Three million people have HIV in South Africa, but it’s estimated that fewer than 100 live openly with the disease. The December murder of AIDS activist Gugu Dlamini in KwaZulu-Natal province was a grisly reminder that coming out is truly a matter of life and death.

After Dlamini, 36, a volunteer for the National Association of People Living with AIDS, announced on radio and TV that she had HIV, a mob attacked her in her home, accusing her of bringing shame on their community. They stoned, kicked and beat her with sticks. She died the next day.

One week before her death, Dlamini was beaten by a man who told her to follow the example of others in her province—30 percent of whom have HIV—and keep silent about her infection. Dlamini alerted authorities, but no action was taken.

Dlamini’s murder shocked and rocked South Africa’s already-skittish activists. Said Prudence Mabele, who in 1994 became the first black South African woman to disclose her HIV publicly: “I just don’t know if people should come out now.”