LONDON -- The young man has just learned he has AIDS. Sitting in the doctor's office, he remembers in a flashback how he became infected.
The camera shows a close-up of a bloodied needle being pulled from a forearm. Blood squirts from the syringe onto a newspaper, and then the needle is passed along to a second person for a drug fix. As the needle pricks the vein of the second forearm, the young man in the doctor's office covers his face.
The message: "Just one fix with an infected needle will really get you out of it. Don't inject AIDS."
This graphic, shocking and even lurid commercial began appearing on British television this month. It met with no government resistance whatsoever, for the commercial was produced by the British government itself.
It is part of the latest and most hard-hitting stage of a massive British AIDS information campaign that began last January with the mailing of a leaflet to every household in the country. The pamphlet, titled "Don't Die of Ignorance," explained how the virus is transmitted and how to protect oneself. It contained such words as "vaginal and anal sex," "semen" and "condoms."
As the global epidemic spreads, many countries in Europe are launching aggressive public education programs to stop the spread of the virus that causes acquired immune deficiency syndrome.
France, which has the second-highest number of reported AIDS cases after the United States, has embarked on a broad information effort that takes a more subtle, less shocking approach than the British campaign.
The Soviet Union, too, recently began an AIDS information drive with the distribution in Moscow mailboxes of 5 million leaflets titled "What you need to know about AIDS."
In contrast, the United States, which has the greatest number of reported cases, has yet to launch a national information campaign.
The new British effort is considered the most aggressive program and will cost almost $33 million in the first year. The commercials, which are noted for their use of explicit and colloquial language, are aimed specifically at drug addicts and potential drug users. They are seen as providing the easiest route for the AIDS virus out of the known risk groups and into the general population. The AIDS virus lives in the blood and can be transmitted invisibly by a needle contaminated with the blood of a carrier.
In Scotland, in particular, the threat is grave. Intravenous drug users represent 56 percent of the more than 1,200 people in Scotland known to be infected with the AIDS virus, according to the government. The figure is 7 percent in the rest of Britain. About 30,000 people are thought to be carrying the virus in Britain, according to the goernment. It is estimated that 30 percent to 70 percent of infected people will eventually develop the fatal disease. So far, there have been 1,013 reported cases of AIDS in England, Scotland and Wales.
To get the attention of its target audience, the government is using explicit language and street terminology in television and cinema commercials, print advertising and posters.
"The British government, for all its reserve and supposed stuffiness, is really doing something about AIDS in terms of the media," said Sammy Harari, the advertiser whose TBWA company developed the commercials.
One advertisement pictures a translucent body bag containing a thin-ribbed corpse beside the slogan "Just one fix can get you totally wasted." Another ad shows a needle poised over a forearm, along with the message: "It only takes one prick to give you AIDS."
Pre-release research on the 18 advertisements produced by the government showed that the "one prick" ad had the strongest effect on the audience.
"It was because it seemed so unlikely that the government would be prepared to say that sort of thing," explained Romola Christopherson, director of information for the British health and social security department. "The kids were impressed by that. If you've got the nerve to use that sort of double entendre, you're worth listening to."
To many health officials, the explicit language of the ads is a measure of how far public opinion has come on the subject of AIDS. The fact that such ads are now routine also reflects the nervousness of political leaders about the spread of the disease. "If we had tried to run 'It only takes one prick' last November, we would never have gotten it through," said Christopherson.
The tone of the commercials and their focus on drug abuse make the British campaign the most aggressive of national education efforts. As Richard McGowan, an advertiser with SSC&B:Lintas Worldwide, who has collected television commercials and print ads on AIDS from around the world, observed: "None of the material I came across dealt specifically with the drug issue. It all had to do with sexual relations and promiscuity. There is nothing as broad scale and up front as what has happened here." Not all health officials in Europe agree with the thrust of Britain's campaign. Alain Pompidou, adviser to the French health ministry on its anti-AIDS effort, criticized the British shock tactics.
"We don't want to raise fears," he said. "If there is fear, there is discrimination and rejection of people. These people must be integrated in social life." To get the attention of its target audience, the British government is using explicit language and street terminology in television and cinema commercials, print advertising and posters.
In June, the French government sent approximately 24 million information leaflets enclosed in telephone bills to French households. The leaflet pictured a young man breaking a rising, red graph line in half accompanied by the slogan: "Le SIDA, il ne passera pas par moi" -- meaning "AIDS, it will not pass through me." That means, said Pompidou, that "I will be responsible for myself and that way break the course of the disease."
The French pamphlet, which provides the same basic information as the British one on how the disease spreads, carries a message of social conscience and responsibility. A series of government-produced television commercials, based on the same slogan of personal responsibility, were reassuring in tone. AIDS is not an epidemic, the commercials said, stressing that people can protect themselves from the disease.
The French government believes that up to 200,000 people in France may be carrying the AIDS virus. About 2,500 have had the disease.
In addition to the pamphlet, commercials and a government-run telephone information service on AIDS, the government itself will actively begin promoting the use of condoms, particularly among young people, in its fall information campaign, said Michele Barzach, the health minister. In January, the French authorities rolled back a health code regulation that had prohibited commercial advertisements for condoms.
To combat the AIDS-drug connection, the French government has begun a one-year test program allowing drug users to buy syringes at pharmacies without a prescription and without having to identify themselves. Between 60 and 80 percent of heroin addicts in France are already carrying the virus.
In Britain, there are 15 pilot programs allowing addicts to exchange used, dirty needles for clean ones.
In all these programs against AIDS, medical considerations are not the whole story. As advertising consultant Harari noted: "Political courage comes into it."
Robin Herman is a free-lance writer living in Paris.