Positive representations? A content analysis of imagery in direct-to consumer HIV drug advertisements from 1997-2005

Since the introduction of direct-to-consumer (DTC) drug advertising, there have been debates about ads' representations of people with HIV/AIDS and the effect on risk behaviors. A 2001 study indicated that those who reported being exposed to HIV/AIDS drug ads believed the ads might contribute to a more nonchalant attitude about the disease and decreased safe sex practices (Klausner et al., 2002). In April 2001, the U.S. federal drug regulatory agency (FDA) released an advisory to drug companies cautioning them to make sure the models in drug ads were “representative” of HIV patients.

This study examines whether HIV/AIDS DTC ads changed after the 2001 FDA advisory. We content analyze imagery in HIV/AIDS drug advertisements from The Advocate and Poz. A sample of issues from both magazines from 1997 to 2005 yielded 250 non-unique ads. The FDA's criticism had centered on overly “robust,” “buff” and “athletic” bodies in athletic gear and/or engaged in athletic or other activities that downplayed potential side effects of the medications. Two coders recorded fitness level for each model depicted in the image (Krippendorff's Alpha = .97). We compared the mean fitness scores for models in ads that appeared before and after the FDA advisory. HIV drug ads tended to depict less fit looking models after the 2001 advisory, F(1, 395)=32.8, p<.001. Models were also less likely to be portrayed engaging in physical activity F(1, 248 ) =171.5, p<.001, suggesting the drug companies' changed their advertising practices after the FDA advisory.