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Commentary & Opinion

Sean Philpott-Jones: Tempering Sheen’s Shame

Television actor and Hollywood bad boy Charlie Sheen revealed that he was HIV positive last month, breaking four years of silence during which he allegedly paid out millions of dollars in extortion in an attempt to keep his diagnosis private.

Public reaction to Mr. Sheen’s announcement was swift and mixed. Many praised Charlie’s so-called ‘courage’ in making his diagnosis known in a live television interview.  Others were quick to condemn or blame him, suggesting that he got what he deserved after engaging in years of unsafe and risky behavior. Still others, myself included, had a more tempered response, wishing Mr. Sheen well but questioning the circumstances and manner in which he revealed his HIV status.

When Charlie initially made his public announcement, some of the first questions that he was asked were about his behaviors in the years since his first diagnosis. Did he inform his intimate partners about his HIV status? Did he have unprotected sex or engage in other activities that could put others at risk of acquiring HIV?

For the most part, I believe that those sorts of questions are inappropriate. What Mr. Sheen does in his private life is none of our business, despite Charlie’s penchant to live his life very publicly. That said, I think it is worth discussing the responsibilities of those who know that they are HIV positive: to whom are they required to disclosure their status, and what precautions must they take to prevent spreading the virus to others?

If you were to ask someone as knowledgeable as former Playboy Playmate and anti-vaccination activist Jenny McCarthy, the answer is quite clear: you should reveal your HIV status to everyone and spend the rest of your life avoiding all human contact.

Ms. McCarthy is apparently upset that she wasn’t told when she played Charlie’s love interest on a few episodes of the television show Two and a Half Men, including scenes in which the script called for her to hug and kiss Mr. Sheen. It is possible that she missed the health science class in which HIV transmission was discussed, that she truly doesn’t know that the virus cannot be spread by hugging, kissing, or drinking from the same glass.

More likely, as is still commonplace in the US and the world, Jenny sees HIV as something to be ashamed of. She has internalized the belief that those who are infected with the virus are somehow dirty and depraved, and are the kind of people that virtuous citizens like Jenny McCarthy have the right to avoid.

What about some of the others that Charlie has been involved with since his diagnosis? Clearly they have a potentially stronger moral claim for knowing Mr. Sheen’s HIV status than Jenny McCarthy. 

It now seems that a number of women that Mr. Sheen has been intimate with in the past four years plan to sue, starting with his former fiancéeScottine Ross. Last week Ms. Ross filed a lawsuit seeking $1 million in damages for emotional distress. According to the court documents filed, she found out that Charlie was HIV positive only after finding his antiviral medications in the medicine cabinet, a discovery that occurred months after they had begun a sexual relationship.

Mr. Sheen, of course, denies these allegations, setting up a classic “he said-she said” argument that the courts will be required to settle. Unfortunately for Charlie Sheen, he could also face criminal prosecution as California is one of 33 US states that makes it illegal to expose an uninfected individual to HIV through sex, shared needles or other routes of transmission.

Here’s the problem with this case. First and foremost, the varying legal requirements for disclosing HIV status aside (a topic I’ve discussed in a previous commentary and in an article in the International Journal of Law in Context), consensual sex implies that there is a tacit agreement between the partners involved. By becoming intimate with Mr. Sheen, Scottine Ross herself had the obligation to ask Charlie about his HIV status and, based on the answer and her own status, to negotiate acceptable behaviors and limits. There may be a greater onus on Mr. Sheen, but unless Charlie knowingly lied to her about his diagnosis Ms. Ross also bears some responsibility in this case.

Moreover, there is an asymmetry here. We assume that those who are HIV positive have a moral obligation to disclose their status. By contrast, people who frequently engage in unsafe sexual encounters but who do not know that they are HIV infected — even if they have a strong reason to assume so, based on behavior — are under no such obligation to disclose this information to a partner.

The moral obligation in this case is not disclosure. Instead, it's the more general obligation to protect your partner from known risks, be it HIV, herpes, or any other sexually transmitted infection. But we know that treatment of those with HIV is as effective in reducing the risk of viral transmission as using condoms. Modern antiretroviral drugs can essentially render a person non-infectious, and we know that Charlie Sheen – unlike so many others currently living with HIV – is on treatment. He and his doctor have said so publicly, and have released medical records to prove this.

As I see it, Mr. Sheen took the precautions that make transmission exceedingly unlikely, meeting his moral obligation to protect his partners from intentional and malicious infection with HIV. Disclosing his HIV status to his partners, or even to the public, was laudable but not morally obligatory. 

A public health researcher and ethicist by training, Dr. Sean Philpott-Jones is Director of the Bioethics Program at Union Graduate College-Icahn School of Medicine at Mount Sinai in Schenectady, New York. He is also Director of Union Graduate College's Center for Bioethics and Clinical Leadership, and Project Director of its two NIH-funded research ethics training programs in Central and Eastern Europe and in the Caribbean Basin.

The views expressed by commentators are solely those of the authors. They do not necessarily reflect the views of this station or its management.

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