I Am Worth... (1995)

Self Esteem Issues Tackled in "I Am Worth..." HIV Prevention Campaign

Historic Collaboration Targets Injection Drug Users and Their Partners

SAN FRANCISCO, CA, 1995 -- A bold new print and television HIV-prevention campaign created by four San Francisco social service agencies targets substance users and their partners with self-image enhancing messages designed to support their ability to reduce their risk for HIV infection.

"Our aim is to affirm injection substance users' belief in themselves, and to demonstrably value their worth as a person capable of changing their behavior," said MacArthur H. Flournoy, Prevention Manager at the San Francisco AIDS Foundation. "The goal of this campaign is to elevate their self-esteem, leading to a healthier self concept and resulting risk reduction behavior changes."

Presented in multiple phases, this campaign, titled "I Am Worth...," kicked off with a series of billboards, bus shelter posters, point of purchase posters, 15- and 30-second public service announcements, and a three-minute educational video. All include messages in an easy-to-understand, conversational style, and images of the target population which includes gay men and lesbians, teenagers, transgenders, substance users and the homeless.

One poster shows a young African-American transgender woman, and says, "I am worth loving. I believe in who I am. I practice safe sex so I can stay healthy. I wouldn't want to face the physical and emotional ordeal that comes with having AIDS." Another shows a young woman and her child, and says, "I am worth peace of mind." The story reveals the mother’s fierce pride in her ability to care for her daughter.

A third poster shows an African-American woman and her teenage son and daughter, and says, "I am worth protection." It goes on: "My kids don't use drugs. They how that I use. They know I keep clean needles. They know I don’t share …"

At the bottom, each poster asks, "What Are You Worth?"

In addition to the San Francisco AIDS Foundation, which is focusing on gay and bisexual men who have sex with men, agencies participating in the collaboration are: the Tenderloin AIDS Resource Center (which focuses on the African-American transgender population), the Haight Ashbury Free Clinic/Haight Ashbury Youth Outreach Team (focusing on youth), and the IRIS Center for Women (focusing on African-American women).

Flournoy said issues faced by these populations include a high degree of polysubstance abuse, homelessness, severely compromised health, poverty, injection substance abuse joblessness and risk for violent crime.

"In general, the outcome of these challenges is a critically diminished sense of self-worth," Flournoy said. "Studies show this population, which is often on the outskirts of society, has the technical information necessary to reduce risk for HIV transmission, but often lacks the will and desire to do so. By affirming and elevating self-worth first, we will then be able to advocate behavior change."

Following the introductory six weeks, the campaign will kick into Phase II, an eight week presentation --  through similar media --  of the core prevention message, including options and alternatives. Phase III will focus on behavior changes, and will be a six-week campaign touting the integration of self-worth with improved self-care.

"As a former substance abuser and someone living with HIV, I know from personal experience that heightened self-worth gives life," Flournoy said. "For me that's the bottom line."

City health officials long have considered specifically targeted HIV prevention messages to be effective in creating behavior changes. In its December 1, 1994 report, the Mayor's Joint Task Force on the HIV Epidemic noted, "Prevention/education efforts must be culturally and linguistically appropriate and must be sensitive to the diversity within, as well as between, populations. Community-based and community-specific interventions are best suited for these needs. Advocates express widespread support for sustained, peer-based and small group interventions and outreach that give special attention to psychosocial issues beyond behavior change, such as grief, self-esteem, family support and community membership."

The $31,000 campaign is part of the $1.3 million, nine-agency AIDS Prevention Collaboration funded since April, 1994 by the Centers for Disease Control and Prevention and designed to help local AIDS service organizations in U.S. communities work together to create education and prevention campaigns. "I Am Worth..." arises from the four-agency, community level intervention component for drug users and their partners. The San Francisco AIDS Foundation is the fiscal agent for the collaboration.

The campaign was designed by Raul Cabra and photographed by Leslie Hirsch, under the aegis of the collaborative partners. Advertising firm J. Walter Thompson donated production services totaling $100,000. The Gannett Co. has donated $ 180,000 worth of outdoor ad space and King, Brown and Associates offered nearly $50,000 in evaluation services.