Ending AIDS: it takes more than two and a half men
01 Dec 2015 by Ludo Bok, Team leader, Development effectiveness, HIV, Health & Development Group, UNDP
The media has gone crazy over the disclosure of the HIV status of one of America's most controversial stars, Charlie Sheen. Much of the reporting has been sensationalist, focusing on his multiple marriages and struggles with substance abuse. The majority of it has been dominated by prejudice and moral finger-wagging. Social media went into overdrive, as #Charliesheen trended around the world.
Responses have been mixed, with reactions ranging from admiration for his very public coming out to speculation about how he contracted the virus and the vilification of sex workers. It also sparked discussions around confidentiality, blackmail and the legal implications of not disclosing his HIV status to his ex-partners.
If there is one take-away message, it is that stigma continues to drive the HIV epidemic, both in the United States and around the world. Thirty years on, the media is still obsessed with sensationalizing HIV and the reporting on it is riddled with misconceptions and false information about the disease.
The coming out of one of the biggest stars in recent history has re-generated an interest in a disease that people had become blasé about. A disease that, while showing declines in a number of regions, has seen an increase in new cases across the western world, the Middle East, North Africa, Eastern Europe and Central Asia.
Truth: It has once again revealed how divisive HIV is and seems to bring out the worst in people.
Truth: UNAIDS estimates that globally, nearly 5,500 people get infected with HIV every day. and have to deal with this reality.
Sheen’s story highlights a range of issues that people living with HIV are up against.
- The stigma and shame that unfortunately is still attached to HIV.
- The fear of disclosure: telling your friends and family and the reactions of potential new lovers, colleagues and others. This is not an easy process and for some this can result in depression or mental breakdown.
- The issue of criminalization for not disclosing your HIV status to your partner and the potential of being charged for exposing them to the virus or transmitting it. In certain countries, once diagnosed with HIV, you could be charged with attempted manslaughter if you have (unprotected) sex with your partner.
These are just some examples. Stigma and discrimination are everywhere - in our communities, hospitals, offices and schools. No wonder HIV testing rates are at an all-time low. UNAIDS estimates that over 50% of HIV+ people don't know they are living with the disease.
Meanwhile, HIV is more and more regarded as a chronic, manageable disease like diabetes or heart disease. And there is reason for optimism. Improved treatment options have prolonged life expectancy. Research has shown that being on treatment and having an undetectable viral load reduces the risk of HIV transmission to sexual partners, and pre-exposure treatment (PrEP) has been introduced as a prevention tool that protects against HIV transmission.
However, this re-medicalization of the HIV response re-enforces the notion that treatment is a magic bullet. But let’s not kid ourselves. We can’t just treat our way out of this epidemic. Without implementing comprehensive combination prevention programmes, addressing stigma and discrimination, and having laws and policies in place that protect people living with HIV and encourage them to seek prevention and treatment services, we won’t reach the end of the AIDS epidemic.
HIV is nothing to be ashamed about. Let’s hope that in the near future, all people living with HIV or those receiving a positive diagnosis can release the shackles of secrecy and isolation. Together, we should inspire a greater understanding of what it means to be living with HIV and work on ending the epidemic by 2030.