Fear-based parenting is an approach that many parents believe is effective. Their children are too scared of them to misbehave--or so they think. As those children get older, they may still be afraid, but the power of that fear to influence their behavior diminishes.

It doesn't take a PhD in child psychology to notice that parents who rely on hitting or screaming at their young children to keep them under control find themselves with older children who hit and scream back and eventually are no longer moved by such tactics.

I'm not a parent, but I've been parented and I've witnessed parenting. I'm also not an HIV prevention expert, but I am HIV positive and I have witnessed the HIV/AIDS epidemic. Scaring people about HIV will not control their behavior in the long term.

That said, scaring the shit out of people does affect their behavior in the short term. Which is exactly why parents who favor this approach rely on it as much as they do. Scare tactics are used the world over in all sorts of situations because this is true.

So when I hear people say "Scare tactics work" or "Scare tactics don't work" I am at a loss. It is nearly impossible to evaluate these assertions without knowing what the person saying this or that really wants as desired outcomes.

Do you want to stop people from having unprotected sex in the short term? Then maybe scare tactics are for you. Do you want to promote safer sex over the long haul? Then maybe scare tactics aren't for you.

The question for me is whether there is room in the world of HIV prevention for both points of view. I submit that there is. The qualifier for me is the manner in which HIV messaging is delivered.

Which leads me to the "Never Just HIV" public service announcement from the New York City Department of Health and Mental Hygiene. For the uninitiated, the ad states that having HIV puts you at higher risk for osteoporosis, dementia and anal cancer.

That the ad conveys those messages is important. People need to know the negative consequences of having HIV. The manner in which the ad conveys that messaging is what I cannot condone.

Watch the ad:

The over-the-top gimmicks in the ad (the horror-movie voiceover, the haunting music, the melancholy faces) leave a bad taste in my mouth, but the Frankenstein ass image of anal cancer makes me want to hurl.

Instead of making me afraid of HIV, that image of anal cancer made me afraid of anal sex. I hope that is an unintended consequence. I loathe to think that such a consequence would have been intended.

If the ad had not included that image (or any image) of anal cancer, I might have been persuaded reluctantly to take a wait-and-see approach on the effectiveness of this ad to lower HIV rates in New York City among men who have sex with men.

As it stands now, however, I cannot support it. The cost of stigmatizing anal sex in the long term is too high a price to pay for the promise of lower HIV rates in the short term.