Marking World AIDS Day this year, the United Nations Program on HIV/AIDS has published new research that shows the number of new HIV cases decreasing worldwide and it says HIV prevention programs are making the difference. But in many African communities, in Britain and elsewhere, fear of HIV still shrouds the virus in secrecy and bars the path to more comprehensive prevention.
Winnie Ssanyu Sseruma has been living with HIV for 21 years.
She was in her twenties when she applied for a job as a health care worker and had a blood test for HIV. When the results came back positive her life turned upside down.
"Shock was the main feeling at that time, and I thought you know what do I do now? Am I going to live for a long time, am I going to die, what is going to happen to me now?" Sseruma said.
Today, 33 million people are living with either HIV, the virus that causes AIDS, or the disease itself.
A new report, just ahead of World AIDS Day, says Africa is still the hardest hit. But it also says the number of new HIV infections is decreasing. And that, the UN says, is a sign that prevention is working.
Winnie Sseruma is one of nearly 80,000 people in Britain who are HIV positive. That's less than one percent of the population. But in the country of her parents, Uganda, six percent of the population is still HIV positive.
Winnie says HIV in Africa won't be contained until people feel free to talk openly about it.
"For us who are infected, there's still stigma, you know. There's still a lot of people who can't come out and say I'm HIV-positive because they wonder what the reaction will be," Sseruma said.
In Britain, two-fifths of all new HIV cases are in the African community.
Marc Thompson is from the AIDS campaign group the Terrence Higgins Trust. He helps HIV-positive people in London's African community.
"What we've certainly seen is that if there's stigma and discrimination, and if there is broadly stigma, people are fearful and are less willing to come forward and be tested," Thompson said.
He says if HIV-positive people aren't tested, they are more likely to pass on the virus to sexual partners and from mother to child.
He says the stigma is especially high in African communities because of taboos surrounding sex.
"So it's about trying to overcome that barrier, it's trying to work with faith leaders so they no longer think that sex is just a taboo and that HIV and AIDS is revenge from God for promiscuity," Thompson said.
For many years Winnie kept her HIV status a secret from friends and family.
She says she first had to come to terms with her shame about carrying the virus.
"I had to access counseling to deal with some of my fears, to deal with some of the shame that I felt at that particular time. And once, you know, I was able to deal with that, then I was able to talk about my HIV status," Sseruma said.
Now Winnie raises awareness about HIV and AIDS through her work at Christian Aid, a charity based in Britain.
She says now that she's confronted the stigma she can live an open life. And she hopes she can help bring an end to the shame that has surrounded the virus for so many years.
"I talk about HIV publicly, I live with it the best way I know how, I share my experiences with people and help others in my situation and I try to educate others about HIV," Sseruma said.
With millions of HIV-positive people taking anti-retroviral drugs, AIDS no longer has to be a death warrant.
But with less than half of HIV-positive people in Africa receiving the treatment they need, experts say prevention is the key to fighting the HIV epidemic.
Dr. Ade Fakoya is a physician and advisor at the International HIV/AIDS Alliance.
"Prevention always gets less of a deal than treatment and that's a shame because for every five new infections, we're only able to get two on treatment, so we clearly have to focus on prevention," Fakoya said.
But prevention is low priority in many countries dealing with the disease.
With HIV and AIDS still spreading, health experts say prevention is a complex challenge that lies ahead.
