In many developing countries, stigma and discrimination together pose one of the most significant challenges to stemming the spread of HIV and Aids. People known to have HIV often are isolated and the targets of gossip and name-calling. They can lose status and decision-making power in the household and community, family and friends shun many, and they frequently lose their jobs and sometimes their housing. As a result, it is not surprising that people often go to great lengths to hide their HIV status or deny that they might have it - fuelling the spread of the epidemic.