What The Polygamist gets wrong about HIV — and what would save lives in real life

A Netflix drama titled The Polygamist, based on Zimbabwean author Sue Nyathi's novel, has sparked controversy over how it portrays the transmission and management of HIV. The show follows Jonasi Gomora, a wealthy businessman with multiple wives and secret partners, who contracts HIV, denies his diagnosis, avoids treatment, and ultimately dies of AIDS-related complications. While the narrative highlights the personal and social consequences of his actions, critics argue that the portrayal misrepresents the current medical understanding of HIV and its treatment. The show frames Jonasi’s death as a consequence of contracting HIV, but experts emphasize that the real cause of his demise was his refusal to seek treatment due to denial, shame, and societal stigma. According to medical guidelines, individuals who consistently take antiretroviral therapy (ART) can achieve undetectable viral loads, meaning the virus becomes so low in their bloodstream that it cannot be transmitted to others. This concept, known as “undetectable equals untransmittable” (U=U), is supported by extensive scientific research and has transformed HIV into a manageable chronic condition rather than a fatal disease. Despite these advancements, misconceptions persist. The show appears to suggest that people on treatment remain infectious, reinforcing harmful myths that deter individuals from seeking testing and care. Such misinformation can have serious consequences, particularly in regions where access to treatment is limited and stigma remains high. Experts warn that these outdated beliefs contribute to delayed diagnoses and poor adherence to treatment regimens, exacerbating public health challenges. In South Africa, where the show is set, the government has set ambitious targets under the 95-95-95 initiative aimed at ending the HIV epidemic. These goals require that 95% of people living with HIV know their status, 95% of those diagnosed receive treatment, and 95% of those on treatment achieve viral suppression. However, recent data from the national health department reveal that the country is currently at 96% awareness, 79% treatment initiation, and 94% viral suppression. These figures highlight a critical gap in treatment uptake, underscoring the need for improved outreach and support systems. Men, in particular, face unique barriers to accessing HIV services. Studies indicate that African men tend to delay testing and treatment compared to women, often due to cultural norms that equate vulnerability with weakness. This reluctance is compounded by pervasive stigma, which affects both physical and mental well-being. Research conducted in KwaZulu-Natal, South Africa, found that young people living with HIV experience heightened anxiety and depression due to stigma, making them less likely to engage with healthcare services. Efforts to combat stigma have shown promise. Evaluations of 13 stigma-reduction programs across sub-Saharan Africa revealed that targeted interventions can significantly improve engagement with HIV services. Programs that foster open dialogue, challenge harmful stereotypes, and promote community involvement have demonstrated measurable success in reducing discrimination and encouraging early diagnosis and treatment. As the global HIV response continues to evolve, accurate representation in media plays a crucial role in shaping public perception. Misleading portrayals, such as those in The Polygamist, risk perpetuating stigma and discouraging essential behaviors like regular testing and consistent treatment. In contrast, informed narratives can empower individuals to make healthier choices and reduce the spread of the virus. The ongoing struggle against HIV in Africa underscores the importance of addressing both biological and sociocultural factors. By challenging stigma, improving access to care, and promoting evidence-based education, communities can work toward achieving the 95-95-95 targets and ensuring that people living with HIV lead long, healthy lives.