Is Stigma the Last Major Barrier to Ending AIDS?

HIV is no longer a mystery. Nowadays, treating,  suppressing, and preventing the virus is damned near a miracle. Antiretroviral treatment (ART) enables individuals to reduce their viral load to be undetectable level. The exposed partner can’t transmit HIV to others this way. The reality of “U=U” has altered how we think about and respond to the epidemic globally. But misinformation, stigma and silence continue to stifle talk about HIV in Pakistan.

Is Stigma the Last Major Barrier to Ending AIDS?

We have dragged science forward while society has stayed put.

A Growing Crisis in the Shadows

The country’s HIV numbers are rising faster than most people realise.
This gap is where stigma does its most damage. Untreated HIV isn’t a medical failure — it’s a consequence of social pressure, fear, and systemic neglect.

Why Testing Feels Riskier Than the Virus

If you ask anyone working in HIV care in Pakistan, and they’ll tell you: people avoid testing because they fear the consequences of a positive result. Pakistan reported a total of 9,713 new diagnoses in the first nine months of 2024: this breaks down to a mere 1,079 per month. If these trends continue, health officials say, the number of new cases could exceed 12,950 by year-end. International collaborators suggest there are between 300,000 to 350,000 HIV infected individuals in the region. However, only around 51,821 are getting the essential care they need.

The fear stretches even beyond the home. A positive result can mean:

1) Losing social standing
2) Being denied employment
3) Being refused services
4) Being labelled as immoral
5) Simply being treated as someone to avoid

In many communities, HIV is still linked to “bad behaviour ,” rather than to scientific facts about transmission. Women, in particular, often suffer the harshest judgment despite being infected primarily through marriage or medical exposure.
Under such conditions, stepping into a testing centre can feel like stepping into a spotlight of suspicion. So many avoid it altogether — and the virus circulates silently.

The Knowledge Gap That Feeds Stigma

Research repeatedly demonstrates that levels of knowledge about HIV in Pakistan are alarmingly low. In a 2024 study of Pakistani women, almost 9 in 10 were ill-informed about basic HIV facts. Misinformation — about how HIV does or doesn’t spread and that it can be diagnosed “just by looking” —  is still rampant. It is this ignorance that allows stigma to flourish. Stigma fuels silence. And silence fuels the epidemic.

A Health-Care System Playing Catch-Up

Even when people do seek help, the health care encounter can be judgemental. Some patients report being treated dismissively by staff or being refused services entirely. Others describe breaches of confidentiality — a fear more powerful than any virus.
Pakistan’s ART centers often struggle with:

1) Understaffing
2) Long travel distances for patients
3) Unpredictable waiting times
4) Drug stockouts
5) Limited outreach to marginalised communities

Those at the margins — PWID, sex workers, trans people — face two stigmas at once: who they are and the fear of an HIV label. Both are enough to keep many from seeking help at all.

If the World Is Ending AIDS, Why Aren’t We?

What we’ve seen around the world is that many countries have already turned HIV into a manageable condition through high levels of awareness, routine testing for those in at-risk groups and health systems that don’t stigmatise the people they are supposed to be serving. But in Pakistan, the epidemic remains tightly entangled with cultural discomfort, taboo and ongoing misinformation.

The struggle today isn’t about finding new medicines. Those exist, and they work. The real challenge is making sure people feel safe enough, respected enough, and supported enough to use them.

Ending AIDS by 2030 — the global goal — is not a fantasy. It is within reach. But only if we address the fear and stigma that continue to hold us back. But not unless Pakistan confronts these core barriers:
1) Fear of judgement that keeps people from getting tested
2) Discrimination that pushes people out of treatment
3) Low public awareness that sustains myths and misinformation
4) Financial burdens that limit access to care
5) Institutional stigma that discourages trust in healthcare
6) Lack of inclusive policies that protect vulnerable communities

The Path Forward

To end AIDS in Pakistan, the country must move beyond medical solutions and address the human ones. That means:
1) Launching sustained national awareness campaigns
2) Training healthcare workers to treat PLHIV with dignity
3) Expanding community-based testing and mobile clinics
4) Decentralising ART services
5) Protecting the rights of vulnerable groups
6) Creating a culture where people can discuss HIV without whispering

At its core, HIV is no longer a medical mystery. It is a social one.

The Real Question

When the means to end AIDS are already available, the question is “Do we still accept that stigma, silence and fear have a place?”
If Pakistan is serious about ending AIDS by 2030, it has to start addressing stigma with the same sense of urgency as the virus. The science alone cannot save lives, however a society willing to stand with its people might.