It is perhaps hard to envisage that there was a time when many people thought you could catch HIV from toilet seats - but that was Britain 20 years ago.

In the mid 1980s, there was intense media focus on this new and frightening disease with no known cure. Victims were often viewed as falling into two groups: haemophiliacs who were often labelled 'innocent victims', and gay men and drug users, who were frequently referred to as 'authors of their own misfortune'. The then-Chief Constable of Greater Manchester Police, James Anderton, referred to people "swirling about in a human cesspit of their own making".

Some tabloid papers reported scare stories as news. People were afraid that gay plumbers might infect a cistern. Afraid that you could 'catch AIDS' from Communion wine. Afraid that you could catch HIV from sharing communal baths. At this time, an estimated 7,500 people had been diagnosed with HIV in Britain. There were an unknown number of people who had the disease but did not know. No one knew how fast the disease could spread.

Government action

The government decided that it must do something, and Conservative Secretary of State for Health, Norman Fowler, and the Deputy Prime Minister, Willy Whitelaw, were tasked with driving through a national public awareness campaign. "I remember it just as an issue which was of fundamental importance", says Lord Fowler. "We didn't know a great deal... nothing like what we know today about HIV/AIDS. There was no cure and literally, public education, advertisement, publicity, they were the only weapons that we actually had."

They commissioned an agency, TBWA, to make the adverts which would shake a nation into taking charge of its own sexual health.

Kevin Thomas, now director of Thomas Thomas Films, was Head of Art with the firm.

"There really was a lot of ignorance around at that time - people still saw it as a gay disease. All of the team at TBWA were asked to come up with ideas. Many were submitted."

"I was thinking about the amount we didn't know about AIDS. We seemed to know so little - and that's why I thought about the iceberg."

He had no idea how iconic the advert was to become. An astonishing voice-over from the actor John Hurt, which began, "There is now a dreadful disease..." electrified the UK.

the public saw it, that they understood it, that they remembered the campaign and most of all it actually did change habits Norman Fowler, former Health Secretary

A leaflet was sent to every household in the country. There was a week of educational programming at peak time. Wholesome family TV presenters were demonstrating condoms on prime time television. And the government brushed aside criticism. Lord Fowler says

"There were obviously the columnists who said this was disgraceful, you know you're sending these leaflets and they can get in the hands of 16 year old children and obviously there was that risk. But when it came to it the public had the common sense just to read them and very, very few people complained about it. They accepted that the government, the health department could give information about health issues as long as it was done in a practical way, and it was."

Although the target of the campaign was HIV, it actually had a profound effect on all sexually transmitted infections. Following the campaign, the number of diagnoses of gonorrhoea in England and Wales dropped from around 50,000 in 1985 to just 18,000 in 1988 - and had dropped to a 20th century low by the mid 1990s. Syphilis dropped from around 1500 annual cases in the mid 1980s to around 150 in the mid 1990s.

New diagnoses of HIV, which were over 3,000 in 1985, dropped by a third in three years. The number of new diagnoses stayed relatively stable until 1999. It has since more than doubled to 7,000 new diagnoses each year.

However, not all STIs fell. Both genital warts and genital herpes continued to rise. This may be explained by the facts that neither disease can be cured, and the fact that condoms, whilst reducing risk of transmission do not prevent their transmission.

Some critics of the campaign now say that the government was guilty of scaremongering. Norman Fowler has no such qualms.

"I think the campaign was extremely effective, I think that all the follow up material shows that the public saw it, that they understood it, that they remembered the campaign and most of all it actually did change habits, it did modify habits."

"And our figures were better than virtually anywhere else, I think anywhere else actually in Europe and it had this knock on effect to general sexual health as well and the figures there actually improved. So I think however you measure it, the campaign had real effect and real impact."

The impact

Professor George Kinghorn is the Director of Infectious Diseases at Sheffield Teaching Hospitals NHS Trust, and one of the UK's leading authorities on sexually transmitted infections.

"The only time in my lifetime that STIs have plateaued was after the AIDS adverts in the eighties. But sadly I think what we gave them (politicians) was a tick in the box."

"What you have to do with any form of health education or promotion is to sustain that effort because you have new generations of young people."

Between 1985-86 and 1992-93 the government allocated over £73 million to the development of the national AIDS public education campaign. It was a huge amount of money at the time.

It has not received the same kind of funding since then. Now, the Government has pledged to spend £50m, over three years, on a new campaign around sexually transmitted infections. The Minister for Public Health for England, Caroline Flint, has announced it is planned to begin in March 2006.