This report explores the causes, manifestations and consequences of HIV and AIDS related stigma in sub-Saharan Africa. Based on a study in Ethiopia, Tanzania and Zambia, it acknowledges stigma as complex, caused by incomplete knowledge, fears of death and disease and sexual transmission. Stigma is also influenced by socio-economic status, age and gender. The report also discusses in detail how people living with HIV react to stigma, and also how they and their families/ friends develop strategies to cope with stigma. Recommendations include the need to provide safe spaces to discuss the values and beliefs about sex, morality and death, find a common language to talk about stigma and ensure a contextually appropriate and ethically responsible role for people living with HIV