When Charlie Sheen came forward with his HIV diagnosis in Nov. 2015, he said he revealed his status to put a stop to years of extortion and blackmail. His televised announcement came one day before a tabloid magazine was set to publish an "expose” that the controversial star is HIV positive.
While the announcement was a coup for NBC's "Today" show and a reported relief to the actor himself, it also accomplished something else entirely: According to experts, it was the most significant HIV awareness event of the last decade.
Researchers behind a new study about Sheen’s impact on HIV awareness say that according to the sheer volume of news his announcement generated, as well as the millions of Google searches people made about HIV, the reveal was the largest prevention event since as early as 2004. What's more, his influence in HIV awareness may be ongoing.
"Charlie Sheen’s disclosure is potentially the most significant domestic HIV prevention event in the last decade," said John Ayres, a public health expert at San Diego State University and lead author of the study. "How do we improve and enhance the 'Charlie Sheen effect,' to make it larger?"
A spike in HIV searches on Sheen's disclosure day
Ayres traced back as far as 2004, the earliest year news data is available via Google Trends. For consistency, he also analyzed indexed news stories from Bloomberg Terminal data since 2004, too. He found that from 2004 to 2015, news stories about HIV declined, falling from 67 per 1,000 to 12 per 1,000.
But Sheen’s disclosure day on Nov. 17 coincided with a 265 percent increase in news stories mentioning HIV, and more than 6,500 additional news stories on Google news alone.
“The potential that Sheen has to do something about spreading messages of awareness and information is potentially greater than when Magic Johnson disclosed his HIV status because of how connected we are and how we share information,” said Eric Leas, one of the researchers and a doctoral student at the University of California, San Diego School of Medicine. "Now we can go online and find information by typing HIV into the browser or asking Siri, whereas in the early 1990s, you couldn’t do something like that."
Sheen's disclosure day also coincided with the greatest number of HIV-related Google searches ever recorded in the U.S. -- a whopping 2.75 million more searches than normal. Some 1.25 million of those were related in some way to public health issues, mentioning additional terms like condoms, symptoms and testing. In all, Nov. 17 saw a 417 percent higher-than-expected search for HIV-related terms, Ayres found.
“With Internet searches, we can see what the public is thinking, and when,” said Ayres. “And moreover, we can see that the public is actively engaged in trying to improve their health or health awareness by search.”
Two important lessons for public health experts and media
Ayres said his findings reveal two pointed lessons: one for the public health community, and one for journalists. The first is that Charlie Sheen, if he were willing, could potentially lend star power to a campaign about how to get tested for HIV or how to prevent it. Currently more than one in eight Americans with HIV do not know they have it, and the federal government estimates that the U.S. sees about 50,000 new infections every year.
HIV is a lifelong disease that can be controlled with the proper medication, but if left untreated, it can lead to AIDS, which can be lethal. If you don't know you have HIV, you could potentially spread the disease to other partners without realizing it.
"Public health advocates are not harnessing the Charlie Sheen disclosure to promote HIV prevention,” said Ayres. "If you look at AIDS.gov for example, they don’t have a single promotional piece of material that mentions Charlie Sheen.”
Of course, Sheen would generally have to be a willing participant in order to go along with such public health campaigns. Leas said that if he could reach out to the actor, he would talk to him about the enormous potential he has to raise awareness about the disease.
The second lesson about this spike in Google searches, Ayres said, is that journalists may have missed an opportunity for more education about the disease.
"Imagine if every news article written about Charlie Sheen also mentioned how to get tested for HIV, or how to prevent HIV,” he said. “What can we do in the media community and the public health community to make that happen?"
The celebrity effect on medicine is real
Sheen isn’t the first celebrity to influence awareness about a medical condition. One year after Angelina Jolie wrote an op-ed in the New York Times about her decision to have a preventive double mastectomy in order to avoid breast cancer, researchers in the United Kingdom said the number of requests for genetic testing among high-risk women more than doubled.
And when Robin William's widow Susan came forward in Nov. 2015 to share the actor's post-mortem diagnosis of Lewy body dementia, Internet queries for the Lewy Body Dementia Foundation -- the only national organization devoted to the disease -- were so numerous that the organization’s site crashed for the day.
Perhaps what’s most amazing about the “Charlie Sheen Effect,” as Ayres dubbed it, is the fact that unlike Jolie's or Williams’ news, Sheen’s announcement was not specifically tied to a public health initiative or call to action for more testing, awareness or research. That means Sheen’s influence could have an even larger impact on HIV awareness and prevention, provided the actor and the cause become intertwined in a purposeful way, the researchers concluded.
“We have people engaged unlike ever before, and they may continue to still be engaged,” said Ayres. "How do we make the engagement turn into public health success with increased awareness of HIV status, understanding of the symptoms of HIV and greater use of condoms?"
Ayres and Leas’ study was published online Monday in the journal JAMA Internal Medicine. Ayres claimed a conflict of interest in the study in that he holds a financial stake in two companies that assisted with the research. The businesses specialize in media monitoring for public health issues and the use of big data to provide insights for doctors and public health experts.
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