Television and outdoor ads for a major public health campaign featuring a rude hand gesture have been pulled just weeks after its launch, the content proving too offensive.

The "Stick it to Hep C" campaign was launched in late July by Associate Health Minister Ayesha Verrall in a bid to curb New Zealand's high mortality rate from the blood-borne virus.

Its advertising featured people presenting their middle digit - a gesture widely recognised as a form of insult and regarded as obscene - to another person, who initially appeared affronted.

They then break into smiles, indicating they have had a prick test on their finger to see if they have been exposed to the disease.

The awareness campaign, slated as a key activity within the National Hepatitis C Action Plan to eliminate the virus, used broadcast, online, print and outdoors media to relay its message.

The middle-finger gesture considered too rude for the face of the hepatitis C public health campaign. Photo / HPA

However, after its July 28 launch the campaign has been severely curbed after 19 viewer complaints to the Advertising Standards Authority were upheld, forcing prime aspects of the campaign off-air and out of public sight.

Public Health Service national director Nick Chamberlain confirmed the authority had upheld complaints about the campaign over its choice of imagery and it was "regrettable" the health agency didn't get the balance right.

"We can confirm that the Advertising Standards Authority (ASA) has upheld some complaints about the hepatitis C awareness campaign.

"As a result, the television advertisements will no longer be broadcast, and the posters will no longer be displayed at bus shelters or on digital display boards.

"We had no intention of causing serious or widespread offence with our choice of campaign imagery and it is regrettable that the ASA considers we didn't get the balance right on this occasion."

He said all free-to-air broadcasts of the television advertisement were after the 8.30pm watershed. Broadcasting the advertisement after this time was assessed by the Commercial Approvals Bureau as unlikely to cause serious or widespread offence.

"We also took steps to place out-of-home advertising such as digital display boards and posters in locations most relevant to our target audience of men aged 45-plus," he said.

On-demand broadcasts of the advertisement were served only to adult viewers based on their account holder profile information.

The double thumbs up replacement picture now being used in the hepatitis C campaign. Photo / HPA

Despite the complaints Chamberlain said the advertisements had been received very positively by many people.

This had been helping to normalise conversations around hepatitis C and led many at-risk New Zealanders to seek testing and treatment.

He said the campaign concept was endorsed by health sector representatives, peer workers and people with lived experience as the most effective way to raise awareness of hepatitis C.

Before the setback campaign metrics indicated the banned TV ad had reached more than half the health agency's primary target audience of men aged 45-plus, and over 1000 people had visited the stickittohepC website after doing an online search for one of the campaign phrases.

The Health Promotion Agency has since swapped out its main campaign image from a middle finger shot to a double thumbs up though the YouTube clip remains online along with a middle-finger image on the dedicated campaign website.

The Advertising Standards Authority said it received 18 complaints about the television ad and one for the outdoor digital street screen and poster.

In its findings it said the complaints board found the advertisement used an indecent and offensive hand gesture which was in breach of the Advertising Standards Code.

The authority said the complainants were concerned the advertisement used an offensive hand gesture which was "vulgar and inappropriate for use within Government health messaging".

"Some complainants were concerned the advertisement could normalise the use of the gesture if children are exposed to it," the decision read.

On the outdoor poster, the complainant said using an offensive hand gesture regarded as sign language for "F*** You" had no place on a billboard which could be seen by children and should not have been sanctioned by a government department.

In defence of the ad the health agency said the use of the finger gesture was only likely to cause offence when accompanied by verbal abuse, threatening behaviour or body language.

However the complaints board did not agree saying it was not uncommon for the gesture to be used with a smile in a passive aggressive manner, which still had offensive intent.

It found airing the advertisement after the adult watershed of 8.30pm or through adult subscriber profiles was not sufficient to avoid exposure of a gesture to those consumers who considered it to be disrespectful, indecent and offensive.

The majority of the board said the connection of the gesture and the finger prick test was not sufficient to justify its use, even in an advocacy advertisement.

When Verrall launched the national hepatitis C awareness campaign to mark World Hepatitis Day in late July she said it was important to do everything possible to capture the attention of the tens of thousands of Kiwis who may be unknowingly infected with the potentially deadly virus.

"It's really important we do everything we can to raise awareness of hepatitis C so we can eliminate the virus that approximately 40,000-45,000 New Zealanders live with," said Verrall at the time.

The troubled awareness campaign was part of the National Hepatitis C Action Plan for Aotearoa New Zealand, which was launched a year ago with the goal of eliminating hepatitis C as a major public health threat by 2030.

"We're calling on Kiwis to 'Stick it to hep C' – 'Werohia te Atekakā C' – because all it takes to find out whether you've been exposed to hepatitis C is a quick and easy finger-prick test.

"Over 200 New Zealanders continue to die each year from hepatitis C even though we now have an easy test and an easy cure. If hepatitis C is left untreated, up to a quarter of cases will develop cirrhosis, which can lead to life-threatening liver cancer or liver failure.

"Every one of these deaths could have been prevented by earlier diagnosis and treatment."