Well, that’s over with. After all those “Which A-List Actor Has HIV?” blind items that made it feel like Ronald Reagan or Poppy Bush were still in office, Charlie Sheen went on the Today show this morning with his doctor and admitted that he’s been HIV-positive (and on medication) for four years. He said he had to come forward to stop yielding to financial shakedowns from “unsavory and insipid” types (by which he likely means sex workers), such as the one who, he says, took a cell-phone picture of the HIV meds in his bathroom and then threatened to blackmail him with it. The secret has clearly been a burden on Sheen: He and his doc said he was struggling with depression and still drinking.
Sheen is 50 and has been a big star for most of his life. So perhaps it is inevitable that this would unfurl in public like any other “celebrity scandal” story, complete with a confessional interview.
But as someone who’s written about HIV-AIDS for 21 years and has lived with HIV for 15, the measure I use when HIV comes up in the public realm is put it to the Diabetes Test: “Are we talking about this the way we’d talk about diabetes?” (That’s another chronic illness manageable with meds; these days, in fact, it’s often harder to manage than HIV.) By that measure, the Sheen story failed. Certainly there wouldn’t have been a media storm centering around “Which A-List Actor Has Diabetes?” Diabetes certainly wouldn’t have made Sheen vulnerable to blackmail over its stigma. Once it was revealed last night that Sheen would likely out himself this morning, the certainly well-meaning Heather Locklear wouldn’t have felt she had to voice Instagram-sympathy for him, nor would Sheen’s publicist, Howard Bragman (who in the past has made a name for himself as the orchestrator of celebrity coming-outs, including Michael Sam’s last year) have felt compelled to to remind us that “this is a disease that can affect anyone.”
But then again, in fairness, diabetes isn’t sexually transmissible and doesn’t raise thorny questions of personal responsibility — questions which, in all too many states, can get blown up into harsh HIV criminalization laws, which can speak more toward homophobia (and HIV-phobia) than actual harm: They don’t account for how effective modern treatment can be, and what it means to be “undetectable.” A major study this year once again confirmed anti-retroviral treatment renders the virus untransmittable assuming it is taken properly. I wish Sheen and his doctor had mentioned that study today rather than let Lauer undermine that game-changing fact a bit. Still, it’s true that not everyone takes the medication regularly, or — worse, both for them and others — knows their status.
But, overall, I think the interview was humane and instructive. I hope people can be decent to Sheen now that he’s come forward, and recognize that, as his doctor pointed out, addiction and depression are far bigger threats to his life and health than HIV. Those are serious things even when they manifest in a big-time star who’s so often behaved like a jerk and a clown.
Yet, coming back to the Diabetes Test, it still vexes me that this story swirled so readily into a salacious 1985-style AIDS scare. Because the truth is, having HIV today — especially (but certainly not exclusively) for a wealthy white American man like Sheen — is just not the cause for mourning and hysteria that it was in 1985, when we learned that Rock Hudson was dying from AIDS. Or in 1992, when Magic Johnson came forward with his diagnosis, again in the years before effective drug therapy. He’s fine and has since become a great champion of people with HIV (and of his own gay son).
Or 2001, when I found out I was HIV-positive and felt assured that the new drugs would keep me alive and healthy, but worried they would mess with my head or disfigure my face and body. (Drugs in the years prior had done just that; but the 2000s and 2010s saw a boom in far gentler treatment options.)
Nor should we be horrified that Sheen identifies as heterosexual and did not, he told Laurer, use needles when taking drugs, but he still got HIV. There is vastly less HIV among straight people. But this is not an era of mystery about HIV transmission. Condoms almost always prevent you from passing it on (not to mention other STDs). And today there is Truvada, the HIV-prevention pill, which I wrote about last year. When taken regularly, if you are negative, it will keep you that way, even if you have sex with an untreated positive person.
That’s the good news. In the past few years, since the FDA approved Truvada for prevention (or what’s called PrEP), I’ve witnessed a remarkable sea change among American gay men in major cities. I don’t have numbers to say definitively just how many gay men are taking preventive Truvada — nobody does yet — but I’ve been happily surprised to see how many guys are proudly taking it (and say so in their profiles on apps like Scruff), and also how it’s seriously cut down on a phobia of HIV-positive guys, which has been a cruel fact of the gay world for nearly two decades. Now I’ll regularly hear from guys who say not only that they’re on PrEP and open to HIV-positive guys, but that they’re not open to guys who write phobic things like “Disease Free, UB2,” or “Be clean.” (Fewer words are more hated among us HIV-positive guys.) I didn’t know if I’d live to see the day when I might have sex with HIV-negative guys and neither of us were obsessing over HIV. But I have, and it’s pretty great.
All of which leads us to some tricky messaging. I don’t want to trivialize getting HIV, even in 2015. Not everyone has the advantages of Charlie Sheen, or even me — a freelancer living in a deep-blue state with very good Obamacare options and a generous state program to help me pay for it. In many states (particularly in the South and Midwest), the income requirement to access that same program, which is called ADAP, is abysmally low, and you’ve got to be a helluva lot poorer to access Medicaid, too. Having HIV is still often stigmatic for people living outside of major cities, where it can be hard to find good treatment — never mind an up-to-date doctor who’s heard of PrEP and willing to prescribe it to you.
But the point of these programs is to stop the spread of HIV. People get treated; they live long, healthy lives; and they protect others from infection. That’s the goal. It would be great if we could react to Sheen’s news like it’s 2015, not 1995, or even 2005. Thanks to researchers and activists, HIV’s not a killer anymore. It’s more preventable than ever. And I remain hopeful we’ll have a cure for it someday. So let’s push back on media that tries to sensationalize it, Reagan-era-style, for cheap clicks. That’s just shaming people living with HIV and scaring others from getting tested for it.
So as people lament Sheen’s news, calling it “sad” and “tragic,” I want to say: Well, yes, it is — I wouldn’t wish HIV on anyone — but Charlie’s likely going to be fine as long as he takes his HIV meds (addiction and depression issues aside). It’s a great opportunity for him to tell straight America that, because he’s on meds, he’s not infectious, either.