Charlie Sheen is one of the 1.2 million people living with HIV in the United States.
The actor revealed on the "Today Show" Tuesday he has known he is HIV positive for some time, and that he has paid people millions of dollars to keep them from exposing his secret.
"I think that I release myself from this prison today," Sheen said.
His reasoning is not unique among HIV patients. "They may be ashamed or worried their HIV status could keep them from finding someone with whom to have a meaningful relationship," says Harry Rosado-Santos, MD, an infectious diseases provider and director of the Ryan White Program at University of Utah Health. "Unfortunately, their feelings may be justified, because a stigma around HIV still exists."
It is that stigma that may keep people from being tested for HIV, even if they are engaging in high-risk behavior. The Centers for Disease Control estimates that of those infected with HIV, almost one in eight are unaware of their status.
"They may be in denial," Rosado-Santos says. "They may reason that people with HIV are sick. If they feel good, they can't possibly have HIV."
Denial is not the only reason some people go undiagnosed. "They may not be cognizant they are at risk," says Sankar Swaminathan, MD, the chief of the Division of Infectious Diseases for University of Utah Health. "They may not be educated as to what the risk is or not realize their partner may place them at risk."
The CDC is clear about who should be tested and when. "Everyone between the ages of 13 to 64 should be tested, regardless of perceived risk," says Swaminathan.
"Those engaging in risky behavior should be tested twice a year, every six months," adds Rosado-Santos.
Identifying HIV infection is key to its proper treatment. While the disease is not curable, it is treatable with a variety of treatment regimens.
"Regimens are tailored to the particular patient," says Swaminathan. "It depends on what they may have been treated with previously, the resistance pattern of the virus they have, and if there are other special circumstances to consider."
The most important part of HIV treatment is the proper administering of medications to suppress the virus in the body. "Patients also should avoid other infection risks," says Swaminathan.
Sheen's admission of his HIV status could be a watershed moment in making people aware of the illness, the need for testing, and the treatments helping patients live long, healthy lives, the doctors say.
"For some people, this could be a message that it's OK to admit to being HIV positive and seek care," says Rosado-Santos. "It could be when they hear Mr. Sheen reveal that he has HIV infection, they will be encouraged to get tested and, if they are positive, to get appropriate HIV medical care."