January 08, 2025

The next frontier in the fight against HIV

topic:	Health and Sanitation
tags:	#HIV, #women's rights, #Africa
located:	Mozambique, Zambia
by:	Kilford Zimondi

HIV remains a persistent global health crisis, with - far surpassing the 2025 target of fewer than 370,000 set by the UN, a milestone on the path to end the epidemic by 2030. Two major issues are threatening the hard-won progress against HIV: funding cuts, with total resources now at their lowest level in over a decade, and a growing anti-rights movement.   

Nowhere is the burden of HIV heavier than in Africa, which continues to record the highest prevalence and AIDS-related deaths globally. This challenge is even more pronounced in Sub-Saharan Africa, where adolescents and young people bear a disproportionate impact of the epidemic. Among this group, adolescent girls and young women are more exposed, with HIV prevalence more than three times higher than that of their male counterparts.

Although significant progress has been made globally - more than 30 million people are now receiving treatment - the world must redouble its efforts to achieve the 2030 target. This requires not only accelerating prevention but also overcoming the barriers that prevent equitable access to both treatment and preventive services, especially in the most vulnerable regions and populations across the globe.

Among these barriers, HIV stigma stands as one of the most subtle obstacles to ending the epidemic. Stigma reinforces harmful gender norms, erodes trust in health systems and perpetuates silence and fear that keep individuals from accessing the care they need. Addressing stigma is essential to breaking the cycle of new infections and ensuring that treatment reaches those who need it most.

Amid these challenges, there is a powerful source of hope: young people. Youth are uniquely positioned to confront stigma and catalyse change in their communities. They bring fresh perspectives, a willingness to challenge harmful norms, and desire to get involved in community initiatives to drive change and normalise conversations around HIV. 

Programmes like Stay On, funded by AIDSFONDS and implemented by ADPP Mozambique, exemplify the potential of youth-driven and community-based approaches. This programme supports sustained HIV treatment and care for adolescents - especially young women - by leveraging family and community networks. It addresses stigma head-on by collaborating with community leaders to disseminate accurate information, promote acceptance and challenge harmful misconceptions. This localised approach has significantly reduced dropouts from the care continuum, many of which are driven by stigma and fear.

A critical benefit of the Stay On project was the sense of belonging it fostered among participants, who no longer felt alone but instead part of a supportive 'family' within a positive living group. These groups provided a safe space for young people living with HIV to come together, share experiences and engage in meaningful discussions about adherence. Participants also received education on health and nutrition and offered mutual support to overcome challenges to living with HIV and maintaining adherence.

Through this project, support was provided to 9,524 people living with HIV, including over 3,000 newly diagnosed individuals and more than 6,000 who were reintegrated into care. Additionally, over 4,000 people participated in community dialogues aimed at raising awareness about HIV and combating stigma and discrimination.

Another crucial focus is addressing the harmful gender norms that exacerbate women’s vulnerability to HIV. In Zambia, the Coaching Boys into Men programme, implemented by DAPP Zambia, empowers boys aged 9 to 14 to become agents of change. This initiative equips young boys with the tools to challenge harmful stereotypes, build gender equality and promote healthy relationships.

The programme's structure was simple yet impactful: boys meet weekly in group sessions led by trainers - often teachers who have undergone specialised training. Over seven lessons, this project trained more than 1,300 boys in values of respect, equality and accountability, fostering dialogue and critical thinking. This model has proven effective in creating supportive environments that challenge stigma, promote gender equity and open meaningful conversations about HIV prevention. 

These examples highlight a critical but often overlooked truth: the role of community-led organisations is indispensable in addressing the local challenges of HIV and amplifying the voices of youth. By working within their communities, local organisations understand the cultural, social and logistical barriers that drive stigma and prevent access to care. 

Yet despite their proven impact, community-led organisations frequently remain underfunded and underrecognised, even as they bear a disproportionate share of the burden in the fight against HIV. Ending HIV as a global health crisis demands bold action: confronting stigma, dismantling harmful norms and investing in youth and community-driven initiatives.

To scale these efforts and achieve lasting impact, community-led organisations need adequate funding, strategic partnerships and sustained global commitment. It is at the local level - where stigma is challenged, trust is cultivated and lives are transformed - that the fight against HIV will ultimately be won.

By empowering young people and amplifying the work of community-led organisations, we can envision a future where stigma is eradicated and HIV is no longer a global health crisis.

Kilford Zimondi is Country Director at Humana People to People in South Africa.

Image by Vonecia Carswell.