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As the world’s biggest HIV conference opens in Rio de Janeiro, one of the epidemic’s oldest enemies remains stigma.
HIV no longer kills people who start treatment early, but shame, silence, and delayed care still do.
Thabani Nyoni explains why scientists say ending the epidemic depends as much as trust, mental health, and communities as it does on medicine.
The 95-95-95 targets aim to get people with HIV onto treatment, but very few countries have reached these goals.
According to the national health department, South Africa is at 96-79-94, meaning only 79% of people diagnosed are actually on treatment.
This is a problem across Africa, making it even more important that TV series such as The Polygamist don’t spread misinformation about HIV.
The Netflix drama suggests a person on treatment is still dangerously infectious, which is not true.
Spreading such false information feeds the fear that keeps people away from getting tested for HIV and taking up treatment if they test positive.
Jonasi, the main character, contracts HIV, but his refusal to accept the diagnosis and seek treatment is what ultimately kills him.
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This is not unusual, as many people, especially men, are slow to take up treatment due to stigma.
Stigma is a direct injury to mental health, and wounded, frightened people are exactly the ones most likely to look away from a diagnosis.
U=U, or undetectable equals untransmittable, is a condition where a person with HIV takes their antiretroviral treatment properly, bringing the amount of virus in their body to low levels, making them unable to transmit it to others.
This support is strongest when it comes from the community, not just health workers in clinics, which is why social media platforms can be useful in providing support and resources for people living with HIV.
Prevention and treatment messages land best when carried by trusted, Black-led organizations and framed around protecting one’s family.
Care has to be respectful and non-judgmental, as a judgmental clinic is a reason people stop coming.
Mental health support belongs inside HIV services and schools, so fear and distress are met early, before they harden into denial.
It is still hard for men to test, to speak, to be treated, because of stigma and shame.
Building the conditions for testing, treatment, and honesty, without shame, is what will keep people safe.
