RIO DE JANEIRO — “People are still afraid of those three letters,” says Gareth Thomas, a former Welsh rugby international who publicly disclosed his HIV-positive status in 2019. Speaking at an event on Ipanema Beach this summer, Thomas emphasized that despite decades of scientific progress, the social stigma surrounding HIV remains a formidable obstacle in Brazil.
Thomas traveled to Rio for the International AIDS Conference as part of the “Tackle HIV” campaign, a partnership with Viiv Healthcare and various charities aimed at educating young people and dispelling myths about the virus. He noted that many people continue to ostracize those living with HIV due to a lack of understanding regarding modern treatments.
“The stereotype of someone with HIV is they are weak, fragile, frail,” Thomas said. “I am none of those things.” He added that many individuals avoid testing or medication because they are unaware that starting treatment early allows them to live a normal, healthy life.
This sentiment was echoed by Welton Gabriel, a 36-year-old activist from São Paulo. Twelve years ago, Gabriel learned he had tested positive for a treatment-resistant strain of HIV. He recalled believing he would die, and his condition deteriorated significantly before doctors could find a regimen that worked. Despite his recovery, when he told close friends about his status, many severed contact.
“They did not want to talk with me,” Gabriel recalled. “I thought I was gonna die.”
Gabriel’s experience reflects a broader crisis in Brazil, which has the highest number of people living with HIV in Latin America, estimated at nearly 1.1 million. According to research by UNAIDS Brazil, more than half of HIV-positive individuals in the country have experienced some form of discrimination, whether from family members, employers, or social circles.
The persistence of stigma is partly attributed to historical perceptions. Gabriel noted that for many Brazilians of his generation, HIV is still viewed through the lens of Cazuza, the iconic singer who died of AIDS in 1990 at age 32. “When I learned I was HIV positive, I looked on Google, and the first thing I saw was the story of Cazuza,” Gabriel said. “For a lot of Brazilians of that generation, that’s still the symbol of HIV.”
Beatriz Grinsztejn, a Brazilian infectious-disease specialist and former president of the International AIDS Society, described the current situation as tragic given the availability of free tests and treatments through Brazil’s public healthcare system. National health data reveals that 27% of people with HIV are diagnosed only at an advanced stage, when their immune systems are severely compromised. In 2024, more than 9,000 people died from AIDS in Brazil.
Even when diagnosed early, retaining patients in care remains difficult. Government figures indicate that while 82% of HIV-positive Brazilians are taking antiretroviral drugs, this falls short of the United Nations’ target of 95%. Gustavo Passos, an equality and rights officer at UNAIDS Brazil, stated that the country is “losing ground every year” on treatment metrics.
Passos highlighted that stigma often originates within the healthcare system itself. Many patients fear illegal disclosure of their status by professionals, leading to a breakdown in trust. “It’s about being judged if you’re seen taking your treatment each day,” Gabriel said. “If someone feels judged, a lot of times they will stop the treatment.”
The crisis is compounded by broader social issues, including violence against sexual minorities. Grinsztejn pointed out that Brazil sees high rates of homophobia and transphobia, with the transgender population facing one of the world’s highest murder rates. While the general life expectancy in Brazil is 76, transgender individuals have an estimated life expectancy of only 30 to 35 years.
Fabiana de Oliveira, a 57-year-old activist with the National Network of Women Living with HIV, emphasized that discrimination is heavily gendered. She shared her own experience of being diagnosed at 26 after suspecting her fiancé of transmitting the virus. He never spoke to her again.
“In Brazil, women are expected to take care of everything,” de Oliveira said. “After an HIV diagnosis, you end up asking yourself, ‘Was this my responsibility?’ It places a lot of burden on your mental and emotional health.”
As the AIDS 2026 conference highlighted new developments, including monthly prevention pills and strategies for long-term remission, activists argue that medical innovation must be matched by a cultural shift to eliminate the fear and discrimination that continue to fuel the epidemic.
I didn’t know treatment-resistant strains were still a thing here. Medical access isn’t enough if people are too scared to test.
The healthcare worker judgment aspect is often overlooked. If patients fear judgment, they simply stop coming.
Cazuza died decades ago. Why is that image still the default reference for HIV in Brazil?
Heartbreaking that stigma still runs so deep in 2024. We need better education, not just medicine.