Exposing HIV to the Public: The effects of Charlie Sheen going public with his HIV diagnosis*

Late last year, the actor Charlie Sheen went on the nationally broadcasted NBC morning show, TODAY, to reveal that he was HIV-positive. According to Sheen, he was being blackmailed by a sex worker who discovered his medication bottles and wanted to set the record straight and to be set free from an unpleasant situation. Sheen ended the interview hoping by revealing his status more people would open up and reveal their status.

While the interview is full of judgments and gotcha journalism, Sheen may have done some good in generating searches for topics relating to HIV.

In a just published research letter in the JAMA: Internal Medicine, researchers tracked the daily number of articles and searches on several key terms around HIV (condoms, testing, symptoms) from 2004 to 2015 by using Bloomberg Terminal and Google Trends.

Their first finding laid out clearly HIV as a media topic had been decreasing 82% in an eleven-year span as a search and news topic. This makes sense in that during this time HIV incidence rates are falling, at least for most groups, and people are living longer.

When Sheen did his interview on November 17th there was a 265% upward spike in number of articles and searches on the same keywords making it one of the highest spikes in HIV media exposure in nearly a decade.

Over one million searches were done on Google that directly related on HIV health topics such as condoms and symptoms during the first 48 hours after Sheen’s interview.

This overwhelming level of engagement with HIV suggests that proper HIV education is once more needed in America and that Sheen did a good job in bringing awareness to the disease once again.

When celebrities go public with their fights with illness, there is a flurry of interest in the disease at hand.

This is not without precedent. When both Rock Hudson and Magic Johnson revealed their statuses, in 1985 and 1991 respectively, mainstream media perked up their reporting on the disease, because it altered public perception of the diagnosis.

When Angelina Jolie went public with her decision to get a double mastectomy because of the breast cancer risk associated with her genetics, the national media picked up coverage on the disorder.

I argue that in Charlie Sheen’s case, though, is something slightly different than what traditionally happens in the media so far.

HIV is not really talked about outside the main risk groups, nor is testing outreach targeted towards the communities least at risk. Thus, when someone that does not fit the traditional narrative of HIV, read “gay”, the result is more concerning to the population at hand.

Sheen upset this reality and produced an “Oh shit!” moment for those outside of the traditional risk groups. Sheen amplified the message that people need to get tested regularly, have safer sex, and if injecting drugs, use clean and unused needles.

When celebrities go against the grain of normal expectations, unlike Jolie, who, as a woman, is supposedly more at risk for breast cancer, it generates more traffic. Breast cancer has a whole month and countless charities to support it, but HIV does not have broad media appeal.


But should people listen to Charlie Sheen about HIV? That is a more complicated question.

Sheen has gone on air and said that he sought out a cure in Mexico contrary to all medical evidence that a cure is currently unavailable in all forms of therapy.

Sheen has now become head HIV advocate for the media, a media hungry for any type of sensational flourishes to a man that tweeted his #winning descent, and what is more sensational than a cure to HIV?

This begs the question, should we listen to our celebrities when it comes to health issue? While Jolie was considered noble and brave coming out about her mastectomy and became an advocate, Sheen is a bit of an interesting case because he has not been the model patient that HIV groups were hoping for.

Julia Belluz, of Vox, believes that despite Sheen imperfections, the public health establishment should use him to generate more exposure.

Personally, that does not sit well with HIV activists or me. Ms. Belluz conveniently skips over the fact that Sheen worked with a physician that claimed to find a cure, which did nothing but to increase his viral load. Sheen knows he can make money and renew exposure of his brand by shilling these stories to Dr. Oz.

HIV is a very socially misunderstood disease and to add imperfect information to the table can create a stigma that is hard to dispel. Let’s face it, some people think that depression is so simple that smiling more, or my personal favorite, just be happy, when in reality it really says that depression is fake or just sadness.

If Sheen wanted to make a difference or make the argument that public health should use him as a resource, he certainly hasn’t shown to be responsible with disseminating the proper medical line.

Yes, it is fantastic that Sheen brought to long overdue light to the continuing fight against HIV, but when one fails to provide the right information, it becomes a questionable endeavor.

Exposure can open up the conversation, but as the conversation continues, the content of the exposure must be critiqued to provide for the realities that the affect everyday people. Not all trans people feel the exposure of trans people in the media has been reflexive of the kinds of issues that celebrities can just bypass with glamor, money, and a promise of a paycheck for each story produced.

When celebrities expose various attributes, like having a certain illness, about themselves in the media, they effectively shine a light on their issue, but then step into that light.

*Previously published on Medium.

HIV and Millennials: The Stigma Epidemic in the United States*

While the LGBT civil rights movement has been steadily moving forward towards greater acceptance among the straight community on things like same-sex marriage, there are still things that lag behind the march towards full equality, such things as transgender rights, safety (especially for transwomen of color), and access to culturally competent healthcare and support for those living with HIV.

HIV And Stigma

For those living with HIV in 2016, the stigma of a disease that was once a death sentence is still a problem within the GBT broader community. This is in sharp contrast to the bonding of a nascent gay communal identity in the 1970s and 1980s, as HIV/AIDS and newly found liberation brought many men together to fight for access to treatment and governmental action. This isn’t to say there was no stigma in the 1980s, but rather the community was more united than divided.

Today, the cause of fighting for a cure, vaccine, and prevention has a largely been left to the medical community to deal with and the problem of stigma has been left to activists.

The disease is still seen as defiling and a risk to greater group health and cohesion, despite it no longer being a death sentence.

 

HIV Is A Foreign Topic To Millennials

As we enter the 4th decade of the pandemic, HIV is a bit foreign to Millennials, as the oldest were just infants or just being born in the 1980s and in elementary school during the 1990s, we, as a group, were unconscious of the realities of sexual health and, at least for some, sexual orientation. It was during this time when the national epidemic raged and ravaged the gay community because of the lack of the powerful medication we have today.

As we grew older, the incidence rates of HIV started to decrease, thus shifting the conversation to other gay related topics began to take focus, such as gay marriage and non-discrimination policies. While discussed in the sexual health unit in my middle school science class, HIV was moved around more pressing topics of gonorrhea and birth control methods to combat national teen pregnancy rates.

HIV On The Rise In Young Populations

However, as we exited high school, and for some, college, the incidence rates of HIV infections started to trickle up. What was alarming was the fact that the newly infected were young men and a significant size were young men of color, with the CDC just publishing a report projecting that 1-in-2 young black men who have sex with men will be diagnosed with HIV some point in their lifetime. Further inspection found that there were variables in transmission that were not seen for a while, such as an increase in condomless sex and a troubling rise in crystal meth use.

HIV Overshadowed By Other “LGBT” Issues, Contributing To Stigma And Lack Of Support

With the increased visibility of the LGBT population in American culture, it stands to reason that HIV should come out of the closet as a major issue that the community should be fighting for, in addition, to fight for basic civil rights such as equal marriage and equal protection. However, HIV health has largely fell to the back of the issues. With the disease less “deadly” and the public health, medical, and governmental establishments ability to take care of the issues, allowed for other, more pressing issues to be fought for.

This contributes to the level of HIV stigma present because the Millennial generation simply has largely not known the disease as a forefront of concerns of the wider movement, nor is HIV education is not part of the sexual education experience that only a segment of the high school population receive. Ignorance is apart of stigma, especially about a disease that is no longer making national headlines. By not understanding the realities of HIV infection, empathy is stymied.

HIV And Spoiled Identity

Given that contracting HIV is considered dirty and the person now becoming a dubious citizen applies a spoiled identity marker. One of the classic sociologists, Irvine Goffman wrote a book on how people with spoiled identities use specific techniques to manage their markers through various social interactions. He showed how stigma is inherent in those identities that are in contrast of the “normals,” or white, straight, and middle class people. Those living with a spoiled identity must work around and manage stigma, sometimes grouping together, retreating from society, or rearranging their identity markers in order to strategically move through the different realities of living among “normals.”

The stigma surrounds people living with HIV is also very caught up in the American pursuit of healthy living. Scholars such as Jonathan Metzl, a medical sociologist, have uncovered that the healthy living “industrial-complex” works as a moral tracker, thus making the argument that engaging in healthy behaviors is considered to be morally correct and practices good citizenship on the part of the individual. To live with a chronic disease that is caught through “unsavory” means, is not being a good citizen.

HIV: Painful Disclosure, Painful Responses

People living with HIV have to exist in a system where revealing their status is a minefield of emotions and microaggressions. This has a real impact on the health of the individual and their partners. If embarrassed about their status, people are not as likely to reveal it until a connection has been made or even at all, despite several states criminalizing knowingly spreading HIV and not disclosing their status to their partner(s), affecting more men of color than any other group. HIV disclosure is a heated and debated topic with many activists believing it should be up to the person to decide to disclose, rather than a mandatory action.

Status disclosure is not only about revealing to sexual partners, but also disclosing to friends and family, who may or may not be supportive in the face of an HIV infection. This creates a stigmatized identity that often manifests in the fear of causal infection. It is absurd to think that one can contract HIV through kissing, sharing toilets, sharing plates and utensils, but alas all of these have played a role in a defining stigma of HIV individuals. The microaggressions of these fears cause psychological distress that builds up over time, leading to mental illness.

Lack Of HIV Eduation And Basic Understanding Of HIV

In addition to not disclosing their status, the stigma of contracting HIV and the various moral judgments that inevitably pop up during testing and treatment in the form of  questions and comments like “How did you contract it,” “Why didn’t you practice safer sex? You should know better” can lead to HIV-positive people to delay, forgo treatment, or dropout of the pipeline of care. By not pursing treatment, the individual is putting their health at risk for serious complications from various infections and other disorders due to a comprised immune system.

The San Francisco AIDS Foundation’s Strut clinic, a resource for the GBT community that provides health and wellness programs, has a program called the Positive Force. It is run by HIV-positive men for other men living with HIV where they address how to deal with stigma at the doctor’s office and topics surrounding disclosure. The Force also runs events for HIV-positive men to socialize with like-minded individuals. This is an important resource for HIV-positive men to have in order to combat the stigma that exists outside these spaces.

DDF, Grindr, And Young Gay Men

If you spent any time with a Millennial gay or bisexual man, you will likely heard about Grindr, a hookup smartphone app for gay, bisexual, and bi-curious men to find like-minded men for hookups and dates. Grindr launched in 2009 by Nearby Buddy Finder LLC. Each profile has the option for some text about what the user is looking for in a partner, which frequently demarcates racial “preference,” sexual position, and sometimes kinks. The profile also has fields for the user to input their stats, such as height, weight, age, and “tribe.”

One thing that is also present on some profiles are the acronyms, like DDF (disease, drug free), and words such as “clean” or “neg 4 neg” (HIV-negative man looking for HIV-negative partner). These descriptors, especially “clean,” can be seen as creating stigma and microaggressions around HIV, as they make HIV-positive individuals undesirable risks to the socio-sexual network of Grindr and beyond.

Continue reading “HIV and Millennials: The Stigma Epidemic in the United States*”

Finding a Cure for Charlie Sheen*

In the latest development of the media circus of Charlie Sheen’s HIV diagnosis, the doctor, Dr. Samir Chachoua, who treated Sheen’s HIV claims to have found the cure the disorder in arthritic goat milk.

Yes, you read that correctly, goat’s milk, as if the 35-year fight to find a cure and vaccine suddenly was in vain because the doctors are too faithful to the scientific method.

Withstanding the critiques of the scientific method and the state of modern medical science, the medical establishment is sure that HIV is difficult to eradicate permanently, with a single HIV patient being cured of the disorder, Timothy Brown, aka The Berlin Patient.

The current treatment regimen for HIV-positive patients is a steady stream of what are called highly active antiretrovirals treatment (HAART). If the patient is consistent in taking their medication regularly, i.e. every day, the virus retreats to the lymph nodes and fails to reproduce, thus sparing the immune system. This isn’t to say that the person is “cured,” but rather, just stemming the tide.

But goat’s milk? Dr. Chachoua claims that his method of Induced Remission Treatment, which apparently works on cancer too, works because of a special agent in the milk that targets the HIV virus. According to database searches, Dr. Chachoua has never published the results of the supposed miracle cure, claiming that researchers at UCLA School of Medicine and its associated hospital Cedars-Sinai Medical Center stole and buried his work.[1]

Continue reading “Finding a Cure for Charlie Sheen*”