The actor Charlie Sheen announced Tuesday that he is HIV positive. He said in an interiew on NBC News that he was diagnosed four years ago.

According to the World Health Organization, nearly 78 million people have been infected with the HIV virus and about 39 million people have died of HIV since the beginning of the epidemic in the 1980s.  Globally, an estimated 35 million people were living with HIV at the end of 2013. Charlie Sheen. Photo courtesy NBC News.

Bertram Jacobs, director of the School of Life Sciences in the College of Liberal Arts and Sciences, and professor at the Center for Infectious Diseases and Vaccinology at Arizona State University’s Biodesign Institute, says HIV/AIDS has gone from a death sentence to a manageable disease. But he emphasizes that costs and other hurdles have put a vaccine a decade or more from becoming a reality. 

ASU Now: How far have we advanced over the past few decades in the treatments for those with HIV/AIDS? And how have these developments affected quality of life and survival rates among those diagnosed as HIV positive?

Bertram Jacobs: We have made incredible progress in treating AIDS since 1995.  The treatments that are available now can allow people to have a relatively normal life span, and can also decrease transmission to uninfected people.  The drugs do have side-effects, which are often manageable, and are expensive.  However, we need to expand access to these life-saving drugs, both in the US and around the world.

ASU Now: Given your research over the past decade, what is the likelihood — and possible timeline — that we soon will develop a vaccine for people diagnosed as HIV positive?

BJ: There are still hurdles to be overcome.  We have had the first positive vaccine trial in Thailand, which suggests that a protective HIV vaccine is possible.  We are learning how people develop broad immune responses to HIV.  All of this suggests that a vaccine is possible, but it is probably still at least a decade away.

ASU Now: From the early days of the epidemic in the 1980s to today, does it seem that this serious disease has slipped from public awareness and involvement? If so, why?

BJ: Certainly, the epidemic has slipped from public awareness. Fewer people are dying, both in the US and worldwide, because of the power of the current anti-retroviral therapy to keep people alive, so HIV/AIDS appears to be less of a problem.  But this comes at a cost, both in the cost of the drugs and the cost to those who don’t have access to the drugs.

ASU Now: How far behind the U.S. are developing countries in responding and treating people diagnosed as HIV positive? Is this tied primarily to the cost of treatment? And how can we close the gap? 

BJ: All countries, including the US, have difficulties getting universal access to life-saving anti-retroviral therapy. That is primarily an issue of cost.  While generic anti-retroviral drugs are available in much of the developing world, they still place a huge cost burden on the economies of developing countries, and are currently subsidized by developed countries.  But they are critical, both to keep people alive and to help stop the spread of HIV. So it is imperative that we find ways to get universal access to these drugs, both from a personal health point of view and a public health point of view, to help stem the tide of HIV infection.