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Culture War Roundup for the week of January 2, 2023

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How the worm turns. Am I remembering correctly that among Charlie Sheen's more grievous sins that finally got him taken off the air, was promoting U=U?

Sheen told NBC's Matt Lauer that it’s “impossible” he could have infected anybody else. But is that true?

Studies have shown that when people take strong cocktails of HIV drugs, they are far less likely to infect someone else. But the odds are not zero.

"A person with HIV can still potentially transmit HIV to a partner even if they have an undetectable viral load, because HIV may still be found in genital fluids (e.g., semen, vaginal fluids)," the National Institute for Allergy and Infectious Diseases says.

Huizenga confirmed he’s told Sheen this.

“Individuals who are optimally treated with undetectable viral loads … it’s incredibly rare to transmit the virus,” Huizenga said. “We can’t say that that’s zero, but it’s a very, very low level.”

Public health experts still advise very strongly that people with HIV use condoms every time they have sex.

It’s easy to forget, and if people don’t take their drugs on time, the virus can not only come back, but it can develop what’s known as resistance. That means the drugs don’t work as effectively, and patients have to move to different mixtures of the drugs to control it.

“We’re petrified about Charlie. We’re so, so anxious that if was overly depressed … he would forget these pills,” Huizenga said.

Charlie Sheen says he has "undetectable HIV." Here's what that means.

Importantly, these drugs don't cure patients, but, as Sheen's physician explained, they suppress the virus to the point that it's undetectable in the blood. That means there's a very small chance that people on treatment can pass on the virus to others. (The rate of HIV infection for negative partners was 96 percent lower if the positive partner was on treatment, according to government data.)

Men who have sex with men (referred to as "MSM" in the chart below) are still the group most overwhelmingly affected by the disease. This is a problem that's only growing in the gay and bisexual community, as Vox reporter German Lopez explains here.

Too bad for Charlie Sheen he wasn't gay, or a pharmaceutical company.