Uganda’s fight to end HIV as a public health threat by 2030 is facing an obstacle that medicines alone cannot solve. A new study by Makerere University and the Ministry of Health has found that stigma and discrimination continue to discourage many people from testing for HIV, disclosing their status, attending clinic appointments and consistently taking life-saving antiretroviral treatment. Researchers say the findings show that, despite decades of progress in expanding HIV services, fear of being judged or rejected remains one of the biggest barriers to preventing new infections and keeping people in care. “Stigma and discrimination have tremendously hindered HIV services at every step, limiting access to and acceptance of prevention services, continued engagement in care, and adherence to antiretroviral therapy,” said Dr John Bosco Ddamulira, one of the study’s investigators, while presenting the findings. The research drew on information collected in 20 districts from 5,387 people living with HIV aged 14 years and above, 524 healthcare providers, 34 key informant interviews, 18 focus group discussions and personal life stories to understand both the scale of HIV-related stigma and its impact on people’s everyday lives. The study found that although many people who disclosed their HIV status received support from close family members and friends, discrimination outside the home remains widespread. According to the report, 45 per cent of respondents experienced stigma or discrimination. Verbal harassment was the most common form, affecting 21 per cent of participants, followed by sexual rejection at 13.9 per cent, blackmail at 12.7 per cent and psychological pressure at 11.8 per cent. Researchers also found that internal stigma, the negative feelings people hold about themselves because they are living with HIV, was even more common. About 70.4 per cent of participants said they had experienced at least one form of self-stigma during the previous 12 months. Dr Ddamulira said this had affected regular clinic attendance and adherence to HIV treatment. The findings, however, also point to areas of progress. The proportion of respondents who blamed themselves for being HIV-positive fell from 50 per cent in 2018 to 33 per cent in 2026. Blaming others for their HIV status declined from 50 per cent to 25 per cent over the same period, while reports of low self-esteem dropped from 67 per cent to 29 per cent. Yet even as self-blame declined, fear of telling others about an HIV-positive status increased. The proportion of respondents who found it difficult to disclose their status rose from 36 per cent in 2018 to 59 per cent in 2026. Feelings of shame also increased, rising from 21 per cent to 35 per cent over the same period. For HIV advocates, those figures confirm what many people living with the virus have been experiencing. Flavia Kyomukama, who has lived with HIV for more than 30 years and chairs the National Forum of People Living with HIV (NFPLHIV), said the findings reflect concerns that have been raised repeatedly by affected communities. “I think these findings are very clear, and they reaffirm what we’ve said over the last few years, that stigma is on the rise,” she said. Kyomukama said family members are often the first people individuals tell after learning they are HIV-positive, but they can also become the first source of blame and discrimination, reinforcing fears about disclosure. She argued that health facilities must do more than integrate HIV services. They should also ensure patients receive care in environments that protect their dignity and privacy. “We still have a lot to do as government to ensure that we have these spaces reformed to fit purpose and ensure that people living with HIV are not lost,” she said. Kyomukama pointed to the gradual disappearance of safe spaces and dropin centres where adolescents and young people once received peer support and felt comfortable discussing their HIV status. “You do realise that because of that, HIV disclosure has reduced because you no longer have those places where you used to meet, the safe spaces, the clinics, you don’t have the drop-in centres,” she said. Professor Rhoda Wanyenze, Dean of Makerere University School of Public Health, said Uganda’s HIV response has increasingly focused on biomedical interventions while giving less attention to the behavioural and social factors that influence whether people seek and remain in treatment. “Over time, as we emphasised evidence-based interventions, we watered down the emphasis on the structural and behavioral issues. And because of this, we see a lot of challenges, not just persisting in terms of HIV prevention, HIV treatment, and treatment outcomes,” she said. Wanyenze said the findings should prompt renewed investment in programmes that address the broader social and economic realities facing young people. “My real interest, as we discuss these results, is what next for the young people. They are the majority in our population, and we need to do more to give them healthier lives and give them a promise for a better future,” she said.The post New Study: Stigma still keeps many Ugandans away from HIV care appeared first on The Observer Media Ltd.