The tabloids got one thing right this week: Charlie Sheen is, in fact, HIV-positive, as he confirmed this morning on the Today show. The rest of the "reporting" in outlets such as the National Enquirer, the Daily Mail, and Radar Online was more problematic. "Hollywood Superstar’s Desperate Battle With AIDS Revealed," screamed Radar Online; "Charlie Sheen AIDS Cover-Up: He's Slept With Thousands Of Women — And Men!" declared the cover of the Enquirer. Slut-shaming (not to mention homophobia and the shaming of sex workers and drug users) reared its ugly head with every assumption that Sheen's "hard-partying ways" caused his HIV+ diagnosis.
To dispel a few HIV/AIDS misconceptions, we spoke with Carlos del Rio, MD, Rollins professor and chair of Emory University's Hubert Department of Global Health. Here's what we need to stop thinking — and saying — about HIV.
1. HIV and AIDS are interchangeable terms.
Human immunodeficiency virus, which is spread through bodily fluids, destroys cells of the immune system called CD4 cells or T cells. Contracting HIV doesn't mean that you'll develop the disease AIDS (acquired immune deficiency syndrome). Rather, that happens when you have fewer than 200 CD4 cells per cubic millimeter of blood (normal counts are in the 500 to 1,600 cells-per-cubic-millimeter range).
Human immunodeficiency virus, which is spread through bodily fluids, destroys cells of the immune system called CD4 cells or T cells. Contracting HIV doesn't mean that you'll develop the disease AIDS (acquired immune deficiency syndrome). Rather, that happens when you have fewer than 200 CD4 cells per cubic millimeter of blood (normal counts are in the 500 to 1,600 cells-per-cubic-millimeter range).
2. HIV is a death sentence.
"Science has advanced to develop medication these days that, if taken like [Sheen] has been taking them...will not only allow a person living with HIV to live a normal life, but [will let that person] actually have their virus suppressed and not transmit HIV to others," Dr. del Rio says. That doesn't mean doctors recommend that people living with HIV have unprotected sex, as Sheen told Matt Lauer he has done with two partners (albeit with the partners' full knowledge and while they were under the care of Sheen's doctor). But it does mean that taking medication can make an HIV+ person's viral load undetectable and drastically reduce his or her risk of spreading the virus. 3. HIV is no longer an issue in this country.
"It’s forgotten, but not gone," Dr. del Rio says. "We still have about 50,000 new HIV infections a year in this country. The problem is that it disproportionately affects minorities and the poor — and we tend to forget things that affect minorities and the poor." Dr. del Rio observes that Charlie Sheen — whom he accurately refers to as a "white, wealthy, well-known individual" — may increase the visibility of less-represented individuals living with HIV. Sadly, while we have the tools necessary to defeat HIV by diagnosing it and then caring for the individuals living with it, which also prevents transmission, in most cases, that's not what we're doing. "As a nation, we have 1.2 million people living with HIV, and only about 30% of them have their virus suppressed, like Charlie Sheen," Dr. del Rio says. "If we don’t get people from diagnosis to [an] undetectable [viral load] in a better way, we’re never going to be able to significantly impact the epidemic." And as long as we continue to stigmatize HIV-positive people by perpetuating misinformation and shame, rates of testing, diagnosis, and treatment will remain disastrously low, both in the U.S. and around the world.
"Science has advanced to develop medication these days that, if taken like [Sheen] has been taking them...will not only allow a person living with HIV to live a normal life, but [will let that person] actually have their virus suppressed and not transmit HIV to others," Dr. del Rio says. That doesn't mean doctors recommend that people living with HIV have unprotected sex, as Sheen told Matt Lauer he has done with two partners (albeit with the partners' full knowledge and while they were under the care of Sheen's doctor). But it does mean that taking medication can make an HIV+ person's viral load undetectable and drastically reduce his or her risk of spreading the virus. 3. HIV is no longer an issue in this country.
"It’s forgotten, but not gone," Dr. del Rio says. "We still have about 50,000 new HIV infections a year in this country. The problem is that it disproportionately affects minorities and the poor — and we tend to forget things that affect minorities and the poor." Dr. del Rio observes that Charlie Sheen — whom he accurately refers to as a "white, wealthy, well-known individual" — may increase the visibility of less-represented individuals living with HIV. Sadly, while we have the tools necessary to defeat HIV by diagnosing it and then caring for the individuals living with it, which also prevents transmission, in most cases, that's not what we're doing. "As a nation, we have 1.2 million people living with HIV, and only about 30% of them have their virus suppressed, like Charlie Sheen," Dr. del Rio says. "If we don’t get people from diagnosis to [an] undetectable [viral load] in a better way, we’re never going to be able to significantly impact the epidemic." And as long as we continue to stigmatize HIV-positive people by perpetuating misinformation and shame, rates of testing, diagnosis, and treatment will remain disastrously low, both in the U.S. and around the world.