There are new effective strategies to reduce the risk of HIV infection.
Charlie Sheen’s recent announcement that he has HIV has raised concerns about whether he may have transmitted the infection to other people.
While we obviously don’t know his specific medical details (and really, it’s none of our business), HIV treatment is effective at reducing transmission. This is known as the “treatment as prevention” strategy.
There have been many advances in HIV care since Rock Hudson was diagnosed in the 1980s. At this time, the prognosis of AIDS was similar to patients with advanced cancer. Since the mid-1990s, combinations of antivirals have markedly improved the survival of people living with HIV. Modern combinations are simple to take (as few as one tablet, once a day) and associated with much fewer side effects than older drugs.
The life expectancies of people living with HIV are now comparable to the general population, both in the developed and developing world.
Antiviral drugs work by interfering with the replication of HIV. This results in a drop in the viral load-the concentration of virus detectable in blood. This doesn’t mean, however, that the virus is eradicated. HIV can hide in sanctuary sites in the body (known as “latency”) and will quickly become detectable if the antivirals are stopped. In many people taking treatment, the concentration of virus is often undetectable, but this doesn’t exclude the possibility of very small amounts of circulating virus that are below the limit of the tests that detect them.