Charlie Sheen offers a stark reminder of the lingering stigma around HIV

"It's a hard three letters to absorb" - Charlie Sheen on being told he is HIV positive. Photo / Getty Images

It's hard to believe that anything the actor Charlie Sheen does could surprise anyone anymore. But he went on the Today show for an interview with Matt Lauer and revealed that he was HIV-positive.

And beyond the simple facts of his health, the former Two and a Half Men star's interview made something depressingly clear. In 2015, more than 30 years after the Aids epidemic began, treatment may have advanced considerably and HIV is no longer a death sentence. But it's still a diagnosis that someone can be blackmailed over, and that we still don't know how to talk about without shame or inquisition.

The complexities of discussing HIV status were evident from the early moments of the interview. "I'm here to admit that I am, in fact, HIV-positive," Sheen said, a telling choice of words. Lauer read from a letter where Sheen said his shame over his diagnosis - which came four years ago after a period when Sheen had a highly-publicised meltdown - contributed to a period of alcohol and substance abuse.

That Sheen spiralled into depression after his diagnosis and was reluctant to come forward may seem surprising: after all, his own industry has worked incredibly hard to combat stigma against Aids and HIV sufferers. But in 2011, when the Henry J. Kaiser Family Foundation polled 2583 adults on their attitudes about HIV, they found though the sense of urgency around the disease had fallen in some communities (remaining among African-Americans), "substantial shares of Americans continue to express discomfort at the idea of interacting with people living with HIV".

Forty-five per cent reported discomfort about the idea of people with HIV handling food they would eat, 36 per cent expressed anxiety about living with someone with HIV, and 29 per cent were worried about having their child taught by a teacher who had tested positive for the virus. The foundation's researchers found the people they polled were less moralistic about Aids and HIV, though those attitudes hadn't entirely vanished.

In 1987, 43 per cent of respondents considered the disease a punishment, while in 2011, only 16 per cent thought so. And the number of respondents who said people who tested positive for HIV or contracted Aids were to blame for their condition fell from 51 per cent to a still-high 29 per cent.

Sheen doesn't seem like a man who has felt much pressure to keep his life and personal behaviour a secret over the years. But with attitudes like these still prevalent, it's perhaps not surprising he wanted to keep his diagnosis private, and that his desire to do so made him profoundly vulnerable to people who threatened to expose him.

Lauer implied the people who had extorted and blackmailed Sheen were sex workers, people Sheen described as "unsavoury and insipid types" in a letter, including one woman who threatened to sell a photo of Sheen's anti-retroviral medication to the press.

"I have paid those people. Not that many. But enough to where it has depleted the future," Sheen said, declining to say precisely how many people he had paid off. "I don't want to guess wrong, but enough to bring it into the millions. And what people forget is that's money they're taking from my children. They think it's just me. But I've got five kids and a granddaughter."

Blackmail and extortion may be the headlines on this particular ugly morality play. But the range of the action and questioning expanded well beyond the money Sheen had paid out of fear.

As if to ensure that he still deserved our sympathy, Lauer grilled Sheen about his sexual behaviour since his diagnosis.

"Why would you make the same mistake over and over?" he demanded, asking Sheen why he kept hiring prostitutes. (It's certainly unsavoury to blackmail someone, but there was a nasty edge to the conversation about the sex workers Sheen hired, as if having sex for money is inherently immoral but paying for it is just a symptom of mental health issues.)

"Because I was so depressed," Sheen told him, giving an answer that is politic if not necessarily in line with his past behaviour.

"Have you knowingly, or even perhaps unknowingly transmitted the HIV virus to someone else since your diagnosis?" Lauer wanted to know. Sheen declared it "impossible."

And Lauer went in for details, asking Sheen, "Have you had unprotected sex on any occasion since of your diagnosis?" Yes," Sheen told him. "But the two people I did that with were under the care of my doctor and they were completely warned ahead of time." And Sheen emphasised that on no occasion since his diagnosis had he failed to inform a sexual partner about his HIV status.

It may have been an educational exchange, but it was still a telling reminder that the public still thinks in terms of good and bad HIV patients. And the idea that Sheen hopes he might get credit for kicking down the door that imposes silence around HIV and Aids is a stark reminder that such a door still exists at all.