Editorial: Silence fuels HIV. Let’s end stigma now

Uganda has long been recognised as one of Africa’s most determined countries in confronting HIV.

Scientific advances, wider access to antiretroviral therapy and sustained public investment have transformed what was once a death sentence into a manageable chronic condition for millions.

Yet the latest study by Makerere University and the Ministry of Health exposes an uncomfortable truth: medicine can suppress the virus, but it cannot, on its own, cure fear. That raises a deeper question.

What does it say about a society when people fear public judgement more than a life-threatening disease? The study should not simply be read as another public health report. It is an indictment of how institutions and communities have allowed prejudice to outlive the epidemic’s darkest years.

Forty-five per cent of respondents reported experiencing stigma or discrimination, while more than 70 per cent said they had experienced some form of internal stigma. Most strikingly, the proportion of people who found it difficult to disclose their HIV status rose sharply between 2018 and 2026, even as measures of self-blame declined.

That contradiction matters. It suggests that while many people living with HIV have become more accepting of themselves, they have become less confident that society will accept them. This is not merely a personal tragedy. It is a policy failure.

Every person who delays testing because they fear ridicule, skips treatment because they worry about being recognised at a clinic, or conceals their diagnosis from family members weakens Uganda’s ambition to end HIV as a public health threat by 2030.

Viruses exploit biology, but stigma exploits silence. Left unchecked, it becomes a force that undermines decades of scientific progress. The study also exposes a recurring weakness in public policy.

Governments often celebrate measurable successes: more medicines distributed, more clinics opened, more people enrolled in treatment, because they are easier to count. But social trust, dignity and inclusion rarely appear on budget spreadsheets despite determining whether those investments succeed.

Professor Rhoda Wanyenze captures this challenge when she argues that Uganda’s HIV response has gradually shifted towards biomedical interventions while giving less attention to behavioural and structural factors.

“Over time, as we emphasised evidence-based interventions, we watered down the emphasis on the structural and behavioral issues,” she observed.

That warning deserves urgent attention. Equally compelling is the testimony of Flavia Kyomukama, who argues that protecting privacy and rebuilding safe spaces for young people must become part of the national response.

Her concern about the disappearance of drop-in centres and peer-support networks points to something larger than healthcare delivery. It reflects the erosion of community itself. The solution is not to abandon biomedical success but to complete it.

Health facilities must guarantee confidentiality. Schools, workplaces and religious institutions should actively challenge discrimination rather than assume it is fading. Community support programmes deserve the same political attention as medicines because both are essential to keeping people in care.

Above all, leaders should recognise that fighting stigma is not peripheral to ending HIV; it is central to it. Uganda has already shown that determined leadership can change the course of an epidemic.

The next chapter demands something different: the courage to confront the prejudices that still keep too many people in the shadows. Until dignity is treated as a public health priority, the country’s HIV response will remain scientifically impressive, yet fundamentally incomplete

The post Editorial: Silence fuels HIV. Let’s end stigma now appeared first on The Observer Media Ltd.