AIDS testing: when fear and shame are stronger than symptoms

HIV/AIDS and other sexually transmitted infections (STIs) have long ceased to be a sentence. Thanks to modern medicine, people with a positive status can live a full life: work, build relationships, and plan for the future.

However, the biggest barrier is still not the diagnosis itself, but what surrounds it: fear, stigma, silence, and lack of awareness of the disease. It is these factors that make many people postpone testing, avoid care, and remain face to face with the risks.

In Ukraine, these barriers are exacerbated by a full-scale war. Destroyed infrastructure, limited access to medical services, and loss of basic security make the issue of sexual and reproductive health even more sensitive.

This is particularly acute for those in vulnerable situations: youth, military, internally displaced persons, and members of the LGBTQ+ community.

In times of crisis, timely and accessible testing is not only a diagnosis, but also a guarantee of support, confidentiality and safety for those who need it most. That is why it is important to develop models that combine professional medical care with a safe and trusting environment where everyone can seek support without fear or judgment.

Relevance of STI issues in Ukraine

Sexually transmitted infections remain a serious threat to public health, both globally and in Ukraine. According to the World Health Organization (WHO) , more than one million new cases of STIs, including chlamydia, gonorrhea, syphilis, herpes, and HIV, are reported worldwide every day. Most of these infections do not have clear symptoms in the early stages, which makes timely detection difficult and allows the diseases to spread almost unnoticed.

In Ukraine, the scale of the problem also remains significant. Every year, about 400,000 cases of STIs are officially recorded, of which more than 40,000 are syphilis. Particularly alarming is the increase in the number of late-onset forms of the disease: while in 2008 it was 3.7%, in 2020 it was more than 15%. This indicates that a significant number of people seek medical care only when the infection has already caused complications and requires more complex treatment .

The HIV situation is another critical link. Today, more than 80% of new cases in Ukraine are transmitted sexually. Often, infection occurs against the background of undetected or untreated STIs, which increase the risk of transmission. The consequences are serious. In women, STIs can lead to infertility, pregnancy complications, and often cancer, including cervical cancer. In men, they can lead to inflammation, damage to the genitourinary system, and fertility problems .

But this is not only a medical problem, but also a social one.

There are still taboos in society about sexual and reproductive health. For fear of being judged or disclosed, people avoid going to the doctor.

Low awareness, stigma, distrust of the medical system, and limited access to quality services make the problem systemic and "invisible.".

The full-scale war has further exacerbated the situation in Ukraine. Destroyed hospitals, lack of staff, forced displacement of people and limited access to testing - all these factors create serious barriers to diagnosis and treatment, especially for the most vulnerable groups of the population: youth, military personnel, internally displaced persons, members of the LGBTQ+ community and others. Under such conditions, the risk of STI and HIV spread increases, and late detection of infections complicates their further treatment.

Given these challenges, it is worth noting that timely, regular and accessible diagnostics are crucial. It is not only about fighting infections, but also about the right of every person to dignity, protection and care for their own health. Creating conditions for simple, safe, and confidential testing is one of the key steps to maintaining the health of society, which should not only be declared at the level of public policy, but also implemented through accessible and sensitive services, including modern medical care centers.

How to make aid accessible: solutions that work

The timely detection of sexually transmitted infections is crucial, as it allows for rapid treatment and the prevention of further spread of the disease. However, the effectiveness of even the most modern medical system is often undermined if people are afraid to seek help, not a diagnosis, for fear of judgment, disclosure or stigma.

In Ukraine, more and more attention is being paid to overcoming these barriers. It is important not only to provide access to testing, but also to create an environment where patients feel safe and supported. Simplicity of procedures, absence of unnecessary formalities, confidentiality and human communication should not be an exception, but a necessary standard.

One example of this approach is the network of Wellness Centers operating in Kyiv and Odesa. This is a medical space where you can get free, anonymous and comprehensive testing for HIV, hepatitis B and C, syphilis, chlamydia, gonorrhea, trichomoniasis and other STIs - without referrals or appointments. The main focus here is not only on treatment, but also on patient comfort, minimizing barriers and stress. This approach allows not only to detect infections at early stages, but also to make medical care truly human-centered .

The results show the effectiveness of this approach. In 2024, more than 2011 combined HIV tests were performed in the Odesa center alone, as well as hundreds of PCR tests, bacteriological tests and cultures. More than 115 diagnosed STI cases were treated. In the Kyiv center, the number of patients treated is even higher - 139 people. But the main thing is not only statistics, but also the living stories of people who were able to overcome fear and seek help in time .

One of the patients said that he had been hesitant to get tested for a long time, but the medical center provided him with support: "I was afraid to go for testing, but the center accepted me with understanding. Thanks to their support, I was able to start treatment and feel relieved.".

The story of Victoria, who came to the Kyiv center with suspected syphilis, is particularly illustrative. She ignored the symptoms for a long time due to fear of judgment and lack of information about the disease. However, during the consultation, she felt support from the medical staff, including moral support. And after the diagnosis was confirmed, she received a full course of treatment and detailed information on further prevention.

Human-centered approach: experience that should become a standard

Patients' stories prove that when the medical system creates an environment of safety, trust and respect, people are ready to seek help. Simple formats, confidentiality, and sensitivity to the needs of each individual allow for timely diagnosis of infections, initiation of treatment, and reduction of health risks.

This format is the result of successful adaptation of international experience. In Ukrainian realities, this approach has been transformed to take into account the conditions of war, population mobility, and limited access to medical services. And it works not as a temporary solution, but as a potential model for systemic change.

But for this experience not to remain a local example, it needs to be scaled up - at the level of policy, the health care system, and public perception. However, it is not only the role of the state or international partners that is important here. Each of us has a role to play in this process .

Being aware and supporting initiatives that put people at the center means contributing to the formation of a society without fear and stigma.

Medical care should be accessible to all, regardless of status, circumstances or place of residence. And this standard should become the norm.