Former Welsh rugby captain Gareth Thomas told the International AIDS Conference in Rio de Janeiro this week that global gains against the virus are being eroded by a stubborn enemy: stigma.
“People are still afraid of those three letters,” Thomas said at a Tackle HIV campaign event on Ipanema Beach, where he and Brazilian activist Welton Gabriel shared harrowing accounts of rejection.
Brazil has nearly 1.1 million people living with HIV, the largest number in Latin America, yet more than half have faced some form of discrimination, according to Unaids Brazil.
“I thought I was gonna die,” said Gabriel, a 36-year-old event organiser from São Paulo who tested positive 12 years ago and lost friends when he disclosed his status.
“They did not want to talk with me.”
Data from the Brazilian health ministry show that 27 per cent of people with HIV are diagnosed only after the disease has progressed to advanced AIDS, and in 2024 more than 9,000 died.
Despite free antiretroviral therapy and new long-acting prevention tools like lenacapavir, fear of being shunned keeps many from testing, treatment, and telling their families.
“Many people don’t know that you can live a normal, happy, healthy life if you start medication straight away, and so people avoid getting tested, avoid the result or avoid the medicine taking,” Thomas told journalists.
Beatriz Grinsztejn, a leading Brazilian HIV researcher, said the real barrier is social terror.
“People are more afraid of how society is going to perceive them than they are of the virus,” she said at the conference, where advocates argued that stigma now drives the epidemic as much as the pathogen itself.
South Africa, which carries the world’s heaviest HIV burden with over 7.5 million people living with the virus, battles an identical crisis where silence and shame still suffocate testing campaigns in townships and suburbs alike.
While the country runs the largest public antiretroviral programme on the planet, late presentation remains common on the Cape Flats, where community health workers regularly encounter untreated infections that could have been managed years earlier.
“On the treatment part, we’re losing ground each year,” Gustavo Passos of Unaids Brazil warned, a sentiment that mirrors the anxiety among Western Cape health officials who have seen stagnant testing rates in high-burden wards.
Brazilian women carry a particular strain of that pressure, explained activist Fabiana de Oliveira. “Women in Brazil are never the ones who are being cared for. We are expected to take care of everything, the husband, the children, so it’s hard to equate HIV as being part of your identity.”
This report is based on coverage by GPB News and the sources they cited. Cape Flats News has contacted the Western Cape Department of Health for local comment and will update when we receive a response.
The conference runs until Friday in Rio; the World Health Organization is expected to release new stigma-reduction guidelines later this year. Cape Flats News will next check with provincial HIV programmes on Monday morning.