Every generation faces its own version of the same question: what do we owe to those who came before, and what do we owe to those who come after? For HIV, that question is not abstract. In the past few decades, science has completely changed what it means to live with the virus. What was once a death sentence is now a chronic, manageable condition. There are medications that prevent infection, treatments that suppress the virus to undetectable levels, and undeniable proof that people living with HIV can thrive. And yet, GLAAD’s sixth annual State of HIV Stigma Report, released on August 20 and produced with Gilead Sciences, shows that public understanding has not kept pace with the science. The report arrives at a moment when the South continues to carry the heaviest burden of new HIV diagnoses, and when communities are still dealing with the human cost of shame, silence, and misinformation. An estimated 1.2 million people in the United States are living with HIV, and about 13 percent of them do not know their status. Black and Latino communities remain disproportionately affected. This is not because they are failing, but because stigma, discrimination, unequal access to care, and a long history of mistrust have built walls between people and the tools that could save their lives. Without those walls coming down, scientific progress means very little.
The report’s numbers are sobering. Seventy-nine percent of respondents said that people living with HIV experience stigma and discrimination. Seventy-seven percent said that stigma can discourage people from getting tested. Seventy-three percent said it can prevent people from seeking treatment. These are not just statistics; they are the reason someone hesitates before walking into a clinic, the reason someone stops returning calls from a case manager, the reason a person hides their medication inside a vitamin bottle. Stigma is a barrier between a person and a test, a prescription, a health care provider, a conversation that might change everything. It is a quiet force that keeps people from taking care of themselves because they are afraid of what other people will think. GLAAD President and CEO Sarah Kate Ellis called the report a call to action for media, public health leaders, policymakers, and advocates, saying, “Americans need accurate information, authentic stories, and policies that reflect today’s realities about living with HIV and the huge advancements in prevention and treatment.” That call matters because anxiety about HIV today is not rooted in the actual science. It is rooted in outdated fears, in racism and homophobia, in old images of crisis and death, and in a culture that still has not learned how to talk honestly about sexuality, prevention, and illness.
One of the most troubling findings in the report is the gap between generations. Only 31 percent of Gen Z adults said they feel knowledgeable about HIV, which is a six-point decline from the year before. Compare that to 60 percent of Gen X adults, a generation shaped by the terror and activism of the AIDS crisis, and the generational loss of memory becomes clear. This matters especially because Gen Z is the most openly LGBTQ generation in American history. They are growing up in a world with more visibility and more acceptance than ever before, but when visibility is not paired with reliable education, young people are left vulnerable to a different kind of danger, a digital ecosystem where misinformation travels faster than public health guidance. The report highlights a recent example: a false claim that “one million people in Atlanta are living with HIV” circulated widely on TikTok. The city’s population is far smaller than that figure, and credible surveillance data do not support the claim. But the fact that it spread at all is a warning. When trustworthy HIV information is missing from classrooms, newsrooms, and social media feeds, misinformation fills the silence. A young person scrolling through their feed may not know that a scary-sounding claim is false. They may internalize it, absorb it, and build their entire understanding of HIV around fear. That is not education. That is harm.
The report also reveals that many Americans do not understand one of the most powerful breakthroughs in HIV science: Undetectable = Untransmittable, or U=U. This is the medical reality that a person living with HIV who takes effective treatment and maintains an undetectable viral load cannot sexually transmit the virus to others. It is not a slogan or a wish; it is a conclusion backed by decades of clinical evidence. But 44 percent of Americans disagree with this fact. They still believe that people living with HIV are dangerous, even when treatment has made transmission essentially impossible. That belief is not just wrong. It is damaging. It makes people feel unworthy of love, terrified of intimacy, and isolated from their own communities. The report also found that fewer Americans said they would feel comfortable around a family member living with HIV, dropping from 66 percent to 61 percent, and around a medical professional living with HIV, dropping from 50 percent to 45 percent. These numbers are painful because they describe everyday human interactions. They describe the moment a person decides whether to mention their diagnosis at a family dinner, whether to be open with a colleague, whether to trust that the person sitting across from them will not recoil. HIV stigma is shaped by racism, anti-LGBTQ bias, economic inequality, and the uneven geography of health care access, particularly across the South. For Black queer and transgender communities, Black women, Latino communities, and people in rural areas, the fight against HIV has never been only about medication. It has always also been about dignity.
There is another finding that should trouble anyone who cares about how storytelling shapes reality. The report describes an “invisibility paradox” in the media. Seventy-two percent of Americans said they had not seen stories featuring people living with HIV in the media during the past year, up from 66 percent the previous year. Seventy percent said they had not seen a depiction of someone living with HIV in television or film during the past year. Only 15 percent said they had seen a social media story about someone living with HIV. And an analysis of podcasts found that only 0.09 percent of episodes mentioned HIV at all. This invisibility has consequences. When people living with HIV are missing from cultural narratives, the public is left with old images of suffering and death instead of the fuller, more accurate reality: people living long, healthy, loving, productive lives while managing a chronic condition. The absence of representation also isolates people living with HIV. It makes them feel like they are alone, like there is no one like them, like their experiences are too shameful to be seen. Yet the tools for a healthier narrative exist. Media outlets can feature people living with HIV in news stories, not only in the context of risk and crisis but as experts, parents, artists, workers, neighbors. Filmmakers and showrunners can write characters whose HIV status is part of their lives but not the whole story. Social media creators can share accurate, affirming information in ways that reach young people where they already are. The report makes clear that silence is not neutral. Silence teaches fear.
Just days before the report’s release, an intergenerational conversation took place at ArtsXchange in Atlanta. Gen Z and Generation Alpha participants joined older generations, including people who lived through the deadliest years of the AIDS crisis, to talk about HIV, PrEP, stigma, and the legacy of activists who fought for survival and treatment. That conversation was a powerful reminder that knowledge about HIV is not inherited automatically. It must be spoken, taught, remembered, and updated. For younger people, it means learning that HIV is preventable with tools like PrEP, the pre-exposure prophylaxis that protects those who do not have HIV from acquiring it. It means understanding the life-changing importance of testing and treatment. And it means hearing directly from people who lived through a time when political abandonment and public indifference made grief a daily language in queer communities. For older generations, it means sharing history without trapping young people in its trauma, making room for honest questions, and insisting that decades of organizing are not erased by misinformation, funding instability, or cultural retreat into silence. The report itself was based on a January 2025 online survey of 2,500 U.S. adults, followed by virtual focus groups conducted by Ipsos in September 2025 with Gen Z adults, men who have sex with men of color, cisgender and transgender women of color, and Spanish-speaking Latine communities, including people living with and without HIV. Ending the HIV epidemic will require more than medical innovation. It will require media institutions that tell the truth, public health systems that reach people before a crisis, and communities willing to trade fear for knowledge. It will require all of us to decide that we no longer want to live in a world where people are judged for a diagnosis, where young people are taught to be afraid instead of informed, and where silence carries more weight than science. That choice is possible, and it begins with listening, learning, and refusing to let stigma have the last word.