52.9% of people with HIV in Brazil have suffered discrimination, says survey

In Brazil, 52.9% of people living with HIV have suffered some type of discrimination due to their serological status. This is what a survey conducted by UNAIDS Brazil, and released this Thursday (8), in Brasília, reveals.

The main experience of discrimination experienced by the participants was discriminatory comments and gossip between people, both within their family circle (34.8%) and outside it (38.8%). In addition, 22.3% of the people who participated in the survey were excluded from activities in at least one of the spaces they occupied (social, family and/or religious activities).

In the only previous survey carried out in Brazil, published in 2019, 64.1% of participants said they had already suffered some form of discrimination.

Despite some progress in the current research, the report released today states that stigma and discrimination continue to be major barriers in the daily lives of people living with HIV in Brazil. The study reinforces the urgent need for public policies that ensure the right to confidentiality, promote equal access to health care and combat prejudice in all social spaces.

“Issues of gender, social class, work, race, identity and sexual orientation still persist. To end AIDS, we need to promote a country free from stigma and discrimination – and the Stigma Index is a tool that provides evidence of how discrimination acts as a barrier to access to services,” says Andrea Boccardi, director and representative of UNAIDS Brazil, the Joint United Nations Programme on HIV/AIDS.

The survey, called the Stigma Index, interviewed 1,275 people in seven Brazilian capitals — São Paulo, Rio de Janeiro, Salvador, Porto Alegre, Recife, Brasília and Manaus. The authors of the study argue that these cities represent the population and epidemiological diversity of the country, and are also the so-called “hotspots” — areas and locations with the highest incidence of AIDS cases or high mortality rates.

The Stigma Index is a tool to detect and measure changing trends in HIV-related discrimination from the perspective of people living with the virus. Launched in 2008, the Index is a joint initiative of the Global Network of People Living with HIV (GNP+), the International Community of Women Living with HIV/AIDS (ICW), the International Planned Parenthood Federation (IPPF), and the Joint United Nations Programme on HIV/AIDS (UNAIDS).

In Brazil, the initiative is from the Consortium of Networks of People Living with HIV and AIDS, led by the NGO Gestos, in partnership with PUC-RS and support from the General Secretariat of the Presidency of the Republic and UNAIDS.

Consequences of HIV stigma

In addition to causing suffering, prejudice hinders the search for treatment. Of those interviewed, 13.1% had been treated discriminatorily in health services in the last 12 months. The most cited forms of discrimination were through negative comments and gossip, minimization of physical contact and breaking confidentiality about their diagnosis without their consent. And almost half of those interviewed (46.1%) suspect that their HIV status is not kept confidential in health services.

For Jô Meneses, Education and Assistance Coordinator at the NGO Gestos, what is particularly striking is the fact that stigma and prejudice still exist in health services: “We already know that people living with HIV, who take their medication correctly and follow their treatment, do not transmit the virus to other people, they are undetectable and transmission is zero. And even this has not helped us, so we need to disseminate data on stigma, disseminate other information that shows that [prejudice] is no longer justified.”

By making the experience of living with HIV in Brazil even more painful, prejudice affects the mental health of this population. Among those interviewed, 29.1% demonstrated symptoms of depression and 41.2% reported symptoms of anxiety related to stigma.

Most people reported not having positive experiences when disclosing that they were living with HIV to people who were not close to them (55.4%). In this sense, Federal Law No. 14,289, of 2022, guarantees confidentiality regarding the condition of people living with HIV, chronic hepatitis, leprosy, and tuberculosis. Even so, some of the interviewees reported that the communication that they were living with HIV was made without their consent to groups outside their intimate circles, such as neighbors, coworkers and employers, teachers and classmates, religious leaders, and through social networks.

Effects of the climate crisis and the Covid-19 pandemic

The 2025 edition of the survey in Brazil included for the first time data on the effects of the climate crises and the Covid-19 pandemic.

Among people living with HIV in the country, after extreme weather events, 82.1% had not yet recovered their family income, 20.5% faced difficulties in obtaining medication and 27.3% had their medical appointment for HIV monitoring cancelled at least once.

The research also investigated the impact of the Covid-19 pandemic on the lives of the people interviewed, as well as on access to care services, whether or not related to HIV.

Among people living with HIV, 47.2% also received a positive diagnosis for Covid-19. Among this subgroup, 76.1% said they received adequate health care, while 23.9% reported the opposite.

Most respondents received a supply of HIV treatment medication for 3 months or more (79.5%) and were able to collect their medication without difficulty. However, 13.6% of respondents faced difficulties, and 2.9% were unable to collect their medication. In addition, 6.1% of respondents received medication for only 1 month or less. And 24% reported that some health service had been rescheduled or canceled due to the COVID-19 pandemic.

Situation in the rest of the world

According to UNAIDS Brazil, there is no single official list that shows the ranking of countries in relation to the stigma index, since, although the methodology is unique, it undergoes changes that adapt to the reality of each country.

But based on a compilation of global data, the entity draws up a ranking of countries by level of stigma, with the best placed being those with the least stigma and discrimination. In this ranking, Brazil appears in fourth place, behind Canada, Portugal and South Africa.

Check out the UNAIDS Global Stigma and Discrimination Ranking:

1. Canada (Universal access to treatment and criminalization of discrimination)
2. Portugal (Dramatic reduction in stigma after drug decriminalization and focus on public health)
3. South Africa (Significantly improved, but still faces challenges in rural areas)
4. Brazil (Advanced policies, but regional inequalities and violence against key populations)
5. Thailand (Leading in Asian region, but workplace discrimination still occurs)
6. Mexico (Legal advances, but violence against vulnerable groups (such as gay and trans men)
7. India (Family and employment stigma, especially against women)
8. Kenya (Recent improvements, but high levels of religious stigma)
9. Russia (Repressive policies against LGBT+ and lack of harm reduction programs)
10. Nigeria (Criminalization of homosexuality and high levels of social exclusion)

The criteria used for ranking were laws and policies of countries that criminalize HIV transmission or key groups, as these tend to have worse rankings; access to health, since discrimination in health units worsens the index; social stigma, as within this criterion there are reports of family exclusion, loss of employment or violence (often institutionalized); and the self-stigma of the person living with HIV for being or having been infected.

In 2021, United Nations Member States adopted a set of ambitious targets as part of the Political Declaration adopted at the United Nations General Assembly High-Level Meeting on AIDS, including the 95-95-95 target: that 95% of people living with HIV know their diagnosis; that 95% of people who know they are living with HIV are on antiretroviral treatment; and that 95% of people on treatment are virally suppressed.

In 2024, Brazil achieved 96-82-95, two of the three global targets for eliminating AIDS as a public health threat. The target that has not yet been achieved, adherence, is directly related to tackling stigma and discrimination.

“We have seen in the index that 60% of the trans population is afraid to seek health services due to stigma. Today, we are very close to eliminating HIV as a public health threat, which is the UNAIDS 95-95-95 target, but we are very far from reaching the second 95 [95% of those diagnosed are receiving treatment]. Why don’t they seek it? It’s free, they are well received, they are well received. They don’t seek it because they are afraid, because they are ashamed of their serological status. And that is what we need to have evidence of in order to create public policies that facilitate access,” says Barreira.

The representative of the Ministry of Health also recognizes the need for public policies to increase access to biomedical tools, such as PREP (Pre-Exposure Prophylaxis) and PEP (Post-Exposure Prophylaxis). In the case of PREP, offering the medication through alternative channels to health units, for example, through dispensing machines, or through civil society organizations that serve the most vulnerable groups.

Brazil reduces AIDS mortality, but records increase in HIV cases