This blog focuses on a series of articles that appeared in the Sowetan last week: “HIV Man Grows Boobs” Condition a side-effect of ARV’s, Sowetan, October 31 st 2007 p1, "Man beats his breasts over ARV effects", Sowetan, October 31 st, 2007, p 5 and “HIV drugs can swell glands”, Sowetan, October 31 st, 2007, p 5.

Both the Treatment Action Campaign and Dr Francois Venter have issued statements in response to these articles. Both statements draw attention to the misleading, inaccurate information about anti-retroviral therapy the article contains and the dangerous consequences for the country’s treatment campaign.

What should also be noted are the powerful effects of images in shaping how people perceive and respond to the epidemic. The Sowetan chose to use an image of a man suffering from gynaecomastia on its front page. The man appears in the image without a shirt, his face partially obscured by a black box, presumably in order to protect his identity. Most prominent are his exposed breasts. This man, who is termed in the headline “HIV Man”, is reduced to his HIV positive status and what the paper depicts as the “freakish” side-effects of ARV drugs. The image and accompanying caption draws a connection between HIV and AIDS and abnormality.

The front-page photograph and screaming headline provide disproportionate coverage of a condition that only serves to compound fear and misunderstanding about ARV treatment. By granting this story disproportionate coverage, the Sowetan has given the impression to its readers that gynaecomastia is common among people who take ARVs and provides no information about how the condition can be treated. Surely some readers will look at the story and think: “If I take ARVs, I will grow breasts.” And this shouldn’t be unexpected as it is only towards the end of the article that the writer begins to suggest that this is not a common problem.

We asked Dr Glenda Gray at the Perinatal HIV Research Unit for her perspective on gynaecomastia resulting from ARV treatment. She said:

“Gynaecomestia is one of the most common body disorders in men irrespective of HIV status. Gynaecomestia is the medical condition and about 40-60 percent of males are affected by it. It has also been associated with ARV treatments like D4T, ddI and EFV. The person with gynaecomastia should discuss his treatment options with his health provider, in some cases it is reversible even on treatment, in some cases it is reversible when medication is switched, in some cases it may not be reversible. I suppose with ARV medication, there are risks and benefits, the benefits are survival, the risks are the side-effects one sees with long term therapy. With limited treatment options (first line containing D4T), we do expect to see metabolic side-effects, which need to be managed depending, if the side effect is severe, the medication should be switched, if it can be managed, then you want to preserve your first line. Sometimes when your choice is limited your choice is living with the manageable side effects, or dying from a life threatening disease. If I was in this person’s shoes, I would choose boobs!”

The Sowetan plans a series of articles on the side-effects of anti-retroviral drugs. Without changing the ways in which people living with HIV and AIDS are represented the side-effects of media coverage are far worse than anything that can be caused by ARV treatment. This kind of coverage perpetuates the fear and stigma around HIV/AIDS and further ostracizes people living with HIV.

How can the tabloid media improve its coverage of HIV/AIDS? Here are three simple suggestions:

Put the person before the disease. The Daily Sun and the Sowetan claim to be newspapers for the people, and yet frequently refer to people living with HIV as “HIV MAN” or “HIV GIRL”. One way to prove that you are actually papers for the people would be to stop dehumanizing people and instead put the person before the disease, as in “Mandla Ngcobo, who is HIV-positive.”

• Ask readers to share their stories about living with HIV. You could call on your readers to share their stories about how they are living with HIV. If people could see a photo of and read about someone who was living healthily with HIV, it may alleviate some of the fear so many South Africans are living with, and might even encourage people to get tested.
• Start a campaign to encourage people to get tested. Steal a page out of the Sunday Times by using your massive popularity to encourage people to take an HIV test. Considering the number of people who read the Daily Sun and The Sowetan, a campaign like this could play a role in reducing the number of new HIV infections in South Africa .

Brendan Kennedy and Kylie Thomas