History and Stigma: What Has World AIDS Day Looked Like in Bosnia and Herzegovina?

It is estimated that between 8 and 10 million people worldwide are living with HIV. In Bosnia and Herzegovina, around 490 people currently registered are living with HIV; however, estimates suggest that the actual number could be up to three times higher.

The Human Immunodeficiency Virus (HIV) infects and destroys cells of the immune system, significantly impairing the body’s ability to fight other infections and diseases. When HIV severely weakens the immune system, it can lead to the development of Acquired Immunodeficiency Syndrome (AIDS). HIV is transmitted through certain bodily fluids: blood, semen, vaginal and rectal fluids, and breast milk—most commonly through unprotected sexual intercourse, sharing non-sterile needles, or from mother to child during pregnancy, childbirth, or breastfeeding.

It is important to emphasize that HIV and AIDS are not the same: HIV is a virus, while AIDS is a condition that can develop as a result of long-term, untreated HIV infection. Thanks to modern antiretroviral therapy, not all people living with HIV today will develop AIDS, and with regular treatment, it is possible to live a long and high-quality life. Without therapy, however, HIV almost always progresses to AIDS.

The Beginning: A Silent Epidemic

Scientific evidence shows that HIV originated from SIV (Simian Immunodeficiency Virus), a virus that naturally circulates among certain species of primates. It is believed that HIV-1, the most widespread type of the virus, crossed from chimpanzees to humans in what is now West and Central Africa in the early 20th century. This transmission most likely occurred through contact with blood during hunting and the processing of wild animal meat, rather than through consumption itself. This represents a classic example of zoonosis, a process not uncommon in the history of infectious diseases.

For decades, the virus circulated unnoticed, and global attention was only drawn in the early 1980s, when doctors began documenting rare forms of pneumonia, cancers, and opportunistic infections in otherwise healthy individuals. During this period, HIV was first identified among men who have sex with men (MSM), which led to a sharp increase in stigma and discrimination against gay people. It soon became clear, however, that HIV does not affect only one community but represents a global public health issue.

In the territory of present-day Bosnia and Herzegovina, the first cases of AIDS were recorded in the mid-1980s, with the first officially registered case documented in 1986. The first HIV diagnoses appeared in the late 1980s, while data from the 1990s and 2000s show a relatively low number of registered cases compared to Western European countries.

Historical data indicate several hundred registered HIV diagnoses from 1986 to the 2010s. However, in recent years, a significant change has been observed in the structure of newly diagnosed cases. According to available data and community reports, MSM account for a large share of new diagnoses, with some administrative units in 2022 reporting between 75% and 89% of newly detected cases among this population.

It is important to stress that this does not mean HIV affects exclusively gay men or the LGBTI+ community. On the contrary, such statistics largely reflect a higher level of awareness, better access to information, and a greater willingness to get tested within this community in recent years in Bosnia and Herzegovina. While gay men and parts of the LGBTI+ community are testing more frequently, a large portion of the general population still does not, often due to fear, lack of information, or social stigma. For this reason, greater visibility of HIV among the MSM population is primarily the result of testing and early detection—which enable treatment—rather than evidence that HIV is “linked” to a particular identity or community.

Low Prevalence, but Not Low Risk

Bosnia and Herzegovina is often described as a country with low HIV prevalence. However, low prevalence does not mean low risk. Long-standing stigma, the lack of systematic sexual education, limited resources for testing, and weak institutional support create an environment in which the real number of infections may differ significantly from official statistics.

Experts have been warning for years that the small number of registered cases does not necessarily reflect the real situation. Reasons include fear of discrimination, insufficient knowledge about HIV and sexual health, and limited access to confidential and tailored healthcare services.

Although most newly diagnosed cases in recent years are recorded among the MSM population, this data primarily points to the need for targeted, inclusive, and community-adapted prevention programs, rather than exclusion or stigmatization. During the 1980s and 1990s, the healthcare system in Bosnia and Herzegovina was focused on basic healthcare, while HIV and AIDS topics were present mainly through professional conferences and institutional reports. The visibility of people living with HIV, as well as the active involvement of communities at risk, was almost nonexistent.

Overall, although Bosnia and Herzegovina has a low HIV prevalence, the concentration of new cases within the marginalized LGBTI+ community points to a serious public health and human rights issue, primarily resulting from long-standing stigma and systemic shortcomings in the development of tailored services.

Stigma, Prevention, and the Fight

World AIDS Day was first marked on December 1, 1988, under the auspices of the World Health Organization, with the aim of raising global awareness, strengthening understanding, and combating stigma associated with HIV and AIDS. This day also serves as an opportunity to honor those who have lost their lives to AIDS-related illnesses.

During the 1980s, AIDS was accompanied by intense fear, moral judgment, and misinformation. It was often wrongly labeled as a “gay disease,” which further deepened discrimination, especially against gay men and people who use drugs. Such narratives led to denial of healthcare, late diagnoses, and neglect of other affected populations.

The development of therapy has significantly changed the course of the epidemic. From complex and demanding treatments in the early stages, progress has been made toward modern combination therapies that allow for a single pill per day and significantly improve quality of life.

Over the past decade, the marking of World AIDS Day in Bosnia and Herzegovina has increasingly taken on a public, inclusive, and educational character. Public actions, panel discussions, online campaigns, and cooperation with the media have contributed to changing narratives, while more attention is being given to modern methods of prevention and treatment, including regular testing, antiretroviral therapy, the Undetectable = Untransmittable (U=U) principle, and preventive measures such as PrEP.

In many cantons, including Tuzla Canton, free counseling and testing for HIV, hepatitis B, and hepatitis C are organized on December 1. Bosnia and Herzegovina is also a signatory to the United Nations Sustainable Development Goals, which envision ending the AIDS epidemic by 2030.

Nevertheless, World AIDS Day often remains one of the few moments in the year when HIV is discussed publicly, frequently without genuine inclusion of the voices of those most affected. The LGBTI+ perspective is often omitted or reduced to stereotypes, which further deepens stigma.

The history of marking this day in Bosnia and Herzegovina reflects broader societal attitudes toward HIV, sexuality, and LGBTI+ people—from silence and fear, through slow institutional responses, to an increasingly strong community voice. In a society where sexual health is still rarely discussed openly, World AIDS Day serves as a reminder that knowledge is the strongest weapon, and solidarity the most important response. HIV is not a matter of morality, but a matter of public health and human rights.

This article was published with the support of the Irish Department of Foreign Affairs and Trade. The content of the article is the sole responsibility of the author and does not necessarily reflect the views of the Tuzla Open Centre or the Irish Department of Foreign Affairs and Trade or the Irish Government.