Rohit Talwar, Senior Strategist, Inizio Evoke Europe, discusses how HCP misconceptions of people living with HIV are actively perpetuating fear and shame in what should be ‘safe’ healthcare settings.
There were approximately 39.9 million people globally living with HIV by the end of 2023. But treatment for HIV has been one of the greatest scientific breakthroughs in modern times: rather than people dying in their thousands, when diagnosed early, people can lead healthy lives and the virus is not transmissible on effective treatment. But decades on from the AIDs crisis, people living with HIV are still living with stigma. What’s most shocking is that such overt discrimination persists in the communities where they should feel safest – healthcare.
When the AIDs crisis hit in the early 1980s with reports of gay men dying from a mystery illness, it struck fear into people across the world. There was no treatment available at the time; people were scared and helpless. And it wasn’t until the 1980s that scientists identified the virus that caused AIDS which was eventually called HIV (human immunodeficiency virus).
Ground-breaking treatment
At the time, there was limited understanding of the virus and how it spread—but science and society have come a long way since then. We didn’t understand the illness, but now we do. Huge advances in treatment mean that HIV can be managed, and its transmission can be prevented. Despite this, one in four people living with HIV have experienced discrimination in healthcare settings [1] according to recent data.
Effective antiretroviral treatment (ART) has been available for almost 30 years. [2] And since 2012, access to PrEP (Pre-Exposure Prophylaxis) has been growing across the world. You may have even seen the campaign U=U, which stands for ‘undetectable equals untransmittable’. It explains that effective treatment with PrEP equals an undetectable viral load, which means that a person cannot spread it to someone else. It goes without saying that this is a significant advancement in HIV treatment and its prevention.
Drugs like this will be instrumental in reaching UNAID’s target to end AIDS as a public health threat by 2030. Unfortunately, there have been headlines recently about much-needed foreign aid being pulled with key bodies struggling across the world already. Developments like these put the UNAIDS target in jeopardy.
Outdated discrimination
HIV continues to be wrongly associated with specific groups, such as LGBTQ+ individuals, sex workers, or people who use drugs—despite clear evidence that the virus affects people across all communities. [3] This takes away from variations in data that need urgent attention, for example, in England in 2020 half of all new HIV diagnoses were in heterosexual people (49%) compared to gay and bisexual men (45%). [4]
Reports from across the world show alarming rates of stigma and discrimination against people living with HIV from within healthcare systems. These harmful beliefs often stem from ingrained moral judgments and systemic misconceptions, which can influence provider attitudes and actions—whether consciously or unconsciously. In some cases health providers viewing PLWH as immoral or irresponsible, believing patients engaged in behaviours that led to their infection. This is affecting people seeking treatment; 1 in 10 PLWH said they were refused healthcare in the UK [5] with multiple reports from the US.
In one case, England’s Health Ombudsman found hospital staff acted inappropriately when they delayed prostate surgery for a man living with HIV, which they said was due to the level of cleaning and infection control that would be needed after surgery to reduce the risk to others. [6] In another recent case, an HIV-positive patient in the US filed a lawsuit against an orthopaedic surgeon after being denied treatment due to his HIV status.
The effect of such discrimination is far-reaching. Biases held by healthcare workers significantly influence patient-provider relationships, treatment recommendations, quality of care, and ultimately, patient outcomes.
According to the British HIV Association, healthcare workers believe stigma is the single most important reason for people with HIV dropping out of care. [7] This needs urgent attention - because without adequate care - the health of people living with HIV is at serious risk.
What can we do to overcome the bias?
As with any type of discrimination in this world, bias towards people living with HIV is mainly driven by fear (specifically fear of transmission in this context) and a lack of knowledge. At the same time, workplace policies and culture are believed to keep this fear alive, which leads to people leaning on stereotypes and the use of unnecessary precautions during treatment. [8]
Greater HCP education and training about HIV and AIDs in the modern day must be the first step to building understanding and empathy. In managing treatment and overall health for PLWH, workplace policies need to be appropriate to create a safe place where both HCPs and their patients feel confident. This will mean proactively working with healthcare teams to put the right solutions in place to change the culture of fear and misunderstanding. [9]
We all have a role in creating a more inclusive, stigma-free system, and as healthcare marketers, it’s up to us to deliver campaigns that challenge stereotypes and prompt our industry to confront outdated beliefs. We all need to embrace the success story of HIV treatment and leave the fear of the AIDs epidemic in the past.
What needs to change?
We must eradicate shame and ensure every person living with HIV receives the respect and care they deserve if we are to meet the 2030 target. Until then, the HIV epidemic will never be over.
It’s time for healthcare to do better, so society as a whole can follow their lead. We need to challenge the stigma affecting people living with HIV, educate providers, and create a healthcare system that truly makes health more human™ - because we all benefit when healthcare is a safe and judgement-free place for everyone.
Join the conversation. Share this message. Advocate for change.
Interested in our approach? Get in touch: Rohit.Talwar@Inizioevoke.com
Sources
[1] UNAIDS, press release, UNAIDS warns that HIV-related stigma and discrimination is preventing people from accessing HIV services, 2017. Last accessed March 2025
[2] NHS England, Spotlight on HIV, 2018. Last accessed March 2025
[3] Stutterheim, Sarah E. et al, Patient and Provider Perspectives on HIV and HIV-Related Stigma in Dutch Health Care Settings, 2014
[4] Terrence Higgins Trust, press release, 2022. Heterosexual HIV diagnoses overtake those in gay men for first time in a decade. Last accessed March 2025
[5] Aidsmap, Almost half of people living with HIV in the UK feel ashamed, 2024. Last accessed March 2025.
[6] Parliamentary and Health Service Ombudsman, Hospital staff failed man living with HIV by unnecessarily delaying surgery, 2023. Last accessed March 2025
[7] Aidsmap, Biggest single reason for people with HIV dropping out of care is stigma, doctors report, 2024. Last accessed March 2025
[8] Baldwin, A, et al, ‘Applying the Health Stigma and Discrimination Framework to Assess HIV Stigma among Health Care Professionals: A Mixed Methods, Community-Based Participatory Research Study’, 2023
[9] Andrasik, M, et al, ‘Stigma, Implicit Bias, and Long-Lasting Prevention Interventions to End the Domestic HIV/AIDS Epidemic’, 2020