Author: Alan Winston

How medicine and medical research has contributed to HIV stigma–and how we challenge it

Alan Winston

World AIDS Day is a vital opportunity to raise awareness about HIV/AIDS and honour those whose lives have been affected by the disease. Professor Alan Winston from the Department of Infectious Disease explores how language and scientific definitions have contributed to the stigmatisation of those living with the disease and emphasises the need for person-centred language and thoughtful scientific communication to reduce discrimination in medicine and medical research. 


The initial fear 

Since AIDS–Acquired Immune Deficiency Syndrome–was first identified in the 1980s, along with its underlying cause–the Human Immune Deficiency virus (HIV)– people living with HIV have encountered immense discrimination and stigma. Whilst this was partly driven by fear of the disease itself and the devastating clinical consequences of HIV without treatment, we should acknowledge that both physicians and scientists have contributed to this stigma. Here, I highlight how this has been mediated through language and scientific definitions. Although these contributors have likely not been intentional, going forward, we need to learn from past experiences and carefully consider how, as clinicians, clinical researchers and scientists, our work can focus on reducing the stigma and discrimination that has surrounded HIV for so many decades. 

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“Why am I depressed, doc?” Experiences of an HIV clinician and researcher

HIV Stop Stigma

Despite major progress in treatment and prevention, being diagnosed with HIV can have a big emotional impact on individuals. People with HIV have higher rates of mental health problems than those seen in the general population. One reason for this may be HIV-related stigma, explains Professor Alan Winston from the Department of Infectious Disease


Since the late 1990s, I have been treating people living with HIV and been involved in HIV clinical research. Many things we read about HIV are success stories, and quite rightly we should celebrate these tremendous scientific and medical advances. Life expectancy for someone with HIV is now similar to that of the general population. Antiretroviral therapy generally has manageable side effects and for most individuals, does not incur that many tablets per day. Indeed, many HIV treatments involve taking only one tablet per day. So, why then do so many people with HIV suffer from depression, other mental health conditions, and a poorer quality of life? 

Experience in clinic 

Most people living with HIV, once on a stable treatment, will attend their treatment centre twice per year. Often appointments rotate between a consultant or medical doctor once per year and a nurse specialist on the other occasion. As we can’t cure HIV, our patients attend for life, and we get to know them very well. At consultations, in addition to routine monitoring, we ask people how they are keeping. What stands out are the number of individuals who report symptoms of depression and other mental health conditions such as anxiety. Whilst many of us suffer from mental health complaints, the burden of these complaints in people living with HIV is very high. Thankfully, we do have help in clinic and have a specific clinic run by a psychiatry nurse specialist we can refer patients to. 

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