According to new data, Black Americans are more likely than the general population to say they understand HIV. Yet nearly half still disagree with a fundamental scientific finding about HIV transmission.
60% of Black respondents in GLAAD’s 2026 State of HIV Stigma Study said they feel knowledgeable about HIV. That compares with 49% of Americans overall. But when researchers asked about Undetectable = Untransmittable, or U=U, a different picture emerged.
48% of Black respondents disagreed with U=U, compared with 44% of Americans overall, GLAAD told The Black Wall Street Times. The Centers for Disease Control and Prevention says a person living with HIV who takes treatment and maintains an undetectable viral load has zero risk of transmitting HIV to sexual partners.
The findings reveal a gap between how knowledgeable people feel about HIV and their understanding of advances that have transformed HIV prevention and treatment. That gap carries particular significance for Black Americans, who remain disproportionately affected by HIV.
For Tim’m West, executive director of the Rustin Institute in Atlanta, the science behind U=U has implications far beyond medicine. West has lived with HIV for nearly three decades and said the discovery helped challenge both the shame associated with HIV and the perception that people living with the virus pose a danger to others.
“At this point in my life, I’ve been living with HIV for longer than I have not,” West told The Black Wall Street Times.
Black Americans remain disproportionately affected by HIV
Black Americans represented about 12% of the U.S. population but accounted for 39% of HIV diagnoses in 2024, according to the CDC. Of the 38,793 HIV diagnoses among people ages 13 and older that year, 15,128 were among Black Americans. The South accounted for 51% of diagnoses nationwide.
GLAAD’s findings suggest misconceptions about U=U aren’t isolated to any single racial or generational group. Among respondents, 48% of Black adults, 45% of Hispanic adults and 43% of White adults disagreed with U=U.
Regional differences were somewhat larger. Forty-seven percent of respondents in the Midwest disagreed, followed by 45% in the South and 44% in the West. In the Northeast, 36% disagreed. Among LGBTQ respondents, 37% disagreed with U=U.
GLAAD said differences across racial and generational groups were not statistically significant. The organization said the findings point to a broad need for U=U education rather than misinformation concentrated within one demographic.
Tim’m West sees that need firsthand. “The number of people that I meet that still haven’t heard of U=U says that there’s a lot more outreach to be done,” he told BWST.
What U=U means for people living with HIV
West tested positive for HIV at 26. He is now 54, and his experience spans an extraordinary transformation in HIV treatment and survival.
During the height of the epidemic, West remembers how quickly people could disappear from his life. He recalled “seeing a friend out at a bar and two weeks later hearing that they had passed.”
Those experiences shaped how he imagined his own future after his diagnosis. “Finding out at 26, I didn’t really necessarily prepare to be 30, or 40, or 50,” West said.
Today, effective HIV treatment allows people with the virus to live long, healthy lives. Maintaining an undetectable viral load also prevents sexual transmission. For West, scientific confirmation of U=U helped address “a lot of shame around living with the virus and being seen as someone that was a threat to people.”
The science has also changed conversations around dating, sex and relationships. U=U and PrEP give people more options for preventing transmission, while allowing couples to make informed decisions about their health and prevention choices.
Gen Z feels least knowledgeable about HIV
The study uncovered a different problem among younger Americans. Only 31% of Gen Z adults said they feel knowledgeable about HIV, compared with 60% of Gen X adults.
However, Gen Z respondents were not the generation most likely to disagree with U=U. GLAAD told BWST that 41% of Gen Z respondents disagreed with the science. The figure was 43% among Millennials and Baby Boomers, while Gen X recorded the highest percentage at 46%.
In other words, Gen Z adults report significantly less confidence in their overall HIV knowledge, but GLAAD’s data does not show them rejecting U=U at higher rates than older generations.
GLAAD points to two factors that may help explain the knowledge gap: declining HIV representation in media and less direct personal connection to the epidemic. About 1 in 4 Gen X adults either know someone living with HIV or are living with HIV themselves, according to information GLAAD provided to BWST. Among Gen Z, that falls to roughly 1 in 10.
Older generations also lived through a period when HIV and AIDS occupied a far more visible place in American public life and media. Gen Z entered adulthood during a dramatically different era of HIV treatment and prevention.
HIV is disappearing from American media
GLAAD argues that younger Americans now encounter far fewer stories explaining the modern reality of HIV. 72% of Americans surveyed said they had not seen media stories featuring real people living with HIV during the previous 12 months, up from 66% in 2024.
70% said they had not seen a person living with HIV depicted in television or film during the previous year. Only 15% reported seeing a story about someone living with HIV on social media, while GLAAD reported that just 0.09% of podcast episodes analyzed mentioned HIV.
The organization describes the trend as an “invisibility paradox”: As people encounter fewer contemporary stories about HIV, outdated assumptions can persist even as medicine advances.
“Our research points to two core drivers behind Gen Z’s knowledge gap: an absence of modern media representation and a lack of direct generational connection to the early epidemic,” GLAAD told BWST in response to questions about the findings.
HIV treatment has changed dramatically
Modern HIV treatment bears little resemblance to the reality Americans encountered during the height of the AIDS epidemic. Antiretroviral therapy can suppress HIV until the amount of virus in a person’s blood becomes undetectable.
When a person maintains an undetectable viral load, they will not transmit HIV through sex, according to the CDC. The finding is the basis of U=U. PrEP, or pre-exposure prophylaxis, can also prevent people without HIV from acquiring the virus.
Yet GLAAD’s survey suggests public understanding has not kept pace with those scientific advances. 79% of Americans surveyed recognized that people living with HIV experience stigma and discrimination. 77% said stigma can discourage HIV testing, while 73% said it can discourage people from seeking treatment.
At the same time, comfort around people living with HIV declined in some areas. 61% reported feeling comfortable around a family member living with HIV, down from 66% in 2024. Only 45% reported feeling comfortable with a medical professional living with HIV, down from 50%.
“Stigma did not disappear. It evolved,” Terrance Hunter, vice president of strategic initiatives at 26Health and a member of GLAAD’s Community HIV Stigma Advisory Committee, said in the report. “If we are serious about ending the HIV epidemic, we must be just as intentional about dismantling stigma as we have been about advancing treatment.”
Tim’m West’s life offers another measure of how dramatically the medical reality has changed. His experience reflects a reality that remains largely absent from American media: People with HIV aren’t simply surviving. Many are growing older, building relationships, leading organizations and planning futures that previous generations affected by the epidemic could not take for granted.
A gap between scientific progress and public understanding
GLAAD’s sixth annual State of HIV Stigma Study combines a nationally representative online survey of 2,500 U.S. adults with qualitative focus groups conducted with Ipsos.
The quantitative survey was conducted in January 2025. Focus groups followed in September 2025 and included Gen Z adults, men of color who have sex with men, cisgender and transgender women of color and Spanish-speaking Latine communities.
GLAAD produced the report through its Media Institute in partnership with Gilead Sciences. The two organizations have partnered on HIV stigma programming since 2019.
The survey’s findings ultimately point to a complicated reality. Black respondents were among those most likely to describe themselves as knowledgeable about HIV, while Gen Z respondents were the least likely. Yet misunderstanding of U=U stretched across racial groups, generations and regions.
For Black communities, that knowledge gap exists alongside persistent disparities in HIV diagnoses. For people like West, the science behind U=U also carries something statistics cannot fully capture: It challenges decades of fear about what it means to live with HIV and how others perceive people who have the virus.
Science has fundamentally changed what it means to prevent, treat and live with HIV. GLAAD’s findings suggest public understanding still has considerable catching up to do.
