A*, a 22-year-old transgender woman, celebrated for her mesmerising performances at wedding parties, saw her life take a devastating turn when she was diagnosed with HIV/AIDS.
The news of the deadly, yet treatable disease was like a bomb shell for her, but instead of seeking timely treatment, she kept her diagnosis hidden from her peers due to fear of losing her livelihood and being evicted from the shared room she called home after leaving her family in Rawalpindi.
“A’s health began to decline with weakness and anaemia clearly visible in her body. Yet, she dismissed it each time and blamed relentless fever as the sole cause of her suffering,” recalls her colleague, W*.
“Dancing at weddings and social gatherings while battling illness became exhausting for A and her health deteriorated rapidly due to avoiding medical treatment, leaving her bedridden within months,” shares S*, a roommate of A, who served as her chaperone during visits to marriage gatherings.
S said he took A to Peshawar’s Lady Reading Hospital (LRH) for treatment, where he learned about her HIV infection.
“We immediately took her to the AIDS treatment centre at LRH and were informed by doctors that she is already registered with them, but the delay in getting medicine has caused severe complications,“ he said. “A’s final days were very heartbreaking as she wept in pain and due to the absence of her parents and siblings in this difficult phase of life.”
Khyber Pakhtunkhwa transgender community president and executive director of the Manzil Foundation, Arzoo Khan, says: “The practice of concealing illness, particularly HIV/AIDS, is prevalent among the transgender community due to societal stigma, psychological trauma, fear of rejection from community and discrimination within the healthcare setting, where they are often denied emergency treatment, refused routine medical care and subjected to harassment and abuse.”
Arzoo adds that many transgender people are living with HIV/AIDS, but due to social stigma, they are avoiding treatment from medical care centres, putting their own health at serious risk.
She said that recently, a transgender person from Malakand district arrived in Peshawar in a serious condition and was taken to the HIV/AIDS treatment centre at LRH.
“P, the transgender from Malakand district, delayed her medical treatment for nearly two years and now her health has severely deteriorated, leaving her in critical condition,” Arzoo adds.
According to the Provincial AIDS Control Programme, a concerning increase has been witnessed in HIV/AIDS infection cases in the province.
The number of HIV patients in KP until June 2025 reached 8,398, of which 6,448 are men, 2,119 women, 197 transgender and 445 children. In the first six months of 2025, around 741 new HIV patients were registered in KP.
There are a total of 13 antiretroviral therapy (ART) centres in KP, with the highest number of registered HIV positive patients in Peshawar.
“A could have challenged the stigma surrounding HIV/AIDs by seeking proper medical advice and starting treatment immediately after her diagnosis, saving her own life and setting an example for others,” regrets Farzana, the president of the TransAction KP.
“The fear of losing her livelihood and being evicted from the community claimed her own life at the peak of her youth, leaving the community in a state of deep dejection and grief.“
Nayyer Mujeeb, an HIV patient and president of the KP chapter of the Association of People Living with HIV Pakistan (APLHIV), says: “In addition to transgender individuals, who already belong to a marginalised community, men and women living with HIV/AIDS also face severe stigma, which often discourages them from visiting treatment centres to collect their routine medicines.“
Nayyer tells APP that she is in contact with several HIV patients who are hesitant to seek treatment publicly, and to ensure continuity of medical care, she delivers medications directly to them at their homes.
A research report jointly compiled by Blue Veins and the National Commission on Human Rights reads: “Transgender individuals living with HIV face a dual crisis: the virus itself and the devastating impact of societal stigma.“
The report, titled Understanding the Impact of HIV stigma on Transgender Persons Living with HIV in Khyber Pakhtunkhwa — the first ever in KP — aims to comprehensively examine the impact of HIV stigma on transgender persons and its broader implications on healthcare access, social inclusion, and legal protections.
The study finds that many transgender individuals experience social exclusion, including rejection by families, employment discrimination and even violence, pushing them further into vulnerability.
Structural inequalities such as economic marginalisation, lack of legal protection and social exclusion push many transgender individuals into high-risk behaviours, including sex work and unsafe injection practices, which increase their vulnerability to HIV and other sexually transmitted infections, the study mentions.
“Exclusion of transgender persons from national healthcare programmes, combined with legal ambiguities and widespread discrimination, has resulted in severe health disparities, particularly in the context of HIV prevention, treatment, and care,” observes Shawana Shah, programme director of Da Hawwa Lur (Daughter of Eve).
Shawana says that Da Hawwa Lur recently conducted a research study to document and understand the experiences, needs and challenges of transgender individuals at the grassroots level.
The study suggests an inclusive, gender-affirming healthcare policy to reduce HIV/AIDS risks among the transgender community through their equitable participation in treatment programmes.
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