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Walking together against HIV stigma
Ending stigma is therefore not a one-off campaign; it is a continuing national responsibility. Uganda has led before, and we can lead again by replacing fear with knowledge, judgement with empathy, silence with support and exclusion with solidarity. If we walk together, no Ugandan should have to face HIV alone.
Nelson Musoba, the director general Uganda AIDS Commission. (File)
By: Admin ., Journalist @New Vision
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OPINION
By Dr Nelson Musoba
Uganda has made remarkable progress in the response to HIV. Testing and treatment are widely available, and people living with HIV can live long, healthy and productive lives. Yet one stubborn barrier continues to undermine these gains: HIV-related stigma and discrimination.
Stigma refers to negative beliefs and attitudes towards people living with HIV, while discrimination is the unfair treatment that may follow, including exclusion, gossip, harassment, denial of opportunities or breaches of confidentiality. Although HIV is now a manageable chronic health condition, stigma can still turn a diagnosis into an experience of fear, shame and isolation.
Recent national evidence demonstrates why Uganda cannot afford complacency. A study on HIV-related stigma and discrimination, conducted by Makerere University School of Public Health with the Ministry of Health and partners, found that 45% of participants had experienced stigma or discrimination from other people in the previous 12 months. Common experiences included verbal insults or harassment, discriminatory remarks or gossip from family members, sexual rejection, blackmail and psychological pressure.
Much of this stigma continues to be driven by fear and misinformation. The survey found that 42.5% of participants believed they were stigmatised because others feared acquiring HIV from them, while 29.2% cited fear of transmission through casual contact. Yet HIV is not spread by hugging, shaking hands, sharing food or utensils, or working together. These persistent misconceptions show why accurate HIV information must continue to reach communities through trusted voices.
The consequences extend beyond hurtful words. Fear that others would discover their HIV status caused 11.1% of respondents to miss a clinic appointment and 11.4% to miss medication during the previous year. Viral-load suppression among participants was 90%, encouraging, but still below the optimal 95% level. We cannot close this gap if people fear accessing the very services intended to protect their health. Stigma also affects emotional wellbeing. About 46% of respondents had recently experienced symptoms of poor mental health, including anxiety, uncontrollable worry, loss of interest or feelings of depression and hopelessness. Mental-health screening, counselling and peer support must, therefore, be integrated into HIV services.
There are, however, encouraging signs. Disclosure to partners was high at 94.6%, and up to 99% of participants described reactions to disclosure as supportive rather than discriminatory.
This demonstrates that when disclosure is voluntary, safe and supported, families, partners and communities can become powerful sources of care and solidarity.
Much of this stigma continues to be driven by fear and misinformation. The survey found that 42.5% of participants believed they were stigmatised because others feared acquiring HIV from them, while 29.2% cited fear of transmission through casual contact. Yet HIV is not spread by hugging, shaking hands, sharing food or utensils, or working together. These persistent misconceptions show why accurate HIV information must continue to reach communities through trusted voices.
The consequences extend beyond hurtful words. Fear that others would discover their HIV status caused 11.1% of respondents to miss a clinic appointment and 11.4% to miss medication during the previous year. Viral-load suppression among participants was 90%, encouraging, but still below the optimal 95% level. We cannot close this gap if people fear accessing the very services intended to protect their health. Stigma also affects emotional wellbeing. About 46% of respondents had recently experienced symptoms of poor mental health, including anxiety, uncontrollable worry, loss of interest or feelings of depression and hopelessness. Mental-health screening, counselling and peer support must, therefore, be integrated into HIV services.
There are, however, encouraging signs. Disclosure to partners was high at 94.6%, and up to 99% of participants described reactions to disclosure as supportive rather than discriminatory.
This demonstrates that when disclosure is voluntary, safe and supported, families, partners and communities can become powerful sources of care and solidarity.
Uganda AIDS Commission continues to co-ordinate national efforts to eliminate stigma and discrimination as part of our goal of ending AIDS as a public-health threat by 2030. Working with the Ministry of Health, civil society, networks of people living with HIV, cultural and religious institutions, political leaders, the media and development partners, we must turn this evidence into practical action. First, we must intensify accurate communication about HIV transmission, treatment and prevention. Ugandans should understand that a person who takes antiretroviral treatment and maintains an undetectable viral load does not sexually transmit HIV, the principle known as Undetectable = Untransmittable (U=U). This message can help replace fear with knowledge and hope. Second, we must protect dignity, privacy and confidentiality. Only 11.6% of respondents knew of international protections for the rights of people living with HIV, while 14.1% were aware of relevant national policies or guidelines. Rights education and accessible mechanisms for addressing discrimination should, therefore, be strengthened in health facilities, communities, workplaces and schools.
We must also pay particular attention to adolescents and young people, vulnerable people, newly diagnosed people and those experiencing mental-health difficulties. Peer-led support, differentiated services, safe disclosure counselling and community-based care can help ensure that nobody is pushed away from treatment by fear or judgement. Every Ugandan has a role. We should use language that respects rather than labels, respond with kindness when someone shares their status, maintain confidentiality and challenge harmful jokes, gossip and stereotypes.
Families should provide safe spaces where young people can ask questions about HIV and sexuality without fear of condemnation. A family member living with HIV needs love and support, not rejection.
Uganda’s progress against HIV has always been strengthened by courageous leadership and honest public conversation. President Yoweri Museveni’s early emphasis on openness, prevention and collective responsibility helped Uganda confront the epidemic decisively. Philly Bongole Lutaaya’s brave public disclosure humanised HIV at a time when fear and silence were widespread.
Ending stigma is therefore not a one-off campaign; it is a continuing national responsibility. Uganda has led before, and we can lead again by replacing fear with knowledge, judgement with empathy, silence with support and exclusion with solidarity. If we walk together, no Ugandan should have to face HIV alone.
The writer is the Director General, Uganda AIDS Commission
We must also pay particular attention to adolescents and young people, vulnerable people, newly diagnosed people and those experiencing mental-health difficulties. Peer-led support, differentiated services, safe disclosure counselling and community-based care can help ensure that nobody is pushed away from treatment by fear or judgement. Every Ugandan has a role. We should use language that respects rather than labels, respond with kindness when someone shares their status, maintain confidentiality and challenge harmful jokes, gossip and stereotypes.
Families should provide safe spaces where young people can ask questions about HIV and sexuality without fear of condemnation. A family member living with HIV needs love and support, not rejection.
Uganda’s progress against HIV has always been strengthened by courageous leadership and honest public conversation. President Yoweri Museveni’s early emphasis on openness, prevention and collective responsibility helped Uganda confront the epidemic decisively. Philly Bongole Lutaaya’s brave public disclosure humanised HIV at a time when fear and silence were widespread.
Ending stigma is therefore not a one-off campaign; it is a continuing national responsibility. Uganda has led before, and we can lead again by replacing fear with knowledge, judgement with empathy, silence with support and exclusion with solidarity. If we walk together, no Ugandan should have to face HIV alone.
The writer is the Director General, Uganda AIDS Commission