As any visitor to Europe can attest, attitudes about sex over there are a lot different than attitudes about sex over here. All you have to do is turn on a television, open a newspaper, or walk through a train station and look at the billboards. Messaging about safe sex is not only more common. It's also a lot more explicit.
Rachel Phelps has collected some examples of these ads in a slideshow at Slate (starting with the image above). And she thinks they make a difference:
In both Europe and America, the age at which most people start having sex is 17. But that's where similarities about teen sexuality begin and end. Teen pregnancy rates in the United States are three to six times higher than in Western European countries. This means that one out of every three American teenage girls becomes pregnant at least once before she reaches the age of 20. (Even poor countries like Algeria, Sri Lanka, China, and Estonia have lower teen birth rates than we do.) The gap between Europe and the United States for sexually transmitted diseases is even greater--gonorrhea and chlamydia rates are 20 to 30 times higher here than in the Netherlands, for example.
What explains these hugely varying outcomes? At the heart of the answer lies a contrast in attitudes toward teen sexuality. This is clear from research about how families talk about sex. And it's also clear from advertising campaigns. The caption for this light-hearted German ad reads "Prevents Shortsightedness." Can you imagine an ad like it in the United States?
This is not an issue on which I've kept up to date, so I can't vouch for Phelps' assessment of the latest research. But it certainly sounds plausible. And it's consistent with what I observed many years ago, on a trip to Brazil sponsored by the Henry J. Kaiser Family Foundation.
At the time, Brazil was winning international acclaim for its fight HIV. The effort had many components, including the decision to produce its own, unlicensed versions of anti-retroviral drugs so that it could afford to treat its HIV-positive population. But a key to its prevention efforts was an aggressive public information campaign about condoms.
Brazilians, like Europeans, have far more liberal attitudes about sex than Americans do. The campaign reflected that:
The Brazilian initiative dates back to the 1980s, and it is perhaps best understood through some of the public service commercials that have aired on television since then. In one, dancers from Carnival, costumed in ancient Roman garb, remind viewers that condoms have a long, distinguished history: "In Rome and ancient Egypt, no one knew who they slept with. Marco Antonia used to wear it. . .. Cleopatra demanded and believed in it. ... Hey, put on a condom." Another spot you might describe as "Father Knows Best" meets "Queer as Folk" takes place in a suburban home and preaches the virtues of tolerance toward gays as well as safe sex. Some ads play out like soap operas, such as the one in which a man cheats on his wife, picks up the AIDS virus, then gives it to his spouse. This commercial, too, promotes condom use. ...
Brazil estimates that just 600,000 of its citizens are HIV-positive today--about half of what the World Bank had predicted. The death rate from AIDS has fallen, too--by more than 70 percent in the last decade.