How a partnership lasting well over a decade between billups and AHF turned bold public health campaigns into cultural landmarks.

Inside the creative alliance between billups and AIDS Healthcare Foundation (AHF), where trust, persistence, and unapologetic creative risks have transformed Out-of-Home (OOH) advertising from space-buying into social impact. Over more than a decade, their partnership has turned sexual health messaging into something unexpected: iconic, conversation-starting, and unforgettable.

We spoke to Jason Farmer from AHF, along with Denise Mercado and Kelley Orozco from billups, to unpack how long-term collaboration, local relevance, and brave creative have led to real-world results and what’s next.

Key Takeaways

• Long-term OOH partnerships unlock trust, creative risk-taking, and impact.
  
  
• Strategic messaging in public spaces sparks public conversation and cultural resonance.
  
  
• Localized creative execution helps brands navigate stigma and censorship.
  
  
• Results go far beyond impressions, to real-world behavior, recognition, and reach.

Thinking of Doing Bold OOH? Start Here

Before launching a campaign in out-of-home media, especially on sensitive topics like sexual health, organizations need to answer some hard but necessary questions:

• Are we ready to talk about things no one else in our category is talking about?
  
  
• Are we willing to risk backlash to spark real, culture-shifting conversations?
  
  
• Do we have a creative partner who will fight for our message and not dilute it?
  
  
• Can we stay consistent over time, even if the results don’t come overnight?
  
  

For AHF, the answer to all of the above was yes. And that’s why their OOH earned recognition, relevance, and resonance.

A Message You Can’t Miss

It started with five markets in 2012. Now it’s 36. Along the way, AHF and billups have redefined what’s possible in public health advertising.

Take the “Just Use It” billboard. Launched on International Condom Day, the simple, cheeky campaign splashed across LA highways. It became a city fixture. For many, these became part of the visual identity of the neighborhoods they stood in. The campaign went on to earn a finalist nod at the 2024 OBIE Awards and took home Silver for Print/Out-of-Home Campaign of the Year.

Jason Farmer, VP of Marketing at AHF, recalls the public response: “The impact of OOH with the mix of creative that we post has elevated our brand and made our billboards an iconic part of many of the cities that we have inventory. Many people have said that our sexual health billboards are one of the top things they miss when they move from LA.”

Tackling Stigma, One Message at a Time

OOH is powerful because it's public, and that makes it complicated. The HIV and STD epidemic comes with deep-rooted stigma. For public health organizations like AHF, the goal is to change what people are willing to talk about.

AHF has leaned into that tension. Whether it was a risqué billboard near Coachella that triggered a cease-and-desist (and even more attention), or a national campaign featuring older couples kissing at sunset under the headline “STDs Are Timeless,” the strategy has always been the same: show up boldly, meet people where they are, and spark conversation.

That latter campaign, launched in 2024, earned media coverage from outlets like the Miami New Times for directly addressing the alarming spike in STIs among adults 55 and older. According to CDC data, syphilis cases in that group rose by 585% between 2012 and 2022. The visual tone was warm and romantic, but the message was urgent.

Cultural timing has also become a major part of the creative strategy. After Lollapalooza, AHF ran post-event messaging under the tagline “Good Bed Chem” that spoke directly to festival-goers: “Big weekends mean big memories - and sometimes, unexpected risks.” The campaign encouraged STI testing with warmth, humor, and a well-placed nudge.

Reflecting on the public response to campaigns like these, Farmer explains,
“We have received praise from the public on the creative messages that we put up and the important topics that we discuss that are often considered taboo. We hope that presenting topics on sexual health in a public space will influence people to have more open conversations about sexuality.”

In 2025, that same philosophy inspired two of AHF’s most distinctive campaigns to date. One featured embroidered sampler-style designs declaring “HIV Stigma Sucks”- a subversive blend of cozy and confrontational. The other, “Testing is Caring,” spotlighted same-sex couples and Spanish-language creative in 34 cities and Puerto Rico, proving that compassion, cultural nuance, and boldness can live side by side.

The creative was daring and deliberate, and AHF treats each campaign as both a message and a test, constantly learning what lands, what moves people, and what breaks through. “After making OOH a priority in our advertising approach, our creative process has evolved due to trial and error,” Farmer says. “We have created an almost templated approach to our messaging as far as elements we include and the amount of words that we know will be effective on outdoor media.”

The Science Behind the Bold

While AHF brought the vision, billups brought the engine that made it happen. With proprietary data tools, patented targeting technology, and deep vendor relationships, billups helped AHF secure premium placements, often in locations or with messaging that other agencies wouldn’t even attempt.

But the real differentiator wasn’t access; it was advocacy.

Over the years, AHF has built a reputation for pushing creative boundaries. That kind of boldness doesn’t always come easy in public spaces. But billups didn’t flinch. They stood beside AHF every step of the way, even when facing resistance.

“In the past, we have seen billups work to defend our messaging when we get pushback from vendors,” says Farmer. “Our work is important to public health, so we will not water down our messaging to appease vendors that choose to censor us.”

That shared willingness to fight for the message became the foundation of the partnership.

Denise Mercado, who has been a part of the billups team on the account since its earliest days, notes that creative bravery is just part of the culture: “AHF has always advocated for culturally relevant and bold creative campaigns,” she says. “That willingness to push boundaries made the work enjoyable and impactful.”

But boldness without context doesn’t work. Together, the teams adapted creative for different environments, recognizing that a message that hits in LA might need to shift tone or imagery in the South or Midwest.

“We always consider local environments,” Mercado adds. “Certain markets require different creative versions to truly resonate with audiences and avoid stigma. It’s about being bold and relevant.”

This balance between data and gut, creative freedom and cultural fit, is what allowed AHF and billups to keep the message sharp, but never tone-deaf. It’s about being understood, accepted, and remembered.

Measuring the Message

While many brands chase vanity metrics, AHF’s focus has always been deeper: does the message stick? Does it change minds or behaviors? The true test of success comes after the billboard goes up.

Simply, it’s about reactions. Are people sharing it? Talking about it? Turning curiosity into action?

According to Jason Farmer, the most meaningful impact isn’t always measurable in clicks or views. “We are most proud when we receive praise for our creativity in our messaging from the ad industry, lifestyle publications, TV, and online through sites like Reddit and social media,” he explains. “Since the youth are one of our largest target audiences for STD transmission, we know that if they are discussing our campaigns, unprompted by us, then we are doing something right.”

Whether it’s an embroidered “HIV Stigma Sucks” message going viral, or someone Googling where to get tested after Lollapalooza, AHF sees those ripple effects as proof the strategy is working.

By the Numbers: A Decade of Impact

The partnership between billups and AHF wasn’t built on vanity metrics. But over time, the impact is clear:

• 36 markets served since 2012
  
  
• OBIE finalist and Silver award for Print/OOH Campaign of the Year
  
  
• 12+ earned media mentions per major campaign
  
  
• 20% spike in “HIV testing near me” searches post-launch of “Testing is Caring”
  
  
• 585% increase in syphilis among adults 55+ addressed in the “STDs Are Timeless” campaign
  
  
• Organic Reddit and social media engagement from youth audiences, unprompted and widespread
  
  

When creative hits culture, results follow.

What It Takes to Make It Work

This level of impact comes from partnership. Real, long-term trust has allowed AHF and billups to push boundaries others wouldn’t touch, and to navigate complex markets with shared purpose.

For Kelley Orozco, that collaborative dynamic is at the heart of their success. “Our partnership with AHF is proof that bold ideas and creative bravery can cut through even the toughest challenges,” she says. “By building a relationship based on mutual respect and a shared vision, we’re able to turn campaigns into moments that truly matter.”

While boldness drives the work, it’s listening that shapes it.

Denise Mercado sees that listening as essential. “Trust is the foundation that allows us to adapt and innovate for every market,” she explains. “By understanding local cultures and listening to our partners, we have created campaigns that push boundaries and connect meaningfully with communities.”

The campaigns may be public, but the magic happens behind the scenes in the long-term commitment, open dialogue, and shared courage to keep raising the bar.

Where OOH Goes Next

As out-of-home advertising continues to evolve, so does its potential. With digital targeting, location-based personalization, and the integration of AI, brands now have the tools to get more precise and effective than ever before.

For AHF, this technology isn’t a novelty. It’s a way to extend their mission with even more impact.

Jason Farmer sees the next chapter as an opportunity to meet people more directly, with tailored messaging that truly reaches those who need it most. “With technology evolving so fast in OOH and the inevitable inclusion of AI, we see this as a great opportunity to use OOH to target further specific demographics that are most at risk of STDs and HIV and get our messaging to them to be able to get them into care and to practice safer sex.”

It’s a future that’s smarter and more human. The tools are changing. The commitment stays the same.

Considering a Long-Term OOH Partnership? Start Here

Short campaigns can raise awareness, but only long-term consistency builds culture. Here’s what AHF and billups have learned about making it last:

• Creative trust is everything. Trust lets you take bigger risks and iterate faster.
  
  
• Pick a partner who will defend the work. Not every vendor will be ready for bold. You need a team that will push back with you.
  
  
• Local context matters. What works in Los Angeles might need a reframe in Alabama.
  
  
• Templates help, but so does testing. Even with a creative formula, AHF is constantly adjusting based on response.

Ready to Get Real?

The story of AHF and billups proves what’s possible when you stop playing it safe. If your brand hasn’t taken a creative risk lately, ask yourself: What conversations are we afraid to start? What could happen if we stopped diluting our message and started owning it?

Bold OOH isn’t about buying space. It’s about claiming one.

If you're ready to move beyond transactional campaigns and build something unforgettable, let’s talk.

Contact billups. Let’s make it matter.

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