The decision by former Wales rugby captain Gareth Thomas to speak publicly about living with human immunodeficiency virus (HIV) is an important milestone.
When first discovered in the 1980s, end-stage HIV, or Aids, was considered a death sentence. The virus severely weakened the immune system, allowing the body to be overrun by other diseases.
As a sexually transmitted virus, early on it became identified with gay men. It later became clear it could also be contracted through blood products.
Thomas said revealing that he was living with HIV was similar to coming out as gay in 2009 because of “the fear, the hiding, the secrecy, the not knowing how people are going to react”. That he received blackmail threats is a grim reminder of the stigma that still surrounds the diagnosis.
By speaking publicly about his HIV diagnosis, Thomas has done a valuable public service
To some extent, attitudes towards HIV are stuck in the past. Public information campaigns in the 1980s, warning people to take precautions against Aids, have left a legacy of misunderstanding. But such is the magnitude of medical advances in the fight against HIV that people living with the condition have a near normal life expectancy.
Lifelong combination antiretroviral therapy (cART) can prevent the virus being transmitted to others. A broad range of anti-viral drugs capable of suppressing HIV infection is now available. Coupled with the advent of PrEP – pre-exposure prophylaxis – whereby people who are HIV-negative take a pill once a day to reduce the risk of getting infected if they are exposed to HIV, the spectre of Aids as a devastating illness has faded.
Thomas used his announcement to promote the hashtag #cantpassiton. Part of an effort to increase awareness of the fact that effective HIV treatment is also effective HIV prevention, it encompasses the message “undetectable equals untransmittable”. With effective treatment, the amount of virus in the blood is undetectable, which in turn means the chance of transmitting HIV to a sexual partner is zero.
By speaking publicly about his HIV diagnosis, Thomas has done a valuable public service.