Decades on, is HIV still a taboo subject?
Charlie Sheen’s recent disclosure that he is HIV positive echoes a similar announcement made by another movie star, Rock Hudson 30 years ago – and it’s interesting to compare the two cases.
Both tried unsuccessfully to conceal their HIV status. Hudson was betrayed by his appearance: he was visibly unwell and his disclosure came just a few months before his death. Sheen appears, and is, healthy, but he says that he was being blackmailed – and his need for secrecy and his vulnerability to extortion suggests that HIV stigma remains strong.
So what has changed between 1985 and 2015?
Well, HIV has changed immeasurably, thanks mainly to the development of effective pharmacological treatments. If Rock Hudson were diagnosed today, he could reasonably look forward to a healthy life expectancy. He might also expect to be non-infectious. Sheen’s use of the word “undetectable” has done much to alert non-specialist audiences to the transformations taking place in the lives of people with HIV.
Of the roughly 80,000 people with diagnosed HIV in the UK, for example, 95% are having regular blood tests to measure levels of the virus. Of those, 90% are on treatments, and 90% of them are “virally suppressed” or “undetectable”. This means that for the majority of people with diagnosed HIV in the UK: (a) their disease progression has been essentially halted and (b) they are functionally non-infectious, that is to say it would be very difficult for them to pass on HIV to their sexual partners. The challenge for public health now is to get the estimated 25,000 people who have undiagnosed HIV infection to come forward for testing.
Changing times