Sheen Story Highlights Advances in HIV Treatment and Care


Viral Suppression, Undetectable and the Need to Eliminate Stigma

SAN FRANCISCO, November 17, 2015—This morning, Charlie Sheen publicly disclosed his HIV-positive status for the first time in an interview with Matt Lauer on NBC’s Today in response to an unfortunate campaign by tabloid media that demonized people living with HIV and reinforced HIV shame and stigma.  During the interview, Sheen spoke about the difficulty of coming to terms with his diagnosis saying about the virus “it’s a hard three letters to absorb.” HIV disclosure is a personal decision and this event provides an opportunity for the public to educate itself on the current facts about HIV, the effectiveness of treatment, and stigmatizing statements that cause fear and shame and prevent people from seeking treatment.

“Whenever a highly-visibly person like Sheen comes out as HIV-positive, it starts conversations around American kitchen tables and office water coolers that wouldn’t otherwise happen,” said Neil Giuliano, San Francisco AIDS Foundation CEO. “This is an opportunity to get the facts about HIV, and about ways that people living with HIV are portrayed that can be harmful. HIV in 2015 is not the same as it was in 1985.”

Viral Suppression and “Undetectable”

Combination antiretroviral therapy (ART) today is extremely effective and easier to take and tolerate than ever before. Some regimens consist of a single once-daily pill. People living with HIV who detect their infection and initiate effective treatment early have normal lifespans. ART is so effective that it can reduce the level of HIV in the bloodstream to an “undetectable” level (fewer than 200 copies/mL) and the virus is said to be “suppressed.” People living with HIV who achieve viral suppression are extremely unlikely to transmit the virus to sexual partners. In March 2014, the results of a second large-scale study showed zero transmissions among couples engaging in condomless sex where one partner was HIV positive with an undetectable viral load. In the United States, more than 1.2 million people are living with HIV but only 30% are virally suppressed.

HIV Stigma

Stigma still exists and is preventing people from seeking treatment. Harmful characterizations of those living with HIV, and those at risk for HIV, damage emotional and mental health and keep people from getting tested and from seeking care. This is especially true for pejorative statements about people who engage in sex work or people who use drugs, who are first and foremost people. While publicly disclosing one’s HIV status is a way to address stigma, it should never be done in a way that denigrates anyone else. Approximately 13% of those living with HIV in the United States are not aware of their status, and 61% are not seeing an HIV doctor for their care.

“Safe sex” vs. “Safer sex”

The phrase “safe sex” implies that there is no risk of transmission, and has historically been used to describe the use of condoms during vaginal or anal sex. Instead, consider other options.  Use “safer sex,” which appropriately indicates a reduced risk when using prevention interventions. There are many ways to reduce the risk of HIV transmission. For people living with HIV, maintaining treatment to lower viral load is important—this is known as Treatment as Prevention (TasP). For HIV-negative individuals, condoms are one way to mitigate the risk of infection. Today, thanks to medical advancements, it is possible for “condomless sex” to also be “safer sex” when it comes to HIV prevention. In 2012, the U.S. FDA approved the use of a once-daily pill for HIV-negative individuals to prevent the transmission of HIV. The regimen is known as pre-exposure prophylaxis (PrEP) and is another highly effective method of HIV prevention. For more on PrEP, visit prepfacts.org.

HIV vs. AIDS

The human immunodeficiency virus (HIV) is the virus that causes acquired immune deficiency syndrome (AIDS). AIDS is an advanced stage of HIV infection where the immune system is so badly damaged that individuals become vulnerable to opportunistic infections. People living with HIV who are taking ART and maintain low viral loads most likely will never progress to AIDS.


About San Francisco AIDS Foundation
No city experienced epidemic levels of HIV faster than San Francisco. At San Francisco AIDS Foundation, we work to end the epidemic where it first took hold, and eventually everywhere. Established in 1982, our mission is the radical reduction of new infections in San Francisco. Through education, advocacy, and direct services for prevention and care, we are confronting HIV in communities most vulnerable to the disease. We refuse to accept that HIV transmission is inevitable. More information about the foundation is available at http://www.sfaf.org.

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