SANAC PLHIV Sector and HSRC Launches HIV Stigma Index 2.0 Report
- Karabo Makgato
The People Living with HIV (PLHIV) sector, led by the National Association of People Living with HIV and AIDS (NAPWA), in partnership with the Human Sciences Research Council (HSRC), the South African National AIDS Council (SANAC), and other stakeholders, officially launched the HIV Stigma Index 2.0 report in Pretoria on Tuesday, 9 December 2025.
Hosted at the National Research Foundation (NRF) Auditorium, the launch brought together key stakeholders from government, civil society, research institutions, advocacy organisations, and PLHIV-led networks to reflect on the findings of the study and chart a way forward in addressing HIV-related stigma and discrimination in South Africa.
The HIV Stigma Index 2.0 is a groundbreaking, PLHIV-led study that captures the lived experiences of more than 5,000 people living with HIV across all nine provinces, with a specific focus on 18 urban and rural districts. It is the first nationally implemented stigma index in South Africa fully led by PLHIV, in line with the Greater Involvement of People Living with HIV and AIDS (GIPA) principles and the National Strategic Plan (NSP) for HIV, TB and STIs 2023–2028, which places communities at the centre of the response.
Conducted with technical support from HSRC, SANAC and international partners, including UNAIDS, GNP+ and ICW, the study provides critical evidence to inform policy, programming and advocacy aimed at improving the quality of life, dignity and rights of people living with HIV.
“This study represents a major milestone in ensuring that the voices and lived experiences of people living with HIV remain central to research, advocacy and policy development,” said Mluleki Zazini, National Chairperson of the PLHIV sector and Project Director for the Stigma Index 2.0.
The report shows encouraging progress, with external HIV-related stigma declining from 14.3% in 2014 to 6.1% in 2024. However, stigma and discrimination remain persistent barriers to HIV prevention, treatment, care and support, particularly for young people, key populations and persons with disabilities.
Key findings include:
- HIV disclosure:While over half of participants voluntarily disclosed their HIV status, mainly to family members, disclosure in workplaces and educational settings remains extremely low, reflecting ongoing fear of discrimination.
- Internalised stigma:Nearly half of participants reported feelings of shame, guilt or fear of disclosure, negatively affecting self-confidence, relationships and mental well-being.
- Healthcare-related stigma:Although many participants reported positive healthcare experiences, some still encountered stigma in healthcare settings, including gossip and moral judgement, contributing to delayed treatment initiation and interruptions in care.
- Key populations and layered stigma:People who use drugs, sex workers, transgender individuals and men who have sex with men reported higher levels of stigma and discrimination linked to both HIV and their social identities.
- TB-related stigma:TB stigma remains widespread, with many participants reporting gossip and discrimination related to TB co-infection.
- Limited access to support:Only 38% of participants belonged to HIV support groups, highlighting gaps in psychosocial support and community mobilisation.
According to NAPWA’s Duncan Moeketsi, co-principal investigator of the study, the findings underscore the urgent need for targeted, inclusive interventions. “Despite progress since the 2014 study, stigma continues to undermine access to services and treatment adherence, particularly among key populations and young people,” he said.
Stakeholders at the launch emphasised that ending HIV stigma and discrimination requires a coordinated, multisectoral response involving government departments, PLHIV-led networks, civil society, traditional leaders, healthcare institutions and the private sector.
HSRC Senior Researcher Dr Mpumi Zungu highlighted the broader impact of stigma on the national response: “Stigma undermines access to testing, treatment and psychosocial support, ultimately affecting health outcomes and well-being. Addressing stigma is essential if South Africa is to achieve its 2030 HIV targets.”
The report outlines key recommendations, including strengthening community-led disclosure and referral programmes, expanding mental health and peer-support services, improving stigma-reduction training for healthcare workers, and implementing targeted interventions for key populations. It also calls for women and youth-led PLHIV networks to play a leading role in education, rights awareness and advocacy.