Charlie Sheen announced earlier this week on the Today Show that four years ago, he was diagnosed as HIV-positive. Although he apparently shared this information with all of his sexual partners, he’s being attacked on social media, and it’s clear that there’s still a very negative stigma around HIV.
His doctor, Robert Huizenga, an assistant professor of clinical medicine at UCLA, joined him on the Today Show and stated that the actor started taking antiviral therapy soon after he was diagnosed, and that he has reduced his viral load. Huizenga said that, while it’s not impossible for Sheen to infect someone with the virus, the possibilities are incredibly low.
So, with the right precautions, people who are HIV-positive can certainly still have safe sex.
“Patients who have HIV can certainly have sex. What’s important is that they do several things to decrease the risk of transmission,” says David Rosenthal, who is a medical director at the Center for Young Adult, Adolescent and Pediatric HIV at North Shore-LIJ Health System in Great Neck, New York.
So, what precautions should be taken?
“The less amount of virus floating around in one’s system, the less chance of giving it to someone else,” says Rosenthal. So, it’s important to decrease the amount of HIV in the blood, semen, and other bodily fluids. This can be achieved with antiretroviral therapy.
Antiretroviral therapy is the combination of three medications that essentially stop the virus from replicating. Patients can see results by taking a pill a day.
“If you’re able to get the viral load low, below the detection in lab tests, it’s very unlikely to transmit the virus. Not impossible, but very unlikely. The risk is far less than 1 per cent,” states Dr. Stephen Boswell, who is the president and CEO of Boston’s Fenway Health–an organization that works with lesbian, gay, bisexual, and transgender patients.
In order for a patient to get his or her viral load below detectable levels, he or she has to be diagnosed early and has to take medication every day. “It’s very hard for people to take a pill day in and day out and not miss a dosage,” says Dr. Boswell, who states that it can be difficult for people to get their viral load below detectable levels using antiretroviral therapy.
Rosenthal recommends using condoms or other types of barriers during sex, regardless of whether or not someone who’s HIV-positive is using antiretroviral therapy.
There’s also a protective option for people who don’t have HIV: pre-exposure prophylaxis, also known as PrEP, such as Truvada. A pre-exposure prophylaxis, commonly in the form of a daily pill, can reduce a person’s risk of being infected by 96 percent.
“Often I see patients that are in multiple relationships with multiple different people and they choose to start PrEP to keep themselves safe from HIV,” states Rosenthal. Pre-exposure prophylaxis is also a great option for someone who’s in a committed relationship with someone who’s been diagnosed with HIV.
Although HIV is mostly spread through anal and vaginal sex, oral sex is also a risk. Another common way to get HIV is by sharing drug paraphernalia, such as needles and syringes.