIV.

Every once in a while I'll get random YouTube pre-rolls for very vague pharmaceutical ads that are generally targeted at LGBTQ communities.

I'm kinda impressed at how bad the YouTube ad engine gets, given you're seeing these and I keep getting Manly Man's Soap ones.

On a CW note, and thinking out loud, what is going on with men where someone is profiting by branding soap as distinctly masculine? Is this downstream of targeted advertising in the internet age ? I guess Irish Springā€™s, ā€œManly, yes, but she likes it, too,ā€ from the ā€˜80s suggests this has been around much longer.

I do wish mild ill on that dollar-store T.J. Miller from the Dr. Squatch YouTube ads ā€” like he realizes he bought sweet pickles instead of dill after biting into a sandwich.

Tangent-to-a-tangent below.

The Dr. Squatch adds are part of a certain streak of marketing that can be described as "tongue in cheek hyper-masculine." The other ones that come quickly to mind are the various, heavily-punned male grooming devices (Gronk did a couple of commercials for one), and beef jerky. The themes of the adds are all fundamentally the same "be a manly man by buying this product ... here are a bunch of pun-ny dick jokes and comic book illustrations of masculinity; chopping wood, wrestling a bear, etc." They stop far short of any actual violence, and the entire air of the ads are always meant to be comical.

So, it's safe-for-kids masculinity. It's not actually genuine or earnest. It's the little boy wearing his dad's work shoes and pretending to "go to the business factory." And this is why a lot of these ads are not-so-secretly hated by traditional masculinity oriented men - because they infantilize the men in them and the men who would buy the products. I'm trying to picture my WW2 vet Grandfather coming home to his wife and saying "look, honey, I bought the MAN soap!" I can, however, easily picture a Laptop Class San Franciscan showing off his "Warrior Berkenstocks" with genuine pride ... because I saw that happen in 2016.

Tin-foil-hat me sometimes thinks this is part of a radical feminist agenda (I told you I was wearing that hat at the beginning of that sentence!) That these advertisers want to create a "dress up pretend fund time" version masculinity that lets husbands and fathers feel like men ... but never, ever lets let actually develop self-assured independent traits that could break them out of the matriarchal dominance of the wives / mothers (often the same person functionally).

Then again, I'm waxing philosophic about men's soap on the internet. I'll go outside and fuck a bear now.

I'll go outside and fuck a bear now.

What kind of man doesn't have a bear inside the house?

Once you're married, dead bears inside (rugs, heads, etc) and live ones outside is a compromise you have to make. (and who fucks a dead bear? Don't answer that.)