It’s a Sin: Why Public Health Campaigns Need the Arts

Previously chastised by The Sun as excessively explicit, and almost never making it to the screens after being turned down by BBC One and ITV, It’s a Sin is now the most binge-watched programme on Channel 4’s streaming service, All 4. This moving mini-series comprised of 5 episodes was penned by Doctor Who’s previous head-writer Russell T Davies, and explores the psychosocial and political landscape shaping London’s gay scene and it’s wider perception, during the 1980’s AIDS epidemic.

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Episodes swing between disco lit scenes blasted with contagious 80s music, love, and tenacious wit and harrowingly sad depictions of AIDs victims, as Davies makes it clear the joy before the tragedy must also be remembered: “That’s what people will forget, that it was so much fun”.

Following initially tentative lead character Richie (played by Years & Years vocalist Olly Alexander), a closeted boy from the Isle of Wight, the story unfolds as he moves to London for university and begins to thrive, exploring his sexuality under the freedom of big-hearted new friends.

Davies crafts characters that feel very real, as although they’re full of likeable qualities the lead characters can also be super frustrating. Richie’s refusal to acknowledge the looming danger of HIV amid the wave hearsay surrounding the disease in the early 80s, had me nail-biting like a worried parent, and when condoms were avoided I was covering my eyes as if watching a horror film. 

We see these lovable characters grow over the course of a decade, as they feel out different relationships, careers and styles, trying to find their feet and navigate their 20s amidst ominous AIDs news, seeping insidiously from America.

*Spoiler Alert*

The story is impressively versatile, giving insight not only into how difficult it was to be gay in the 80s, but also how families of AIDs victims or openly gay people struggled – families who couldn’t understand what being gay was, refused to accept it, or didn’t mind at all but lived under a veil of societal shame. Roscoe’s family pray to God to make him straight, Richie’s mum couldn’t acknowledge her son was gay even when he was dying of AIDs, and when poor Colin was dying, his kindhearted mother who accepted everyone, was sent hate mail by the local community.

From a public health point of view, these episodes struck me as invaluable. It’s a Sin starkly presents how terrifying it can be to be at the mercy of hear-say, when there is a lack of clear information on a disease. Richie voices an understandable view when addressing the rumours in episode two, as the trickles of information people received about AIDs were cocktails of prejudice and speculation, and no one knew what to believe –  akin almost to misinformation teenagers can gather about sex, when no clear education has been given.

 “He said, she said, they said, they’re always saying something… they say that God created it to strike us dead. They say it was created in a laboratory to kill us…..They say it’s a cancer, but you can’t catch cancer… ‘Cause imagine it, gay cancer, how is a cancer gay? What does it look like? Is it pink? Where is it? Is it in the wrists? For God sake.”

This show demonstrates how stigmatizing disease can be fatal, deterring people from seeking medical help, and shaping a culture of shame and psychological burden: Men avoided HIV tests, characters didn’t tell their families they were HIV positive and often suffered alone, gay men couldn’t find employment and many patients were filled with self-blame. Gloria worries “I’ll get sacked if word gets out, they sack people for being gay, never mind AIDS” and the audience see this stigma as inflammatory for patient self-blame, as Jill voices during the final heart-breaking scenes, projecting this perspective into many a living room:

“That’s what shame does. It makes him think he deserves it. The wards are full of men who think they deserve it. They are dying, and a little bit of them thinks, yes, this is right. I brought this on myself, it’s my fault, because the sex that I love is killing me.”

So many aspects of HIV were addressed through this story. Davies makes sure viewers see HIV can be contracted by sleeping with just one person through Colin’s character, the gentle, quiet welsh boy who “was always good”– combatting the preconception that to contract HIV you have to be promiscuous.

Much of the dialogue addresses questions people may feel hesitant to voice due to much stigma still surrounding homosexuality, but that are a vital part of the conversation regarding all kinds of sexual health and the general public’s perception of HIV.

Impact of the Arts

As someone who never watched Doctor Who, when I binged this show, I began to understand how everyone seems to know what a sonic screwdriver is, and the function of a Tardis. It isn’t because these concepts are easy to remember, but because Russell T Davies, and countless other writers, musicians, and artists, made these ideas integral to Doctor Who’s plot – and information necessary to a story is information people tend to remember.

In this way, Davies forged an informative medical masterpiece in five episodes; with an intriguing plot and interesting characters played by well-known actors, It’s a Sin engages people in a way enviable by the best public health campaign. It struck a record 6.5 million views according to Channel 4 by the 4th of February, meaning more than the entire population of Ireland were exposed to empathetic perspectives and concepts about HIV through this artistic platform – now the “most binged watched series ever”.

The Terrence Higgins Trust Charity for HIV tweeted that the show, and action across social media by famous Olly Alexander, caused a spike in free HIV testing kits uptake. Previously, 2800 topped the daily HIV tests ordered but following It’s a Sin 8200 tests were requested in a single day, and NHS England requested another 10,000 tests for National HIV Testing Week. A T-shirt inspired by the show and sold by the Terrence Higgins Trust, also raised £20,000 in just 24 hours and by the 19th of February had raised £200,000 for HIV support.

These numbers are evidence for the synergistic relationship the arts have with many public health campaigns. The arts reach everyone who would never set foot in a hospital and offer the illusion of choosing to learn about medical issues. No one is being forced to read a boring leaflet or go to an unengaging sexual health lecture at school, but people may choose to stick on a popular programme, and find in doing so a story-driven incentive to learn about health. People want to learn about something if they care about a character affected by it. The arts can humanise issues in a way fact, reason and statistics never can.

Much has changed regarding HIV since the 80s, with current medications saving lives, like PrEP reducing the risk of contracting the virus, and drugs to keep HIV under control in patients who test positive. 

However, stigma, fear and ignorance are still prevalent surrounding HIV and many other diseases. The arts within popular culture hold real power in public sway, posing different perspectives, encouraging conversation and humanising problems, and public health campaigns need this powerful influence. One programme can change thousands of minds, a sex ed. TikTok  could reach millions, and issues present for centuries, through the arts, could be de-stigmatised much faster.