The Charlie Sheen Effect on Rapid In-home Human Immunodeficiency Virus Test Sales
One in eight of the 1.2 million Americans living with human immunodeficiency virus (HIV) are unaware of their positive status, and untested individuals are responsible for most new infections. As a result, testing is the most cost-effective HIV prevention strategy and must be accelerated when opportunities are presented. Web searches for HIV spiked around actor Charlie Sheen’s HIV-positive disclosure. However, it is unknown whether Sheen’s disclosure impacted offline behaviors like HIV testing. The goal of this study was to determine if Sheen’s HIV disclosure was a record-setting HIV prevention event and determine if Web searches presage increases in testing allowing for rapid detection and reaction in the future. Sales of OraQuick rapid in-home HIV test kits in the USA were monitored weekly from April 12, 2014, to April 16, 2016, alongside Web searches including the terms “test,” “tests,” or “testing” and “HIV” as accessed from Google Trends. Changes in OraQuick sales around Sheen’s disclosure and prediction models using Web searches were assessed. OraQuick sales rose 95% (95% CI, 75–117; p < 0.001) of the week of Sheen’s disclosure and remained elevated for 4 more weeks (p < 0.05). In total, there were 8225 more sales than expected around Sheen’s disclosure, surpassing World AIDS Day by a factor of about 7. Moreover, Web searches mirrored OraQuick sales trends (r = 0.79), demonstrating their ability to presage increases in testing. The “Charlie Sheen effect” represents an important opportunity for a public health response, and in the future, Web searches can be used to detect and act on more opportunities to foster prevention behaviors.
KeywordsHuman immunodeficiency virus HIV HIV prevention Surveillance Health informatics
Dr. Ayers had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. We thank OraSure for freely sharing their testing data with our research team.
Compliance with Ethical Standards
Conflict of Interest
Dr. Ayers and Dr. Althouse share an equity stake in Directing Medicine LLC that advises clinician-scientists how to implement some of the methods embodied in this work. Dr. Dredze has received consulting fees from Directing Medicine LLC and Sickweather LLC, who use social media for public health surveillance. Bloomberg LP provided salary support for authors [MD], but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The company who provided testing data (OraSure) did not have any role in the study design, data analysis, decision to publish, or preparation of the manuscript. Neither the data nor the methods described in this article are proprietary. There are no other conflicts to be reported.
This study did not involve human subjects but relied upon secondary data analysis of publicly available data.
Did not apply
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