HIV has changed. Now our attitudes must

Over the last two decades, HIV care has undergone a transformation so profound that it is difficult to recall the early years of the epidemic, when a diagnosis was almost synonymous with fear, stigma, and the certainty of premature death. Today, we stand in a very different place. Thanks to scientific breakthroughs, global commitment, and the widespread availability of effective treatment, HIV has become a chronic, manageable health condition—one in which people living with HIV (PLHIV) can expect long, healthy, and productive lives.

The single most important factor of this shift has been the advent and evolution of antiretroviral therapy (ART). Two decades ago, ART regimens were complex, toxic, and expensive, accessible only to a few. Mortality was high, and HIV-care infrastructure in many parts of the world, including India, was limited. Over time, ART has evolved into simple, safe, once-daily regimens with minimal side effects. This scientific progress has turned the tide of the epidemic. A young person newly diagnosed with HIV today, who begins ART early and adheres well, can have a normal life expectancy, comparable to those without HIV. Medically, HIV is no longer viewed as a fatal illness but as a chronic manageable condition—akin to hypertension or diabetes—requiring regular medication and monitoring but compatible with a full and meaningful life.

However, while science has moved forward, societal beliefs have not kept pace. A majority of the general population still holds outdated ideas about HIV. Many continue to believe that the infection is spread casually through touch, sharing food, or simply being in the same room as a person with HIV. Others assume that PLHIV cannot marry, cannot have children, or will inevitably die young. These beliefs belong to an earlier era, and this gap between knowledge and perception remains one of the biggest challenges faced by PLHIV.

The reality is very different. ART not only preserves health and lifespan, it also prevents transmission. When a PLHIV is on effective ART and achieves viral suppression, they cannot transmit the virus to their sexual partners—this principle, known globally as “U=U” (Undetectable = Untransmittable), has transformed how we view relationships, marriage, and sexuality for PLHIV. Today, PLHIV can marry partners who are HIV-positive or HIV-negative, have fulfilling relationships, and build families. With appropriate care and preventive interventions during pregnancy, childbirth, and breastfeeding, the risk of a mother transmitting HIV to her baby is almost zero.

Perhaps the strongest testament to progress is found in the lives of children who grew up with HIV. Many who were infected at birth are now healthy adults, completing education, pursuing careers, getting married, and having HIV-negative children. In many families, HIV transmission has effectively stopped by the third generation--proof that with treatment, support, and awareness, HIV need not define or limit anyone’s life.

India’s progress has been substantial. The scale-up of ART services, strong community engagement, and dedicated institutions have been pivotal. The National AIDS  Control Organisation (NACO) has played a transformative role by ensuring free nationwide access to life-saving ART. The AIDS Society of India  has provided regular updates on HIV to its doctors through its national conferences over the last 25 years. Numerous children who received care from ASHA Foundation have grown into confident, healthy adults living full lives, many now married and parents to HIV-negative children.

The progress in the field of HIV is a reminder of what science, solidarity, and sustained commitment can achieve. However, the journey is not over. Medical advances alone cannot eliminate stigma. To truly transform the lives of PLHIV, society must update its understanding and accept that HIV is no longer a death sentence. PLHIV can--and do--lead long, healthy, productive, and joyful lives.

The message is clear: HIV has changed. It is time our attitudes changed too. With continued access to ART, strong support systems, and community-driven efforts--especially among key populations--the next generation can grow up in a world where HIV is neither feared nor misunderstood—but seen simply as another medical condition with effective treatment.

The story of HIV today is not one of despair but of resilience, science, and hope. The growing number of HIV-free children born to parents with HIV,and the vibrant lives of young adults who grew up with the virus stand as powerful proof that progress is not only possible—it is here.

(The writer is president, AIDS Society of India and founder- director, ASHA Foundation, an NGO working in the field of HIV)