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Charlie Sheen Has HIV, But His Chances Are Good

Actor Charlie Sheen said Tuesday he’s infected with HIV, the virus that causes AIDS. But he's lucky enough to have access to treatment for it.
Frederick M. Brown / Getty Images file

Actor Charlie Sheen said Tuesday he’s infected with HIV, the virus that causes AIDS. But he says he’s being treated for it and that the virus is “undetectable” in his blood.

Here are five things to know about living with HIV in the U.S. today:

It’s not a death sentence any more

Dozens of drugs are on the market now to treat the human immunodeficiency virus (HIV). Many studies have shown that when people take them as directed, they can stay very healthy and don’t develop the diseases, from cancer to pneumonia, that used to make AIDS so deadly. People are now advised to start taking drugs as soon as they’re diagnosed.

Image: Charlie Sheen
Frederick M. Brown / Getty Images file

But there’s still no cure

The drugs have to be taken for a lifetime. People might be able to safely take short breaks from medication, but the AIDS virus lurks in the body and almost always builds back up in the blood if people stop taking the drugs that suppress them. When patients have “undetectable” levels of virus, that doesn’t mean it’s not there. It just means what virus is in their bodies isn’t circulating in obvious places, like the blood.

Drugs are easier to take and safer than ever before

The drugs that control HIV only work well when they’re taken as cocktails, controlling the virus from several different directions. This made it difficult in the past for HIV patients – they had to take different pills at different times of day, some with food, others without. Now combinations of pills make it easier. And new formulations mean side-effects, such as diarrhea and unhealthy cholesterol levels, are far less likely to happen. There’s even a once-a-day-pill that combines four powerful drugs into one dose.

Treatment can protect sex partners

Studies have shown that if people are taking HIV drugs consistently and have the virus driven down to undetectable levels, their sex partners are far less likely to become infected – as much as 95 percent less likely. And sex is by far the number one way HIV is spread. It can spread through all types of sex – anal sex, vaginal sex and oral sex. Kissing almost never spreads HIV but it can be spread via shared needles, in blood transfusions, in breast milk and between a mother and baby at birth. And while good treatment can reduce the risk of passing HIV along, that risk is not zero.

“A person with HIV can still potentially transmit HIV to a partner even if they have an undetectable viral load, because HIV may still be found in genital fluids (e.g., semen, vaginal fluids). The viral load test only measures virus in blood,” the National Institute for Allergy and Infectious Diseases says.

“A person’s viral load may go up between tests. When this happens, they may be more likely to transmit HIV to partners.”

Many factors can affect how well HIV drugs work from day to day and people can forget to take their drugs, as well. So infectious disease experts recommend that everyone who has HIV use a condom when having any type of sex. The Centers for Disease Control and Prevention says only 30 percent of Americans infected with HIV have it under control.

Drugs can also protect people who don’t have HIV

There’s no vaccine against HIV, but taking just one HIV drug every day can protect people from catching the virus. Tests in people married to or living with HIV infected patients show they’re far less likely to become infected themselves if they take a pill called Truvada every day. It’s called pre-exposure prophylaxis, or PrEP. The latest study, published in the Journal of the American Medical Association on Monday, found just two people out of more than 550 who took the drugs became infected over four years, and their blood tests showed they were not taking the drugs consistently.

The 2010 Affordable Care Act, aka Obamacare, is supposed to make it easier for people to get treated for HIV and it requires health insurance companies to pay for testing and treatment. Medicare pays for the drugs for everyone over 65. But Medicaid, which insures people with low incomes, varies from state to state and different private health insurers provide differing amounts of coverage. So people without health insurance or who don’t have generous health insurance plans can find it difficult to pay for the drugs, even with plans such as the federal government’s Ryan White HIV/AIDS program.

HIV infects 36.9 million people around the world, according to the United Nations AIDS agency UNAIDS. Two million people are infected every year and more than a million die of AIDS. In the United States, more than 1.2 million people have HIV, and about 50,000 people are newly infected each year.