So I was peacefully watching Bones the other night on Hulu when this ad came up. At first, I didn’t quite understand/believe what I was seeing. A narrator with a tremulous voice talked over a series of sprightly and swirly animations with ominous music, telling us about her abnormal pap smear, linking from there directly to the human papilloma virus (HPV), going from there to cancer, and then informing viewers that this ‘doesn’t have to happen to you’ if you get the handy-dandy HPV vaccine.
The ad, of course, was created for Merck Pharmaceuticals. I can’t seem to find a copy of it to embed here for your viewing pleasure, but it’s pretty bad. I’m not the only one who is not impressed with this ad. Evidently there’s another ad, which I haven’t seen, pushing the heterosexual dream life and warning people that if they don’t get vaccinated, they will get The Cancer and be denied all opportunities at love, a family, and happily ever after.
There are a whole slew of problems with the ad I saw.
Starting with the ‘abnormal pap smear=cervical cancer’ assumption. In fact, abnormal pap smears are not uncommon, and there are all kinds of reasons to have abnormal results. If you have any kind of inflammation or infection, for example, the results will be ‘abnormal.’ When you get abnormal results, the usual recommendation is to follow up with another smear test in a few months to see if hinky stuff is still going on. If it is, then it’s time for some more aggressive diagnostic testing to learn more about what is going on.
So, for a lot of people, you get an abnormal pap smear, and nothing comes of it. Yet, folks with cervixes are terrified of getting abnormal smear test results. Because they’ve been taught that an abnormal result means omgcancer! so clearly it means that it’s time to panic. Ads like this don’t really help with that; instead of disseminating accurate information about what happens when a smear test is abnormal, it suggests that, yes, you should panic if you get abnormal results. There’s also some blame to be laid here with the medical community, which doesn’t really educate patients very well about what abnormal results mean; I have a number of friends who have had very bad experiences with abnormal results and doctors terrifying them.
One doctor once told me that there’s a fear that patients won’t return for followups, which is why they don’t provide accurate information. If that is in fact true, that is quite frankly horrific. It assumes that patients cannot be trusted to follow up on and be proactive about their own health, and need to be tricked, shamed, and frightened into followup appointments.
There’s also a hint of slut-shaming in the ad. The woman talks about a past relationship with a note of regret, like she wasn’t ‘careful enough’ and now she’s having to ‘live with the consequences.’ Because, you know, sex has consequences! And when you are a dirty whore who has sex with people, then you get cancer.
There’s a lot of scaremongering that goes on about sexual health, especially for people with the vagina-cervix-uterus package, and it’s often combined with slut-shaming, as seen in this ad. Even in supposedly woman-friendly communities, I see a lot of attitude about how people who are promiscuous and ‘good’ need to get regular sexually transmitted infection (STI) screening and the HPV vaccine and the whole nine yards if they want to retain their good slut credentials; otherwise they are just dirty gross bad sluts.
A surprising amount of misinformation and shaming surrounds the smear test itself. Here in the United States, most people are under the impression that the test is needed annually and those who don’t get annual tests are shamed for it. In fact, research strongly suggests that annual testing is not recommended and in other nations recommendations range from three to five years, except for people in special circumstances. Here in the States, it’s ’empowering’ and ‘proactive’ and ‘taking charge of your sexual health’ to get an unnecessary medical test every year and woe betide the person who says otherwise[1. Please note that I am referring specifically to the smear test here, not to an annual medical exam.].
One problem with getting tests too often, as we do in the US, is that you are more likely to get a false positive which leads to costly followup diagnostics to chase down a ghost. In addition, for people with pelvic pain and for rape victims/survivors, the test is traumatic and unpleasant, which makes a strong argument for doing it less often, especially when it’s not necessary. When most recommendations actually state that the test shouldn’t be performed as often as it is in the US and the test is actively harmful for some folks, one might wonder why it is that the people who write the recommendations in the United States are resistant to deviating from the once a year schedule.
And why so many people feel the need to police each other. I see numerous supposedly feminist web sites filled with threads about how ‘important’ it is to get a smear every year and how it’s ‘so easy’ and ‘not at all painful’ and ‘isn’t an inconvenience’ and people who don’t want the test annually are ‘just whiners’ or ‘stupid’ and ‘should take better care of themselves.’ This despite the fact that evidence clearly shows that getting the test less often than once a year is actually ‘taking better care of yourself.’
So, here we have an ad reinforcing bad information about the smear test and also reinforcing social attitudes about people who have sex.
In order to sell a vaccine.
Now, I happen to be a big fan of vaccines and I think that people who are good candidates for the HPV vaccine definitely might want to consider getting it. But I also balance that with the knowledge that the vaccine is expensive, which makes it out of reach for some folks, and with the fact that it’s being heavily marketed towards women as opposed to all genders (just as birth control is always a woman’s responsibility, so is STI prevention, apparently). And I think that if you need to frighten and shame people into getting a vaccine, you are probably doing something wrong. Merck’s other ads for the vaccine haven’t been ideal, but have been less offensive than this one.
I’m not quite sure why Merck thought that framing the ad in this way was a good idea, but in my opinion, it was a very poor choice.