Living With HIV: Transgender Community In Khyber Pakhtunkhwa Battles Double Stigma

Parwa Jan (name changed), a transgender person from Mardan, was asked to leave her dera (residence) by her guru after she was diagnosed with HIV. Recalling that moment, Parwa says it was the most painful day of her life:
"When the doctor told me I had HIV, it felt like the ground had slipped from beneath my feet. I broke down in tears right there, thinking about how much more difficult life was about to become. At that moment, all I could do was cry and feel utterly helpless."

She adds that life had already been no less than a torment, and this diagnosis pushed her over the edge:
"After that, even my own community started distancing themselves from me. I began feeling more and more isolated. People stopped inviting me to events, and as a result, my financial struggles grew worse."

According to documents from the Provincial Integrated HIV/AIDS, Hepatitis, and Thalassemia Control Program, a total of 13 medical centers have been established across Khyber Pakhtunkhwa for the diagnosis and treatment of HIV/AIDS. As of June this year, a total of 9,209 HIV-positive patients have been registered across these centers.

A recent study conducted by the National Commission for Human Rights and Blue Veins, an organization working for transgender rights, reveals that transgender individuals in Pakistan already face deep-rooted social prejudice, economic hardships, and legal barriers.

However, those living with HIV encounter significantly more challenges. The study highlights the harsh realities of their lives and how the lack of access to adequate healthcare in the province exacerbates their situation. There is an urgent need for reforms and tailored support for transgender individuals living with HIV.

Also Read: Pakistan Steps Up War on Human Trafficking as Organised Crime

The research also found that transgender persons face blatant discrimination in healthcare access. In many places, they are denied treatment, treated disrespectfully by hospital staff, and made to wait longer than other patients. Out of fear of such treatment, many avoid seeking medical help, which worsens their condition and puts their health at serious risk.

Dr. Tariq Hayat, head of the HIV/AIDS, Hepatitis, and Thalassemia Control Program, says the rise in reported HIV cases in Peshawar and other districts does not reflect a spike in infections, but rather increased screening and improved reporting. He noted that recent surveys revealed over 30,000 potential HIV cases in the province, but only around 9,000 patients are currently registered and receiving treatment.

Program documents show that:

The HIV/AIDS Center at Hayatabad Medical Complex, Peshawar has the highest number of registered patients: 2,723, including 1,966 men, 555 women, 49 transgender persons, 95 boys, and 58 girls.

The Lady Reading Hospital is second with 2,082 patients (1,050 men, 348 women, 101 transgender, 57 boys, 45 girls).

At Khalifa Gul Nawaz Hospital, Bannu, 1,097 patients are registered (728 men, 291 women, 6 transgender, 40 boys, 22 girls).

DHQ Hospital Kohat has 678 cases (474 men, 181 women, 2 transgender, 10 boys, 11 girls).

In Batkhela DHQ, there are 471 cases (321 men, 132 women, 3 transgender, 7 boys, 8 girls).

Ayub Teaching Hospital, Abbottabad has 466 cases (304 men, 135 women, 5 transgender, 14 boys, 8 girls).

Mufti Mehmood Memorial Hospital, Dera Ismail Khan has 448 patients (315 men, 130 women, 10 transgender, 8 boys, 10 girls).

The Saidu Hospital in Swat has 385 patients (236 men, 123 women, 12 transgender, 7 boys, 7 girls).

DHQ Mardan has 337 cases (228 men, 85 women, 8 transgender, 6 boys, 10 girls).

Bacha Khan Medical Complex, Swabi registers 230 patients (137 men, 49 women, 1 transgender, 4 boys, 3 girls).

DHQ Khar, Bajaur has 125 cases (74 men, 42 women, 7 boys, 2 girls).

DHQ Miranshah reports 122 patients (70 men, 48 women, 2 boys, 2 girls).

The center in Parachinar, Upper Kurram, has the lowest: 45 patients (18 men, 25 women, 1 boy, 1 girl).

Farzana Jan, a transgender rights activist, says that transgender people living with HIV suffer doubly - once due to their identity, and again due to the illness.

"Until society changes its thinking and the government takes concrete action, we will remain deprived of our basic healthcare rights," she said.

She urged the government to train healthcare workers to treat transgender individuals without bias. Awareness campaigns are also needed to dispel misconceptions around HIV and gender identity to help foster social change.

Documents further show that 831 patients from other provinces and countries are receiving treatment at KP's HIV centers: 355 from Punjab, 397 from Afghanistan, 55 from Sindh, 14 from Balochistan, and 10 from Gilgit-Baltistan.

The NCHR and Blue Veins study also found that HIV-positive transgender individuals often suffer social isolation, exclusion, and humiliation. Many are expelled from their own community systems and 'guru' networks after diagnosis. This leads to worsening mental health, including depression, anxiety, and suicidal thoughts.

Despite the Transgender Persons (Protection of Rights) Act, 2018, transgender people remain deprived of basic rights due to the law's poor implementation. Judicial decisions, societal prejudice, and policy failures have pushed them further to the margins of society.

Parwa Jan, now 30, has been living with HIV for the past four years. She says she chose to fight back instead of giving up.
"I registered myself at the HIV/AIDS center at Hayatabad Medical Complex and began treatment, which continues to this day," she shared.

"I go regularly for check-ups. While the treatment is free, my financial situation has deteriorated. I used to send money home, but now I struggle just to cover my own expenses."

KP Health Minister Ehtesham Ali said the provincial government is taking serious steps to control HIV. He announced that the number of screening centers will be increased to 20, enabling early diagnosis and wider coverage.

"HIV already exists in our society-it's like a hidden bomb. The more we screen, the safer our communities will be. We aim to make the process of screening easier and more accessible," he added.

Farzana Jan emphasized the need to include transgender individuals in social health protection schemes and to establish community centers where they can safely access mental and physical healthcare.

"The time has come to act instead of staying silent. We must break biases and give transgender individuals the respect, rights, and opportunities they rightfully deserve. Listening to their voices and addressing their concerns is now a collective responsibility."

According to data compiled up to June this year, 7,027 HIV cases have been reported from KP's settled districts, while 1,371 cases have emerged from the merged tribal districts.

Among settled districts, Peshawar tops the list with 1,724 cases, followed by Bannu (939), Swat (437), Mardan (427), Charsadda (391), Lakki Marwat (349), Swabi (335), Lower Dir (321), Nowshera (279), Kohat (257), Mansehra (229), Abbottabad (221), Upper Dir (156), Karak (153), Hangu (137), Buner (131), Malakand (125), Shangla (103), Tank (101), Haripur (86), Battagram (61), Chitral (36), Kohistan (15), and Torghar (14).

In the merged districts, the highest cases were reported from North Waziristan (354), followed by Khyber (286), Kurram (224), Bajaur (218), South Waziristan (140), Malakand (87), and Orakzai (62).

Dr. Tariq Hayat added that while HIV was once considered a taboo, growing awareness has encouraged people to come forward for screening.

"Anyone who suspects exposure through blood transfusion, sharp instruments, or unprotected sex should get tested so that timely treatment can begin," he advised.

He also confirmed that transgender individuals from different districts are registered in the HIV Management Information System (MIS) and are receiving the same treatment as other patients.

MENAFN30072025000189011041ID1109864562