A new report from the Williams Institute at the UCLA School of Law finds that in 2024, 43% of adults in the United States held at least one stigmatizing belief about people living with HIV (PLWH), an increase from 31% in 2021.
The report describes HIV stigma as encompassing two primary dimensions. Fear-based stigma refers to discomfort with being around PLWH due to exaggerated or inaccurate beliefs about how HIV is transmitted. Blame-based stigma reflects the belief that PLWH have engaged in immoral or blameworthy behavior and therefore deserve HIV infection.
In 2024, 26% of adults reported blame-based stigma, and nearly one-third (31%) expressed fear-based stigma. The proportion of adults endorsing both forms of stigma increased substantially from 8% to 14% between 2021 and 2024.
“HIV stigma continues to pose a significant barrier to addressing the HIV epidemic in the United States,” said lead author Jordan Grasso, Research Data Analyst at the Williams Institute. “Persistent misperceptions about transmission, along with moral judgments about people living with HIV, shape public attitudes in ways that undermine health and well-being, contributing to poorer mental health outcomes, reduced engagement in care, and lower quality of life.”
Heterosexual adults (45%), those with a high-school diploma (51%) or less (52%), and conservatives (61%) were more likely to express stigmatizing views. Conservatives (43%) were more than twice as likely as liberals (12%) and moderates (21%) to agree with statements demonstrating blame-based stigma.
Researchers analyzed data from the nationally representative General Social Survey (GSS) to assess the prevalence of HIV stigma in the U.S. and examine the ways HIV stigma contributes to the persistent criminalization of people living with HIV.
Currently, 32 states have laws that criminalize PLWH, and 28 states impose enhanced penalties tied to a person’s HIV status. Many of these laws were enacted at the height of the AIDS epidemic and do not reflect contemporary scientific understanding of HIV transmission, treatment, and prevention. The Centers for Disease Control and Prevention has noted that HIV criminalization can discourage testing and increase HIV-related stigma.
“Outdated HIV criminal laws frequently criminalize behaviors that scientific evidence has shown to pose little or no risk of HIV transmission, such as spitting,” said co-author Nathan Cisneros, HIV Criminalization Project Director at the Williams Institute. “Ending the HIV epidemic requires expanded public health outreach, modernization or repeal of HIV criminal laws, and investments in evidence-based interventions to reduce stigmatizing beliefs about people living with HIV rooted in fear and blame that feed HIV criminalization.”