HIV in North America: Prevalence and Stigma

By Joey Hull, Perspectives Social Media Coordinator (2024-2025)

A red ribbon, symbol of solidarity for people living with HIV, is displayed in front of the White House.

When cancer is diagnosed, it is often met with a wave of support, but with HIV, there is a cloud of avoidance and a shadow of blame. This is the case around the world, and even in North America, where people are said to be more supportive of this diagnosis, there remains a stigma that impacts the disclosure and comfort of people living with HIV (PLHIV). Specific populations and communities face a disproportionately higher risk of HIV exposure and are simultaneously affected by various forms of stigma. This creates complex challenges for prevention, treatment, and maintenance of overall well-being. Those at the highest risk in North America are gay or bisexual men, men who have sex with men, and Black and Latin/Hispanic people (HIV.gov, 2025). This trend can be seen here in Montreal as well. 

Another critical element to consider is the impact of broader public health challenges on HIV. Cases rose 120% in Montreal from 2021 to 2022 (CBC, 2023). This increase represents a trend of rising sexually transmitted infection (STI) prevalence since the pandemic. Once on track to limit the spread of STIs, Canada is now struggling to regain the numbers it had pre-pandemic (CBC, 2023). 

When discussing HIV prevalence, it is essential to think about the people living with the virus and their experiences since diagnosis. Women are not talked about enough when discussing HIV, especially in North America. In a study conducted by three Montreal researchers, it was noted that for women living with HIV, social exclusion, internalized stigma, and fear of disclosure were three of the most important factors impacting their emotional health (Rouleau et. al, 2012). These women shared their stories, describing the embarrassment and exclusion they often felt living with the virus. Women living with HIV (WLHIV) also feel more pressure, often from society as a whole, with their diagnosis. This arises from a misunderstanding of the transmission of the virus and an intersection of stigmas. Women living with HIV may experience multiple stigmas related to their race, gender, and HIV status, which can negatively affect not only their mental health, but also their HIV treatment outcomes (Malama et. al, 2023). 

Access to pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP) is essential for preventing HIV. The medicines work to limit the spread of the virus, especially for those at high risk. While these medicines work well, there is a disparity in access among different communities. At McGill’s Global Health Night 2024, Dr. Oni Blackstock, former assistant commissioner for the New York City Department of Health and Mental Hygiene, discussed HIV transmission in New York City and the disparities in PrEP usage. She explained how people of non-white races are at higher risk of exposure to the virus and experience higher incidence, yet usage of PrEP is equal across all groups, but not equitable. As non-white communities are at higher risk, they should use PrEP at a higher rate. This disparity is relevant across North America and requires a policy that focuses on educating people about the use of prophylaxis and provides increased access to those most at risk.

Over the past few months, I’ve had the privilege of working with AIDS Community Care Montreal (ACCM), an experience that has been both eye-opening and deeply meaningful. During my time there, I’ve had the opportunity to share space and conversation with a diverse group of community members, many of whom are living with HIV. What struck me most was the sheer variety of experiences, identities, and stories that each person carried. Despite these differences, there was a powerful sense of unity and a collective celebration of life, sexuality, resilience, and acceptance. It became clear to me how crucial spaces like ACCM are, not only as support systems but also as vibrant centers for building community and affirming identity. These centers foster belonging, provide vital social capital, and offer a safe environment where people can heal, grow, and thrive together. They help dismantle stigma and create networks of care that extend far beyond medical treatment. Being part of this community, even in a small way, has taught me that true support involves more than just services––it’s about connection, recognition, and creating spaces where everyone can be seen and valued.

Better access to health care not only promotes physical health, but can also lead to increased resilience and less stigmatization, helping to combat fear-based thinking. While “nearly 90% say they are either knowledgeable, or feel they know a little about HIV. And, up to 43% of Americans are now comfortable interacting with people living with HIV in various scenarios, compared to 36% in 2020” (Ellis & GLAAD, 2022), there still needs to be more done for HIV prevention and destigmatization. The media must do more to accurately portray the lives of PLHIV, so the public can better understand their experiences. While North America has increased its supply of medicines to combat HIV, it requires a supportive environment that encourages people to get tested and treated before it is too late. 

Joey Hull

is a second year undergraduate in Environment - Ecological Determinants of Health - Population. He is from Columbus, Ohio and participates in multiple global health-focused clubs at McGill. He has a strong passion for understanding the impacts of climate change and land development on health. He served as Social Media Coordinator for Perspectives 2024-2025.

References

Blackstock, O. (Presenter). (2024, November 21). Uprooting health inequities: Advancing inclusive and participatory approaches to clinical research and public health. Lecture presented at McGill Global health Night 2024, McGill University, Montreal, Quebec, Canada.

Ellis, S. K., & GLAAD. (2022). 2022 state of HIV stigma report. GLAAD. Retrieved March 4, 2025, from https://glaad.org/endhivstigma/2022/#:~:text=The%20State%20of%20HIV%20Stigma%20study%20shows%20a%20majority%20of,know%20a%20little%20about%20HIV.

HIV.gov. (2025, February 7). Who is at risk for HIV? HIV.gov. Retrieved March 4, 2025, from https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/who-is-at-risk-for-hiv#:~:text=In%20the%20United%20States%2C%20gay,population%20most%20affected%20by%20HIV.

Malama, K., Logie, C. H., Sokolovic, N., Skeritt, L., O'Brien, N., Cardinal, C., Gagnier, B., Loutfy, M., Kaida, A., & de Pokomandy, A. (2023). Pathways from hiv-related stigma, racial discrimination, and gender discrimination to HIV treatment outcomes among women living with HIV in canada: Longitudinal cohort findings. JAIDS Journal of Acquired Immune Deficiency Syndromes, 94(2), 116-123. https://doi.org/10.1097/qai.0000000000003241

Morris, E. (2023, December 7). Montreal saw a 120% increase in HIV diagnoses last year. CBC. Retrieved March 4, 2025, from https://www.cbc.ca/news/canada/montreal/montreal-hiv-increase-1.7050753#:~:text=Montreal%20Public%20Health%20will%20be,%22Stigma%20is%20really%20powerful.

Rouleau, G., Côté, J., & Cara, C. (2012). Disclosure experience in a convenience sample of quebec-born women living with hiv: A phenomenological study. BMC Women's Health, 12(1). https://doi.org/10.1186/1472-6874-12-37