I usually work behind the scenes at TheBody.com, on online HIV resource, but after spending eight years quietly immersed in the HIV community, it turns out I can no longer see HIV in the news without having some pretty strong reactions.
Since rumors began, and were confirmed yesterday, that Charlie Sheen is HIV positive, oh man, has the news coverage been making me cringe -- and that was before I made the No. 1 Internet mistake of reading the comments on some mainstream coverage.
I started to rant about it to my coworkers, and they encouraged me to actually write those rants down, so here you go: my five initial reactions to the conversation around Charlie Sheen's HIV status.
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1) Charlie Sheen Has Done Terrible Things, but HIV Is Not a Punishment for Being Terrible
I am not going to defend Charlie Sheen. Sheen has a long history of domestic violence accusations. He has frequently behaved like a total jackass (and a borderline anti-Semitic one at that). He's also anti-vaccination. Charlie Sheen is not a guy I want to know or spend time with. I avoid his TV shows and movies.
I get that it's tempting, when bad things happen to a bad person, to revel in the schadenfreude -- especially given that Sheen has always seemed to be ultra-proud of his sex-and-drugs lifestyle. But this isn't comeuppance or just desserts -- and sorry folks, the contracting-HIV-from-tiger-blood jokes aren't funny.
HIV is not a punishment for bad behavior. It's an illness. And it's not OK to act like it is a punishment for some crime, even when the "criminal" is a public jackass like Sheen, because that just reinforces the HIV stigma our culture is already swimming in. HIV stigma makes it less likely that people get tested for HIV, and makes it dangerous for people living with HIV to disclose their status and lowers the chances they'll get health care.
So look: I'm not defending Sheen. But he deserves your scorn for the crappy things he's done and said, not because he has HIV.
2) Charlie Sheen Has Access to Better Care Than Most People Living With HIV
Hey, did you know HIV medications are super expensive? They are! Do you know who has a lot of money? Charlie Sheen, the former highest-paid man on television! But do you know who isn't that wealthy? Most people living with HIV.
The super awesome thing is that with effective medication and care, people living with HIV can expect to live roughly as long and healthy a life as their HIV-negative peers. But HIV disproportionately impacts marginalized communities, which means that a high percentage of people living with HIV can't get the care they need, let alone pay for the meds that literally save their lives -- especially if they live in one of the states that has refused federal money to expand Medicaid, the biggest payer for care to people with HIV in the United States.
Living with HIV won't be a walk in the park for Sheen, but he has access to resources that the majority of people living with HIV just don't.
3) Because Sheen Is Getting Proper Care and Treatment, He's Less Likely to Transmit HIV
Now that the interview with Matt Lauer has aired, we know that Sheen is on HIV treatment, that he has alerted his sexual partners to his status, and that, yes, he has had unprotected sex since his diagnosis. He said it's "impossible" that he transmitted HIV to them. For outsiders to the HIV community, that might not sound true, but actually? It pretty much is. Yes, even when the sex was unprotected.
Basically, when people are on effective HIV treatment, the amount of actual virus in their bloodstream goes way down -- and if the virus isn't there, they can't pass it on to other people. (Here, have a video.)
So while I would hope that no one wants to have sex with Sheen, that's because of the aforementioned alleged domestic violence stuff, not out of fear of acquiring HIV. And yes, right now there are a lot of rumors that he may have actually passed HIV on to others, but...
4) HIV Criminalization Might Sound Good on the Surface, but It Increases HIV Transmission
There's been a lot of speculation of the legal trouble Sheen might land in if he did knowingly pass HIV to anyone else. And on some level, it might feel good to say: "Yeah! He's ruined people's lives, he should pay for it!"
Except that first, the idea that HIV is a life-ruiner is, again, stigmatizing, and second, criminalizing HIV doesn't help anything -- in fact, it actively does harm. In order for transmitting HIV to be a criminal offense, the transmitters have to know their HIV status. That... really just gives people a pretty good reason not to get tested. It can seem counter-intuitive, but is incredibly important to understand -- so here are some more really good points about why criminalization doesn't work.
And oh yeah, let's also keep in mind, it's stigma that made it possible for Sheen to be blackmailed over his status. If we removed the idea that HIV is something awful and shameful -- something worth literally sending people to jail for -- then you also remove the reason even celebrities like Sheen feel a need to keep their status silent.
5) Adult Film Stars Have Relatively Low Rates of HIV
And finally, there's this: Sheen has been open about the fact that he's dated and slept with porn stars. People are citing that as if it means of course he was going to acquire HIV. But in reality, porn stars are tested really frequently for HIV. It's big news when a production is shut down due to possible HIV transmission -- but it's big news because it's rare.
When adult film performers test positive, they find it out much more quickly than most people. Again, I don't know the lives of the people Sheen has slept with -- but the porn stars probably knew their HIV statuses. Which, considering that one in eight people living with HIV in the U.S. don't know it, is pretty impressive.
So while we're working to avoid stigmatizing HIV, let's try not to stigmatize sex workers, either, OK? (And that goes for you, too, Matt Lauer, for referring to sex workers as "unsavory persons" throughout the interview.)
There is a lot more to say about this, especially about the intersection of mental health, drug addiction and HIV. But if nothing else, please keep this in mind: The jokes you make about Charlie Sheen won't hurt him. He's a super wealthy celebrity in a culture that worships those. But most people living with HIV don't have those advantages, and the stigmatizing jokes and misinformation can and do hurt them.