One ad questions if your medicine will turn your skin and eyes yellow, another suggests that you might be spending a lot of time on the toilet – if you choose the wrong medicine. Both ads are being attacked by patient advocates as scary HIV drug ads that might drive patients away from seeking the care they need.

As the HIV drug market grows increasingly crowded, and with few stand-outs, drug makers have traded down their messages of hope and inspiration to ones of fear and concern.

A new group of GlaxoSmithKline and Bristol-Myers Squibb ads are being called “irresponsible” and “insensitive” by advocates, who fear HIV-patients will be scared of taking the medications.

Glaxo is the primary target of activist groups such as AIDS Healthcare Foundation (AHF), which recently ran print ads in various publications denouncing their recent First Impressions ... Can Be Deceiving ads, which appeared in the July/August issue of POZ magazine.

One Glaxo ad shows a photo of two serene sailboats at sea drifting into the sunset stacked on top of a close-up of the boats' sails revealing them to really be shark fins. The text reads, “First Impressions ... Can Be Deceiving – Avoid hidden dangers from changing your HIV medicines. If you are thinking about switching your HIV medicine, make sure you know what you're getting into.”

“With these ads, GSK has sunk to a new low,” said AHF President Michael Weinstein in a prepared statement. “The company has resorted to exploiting patient fears in order to sell a product, while remaining unconcerned about the harm caused to patients who are scared off treatment altogether because of GSK's tactics.”

In an ad promoting Glaxo's protease inhibitor Lexiva, the text reads, “Will the HIV medicine make my skin or eyes turn yellow?” Several competing medications list this side effect.

And a Bristol-Myers Squibb advertisement features a toilet and says, “Ask your doctor if there are HIV medications with a low risk of diarrhea.” The company's target is Abbot Labs' Kaletra, which lists diarrhea as a possible side effect.

Speaking to the Wall Street Journal, Glaxo Spokesman Marc Meachem said: “While we acknowledge that some people may find the headline and imagery of the materials to be provocative, GSK stands firmly behind the ads and their underlying message: Patients considering changing HIV therapy ought to consult closely with their physician to fully understand the near and potential long-term health implications of such changes.”

While some have attacked the ads, others believe they add a dose of reality to what it means to be on the medications. “I ... think that the relentlessly upbeat advertising that has been the norm for HIV meds for years now might be just as damaging,” said former UNAIDS epidemiologist and The Wisdom of Whores author Elizabeth Pisani on her blog. “Perhaps, inadvertently, Big Pharma is now sending a different message: being on HIV meds for the rest of your life may not be such a painless thing after all.”