The creators of an Aids awareness advertisement that shows a woman having sex with a series of dictators [Warning: video contains graphic sexual images], including Hitler and Stalin, defended it today, amid growing criticism.

The ad is due to run until World Aids Day on 1 December. Photograph: Uwe Duettmann/AFP/Getty Images

Das Comitee, a Hamburg advertising agency, said the advert's shock value was aimed at highlighting the dangers of unprotected sex at a time when public awareness about the risks was diminishing. "We knew the face we gave to the illness could not be a pretty one," said Dirk Silz, the creative director.

The advert was trying to "show the ugliness of the illness, not of aids victims", he added.

But organisations representing people with Aids across Europe have condemned it, saying it only adds to the stigma they already suffer by appearing to put them on a par with mass murderers.

Others criticised the campaign for failing to offer any prevention advice, such as the use of condoms.

The 45-second advert, which is being launched on German television and in cinemas this week but cannot be broadcast before the 9pm watershed because of its content, shows a couple having sex. Towards the end the man's face turns into that of Adolf Hitler, along with the slogan "Aids is a mass murderer". In poster versions for the campaign the images of other dictators such as Joseph Stalin and Saddam Hussein have also been used.

The campaign was the brainchild of the German Aids awareness group, Regenbogen eV, and is due to run until World Aids day on December 1. Das Comitee said it had worked for nothing on the film, and had received a positive response so far. "If it wakes people up to the dangers of unprotected sex, we've been effective," Silz said.