May 30, 2025
By Iqra Manzoor
LAHORE
In a bid to bridge long-standing gaps in healthcare access for marginalized communities, the AIDS Control Network—an initiative by the women-led NGO Da Hawa Lur—is advocating for the meaningful inclusion of the transgender community in Khyber Pakhtunkhwa’s (KP) government-led HIV-AIDS Control Programme.
Currently, 13 treatment centres operate at the divisional level across Khyber Pakhtunkhwa, offering free diagnostics, antiretroviral therapy, and psychological counselling to over 6,500 registered HIV patients. According to official data shared with Voicepk by a representative of the KP HIV-AIDS Control Programme, 176 of these patients are transgender individuals. Of them, 147 are actively receiving treatment, nine have passed away, and 20 have been lost to follow-up—highlighting significant challenges in continuity of care and community outreach.
The data underscores the urgent need for greater transgender representation within the HIV-AIDS Control Programme. Activists stress that involving transgender individuals in the design and delivery of services can help build trust, improve outreach, and encourage more community members to come forward without fear or stigma to access timely diagnosis and treatment.
Policy gap and provincial strategy
Shawana Shah, Programme Director of Da Hawa Lur, told Voicepk that existing national health strategies fail to openly acknowledge transgender communities as a high-risk group, leaving critical gaps in both recognition and service delivery.
“Health policies, health strategies, and legal reforms must be inclusive and gender sensitive,” she emphasized. “Even in national strategies, the transgender community is not openly mentioned. Services provided at the national level must be designed to meet the needs of every group that requires and deserves them.”
While a National AIDS Strategy exists, KP lacks a provincial AIDS policy or legal framework to contextualize and address the region-specific needs of vulnerable populations. This policy vacuum, according to Shah, results in inadequate funding, programming, and implementation around sexual and reproductive health rights, HIV prevention, and treatment services.
“Without a provincial strategy, we cannot secure the resources or deliver programming effectively,” she said.
Stigma surrounding HIV/AIDS and sexual health continues to discourage individuals from seeking timely treatment. A coordinated effort involving both state and civil society actors is needed to destigmatize these issues and train healthcare providers in non-discriminatory service delivery.
A key component of Da Hawa Lur’s advocacy is the demand for greater representation of transgender individuals within the programme structure.
“We believe any national or provincial programme should hire transgender representatives to improve outreach and relevance,” Shah said. “In our own organization, we work with transgender individuals on health-specific initiatives. It’s essential that the people most affected by the issue have a say in the design and implementation of solutions.”
Though the 13 HIV treatment centres are receiving a growing number of patients, Shah pointed out that KP has over 35 districts, and the existing infrastructure is insufficient to meet the province’s needs.
To address this, the AIDS Control Network is urging the government to develop a comprehensive provincial AIDS strategy that explicitly ensures the inclusion and legal protection of the transgender community, alongside gender-inclusive healthcare services.
“When stigma prevents people from disclosing their illness, it is crucial that service providers are accessible and equipped to offer confidential, nonjudgmental care,” Shah added. “Only then can we begin to close the gap in HIV prevention and treatment for the transgender population in KP.”
Transgender advocate calls for representation & dignified care
Arzoo Khan, Executive Director of the Manzil Foundation and a prominent transgender rights advocate, emphasized the urgent need for transgender inclusion in the HIV-AIDS response during a conversation with Voicepk.
“There are many transgender individuals who have been diagnosed with HIV, but most are hesitant to disclose their condition to male or female healthcare providers,” said Khan. “They feel safer opening up to transgender leaders and peers who already support them and understand their challenges. Representation is crucial—not just for trust, but for effective communication and outreach.”
Khan highlighted the systemic neglect the community faces. “Transgender persons are often abandoned by their families, denied shelter, and pushed into sex work to survive. Once diagnosed with HIV, their situation becomes even more precarious due to the layers of stigma they face.”
She pointed out that having transgender staff or focal persons at hospitals and HIV centers can improve outreach and encourage more individuals to access care without fear. Khan also called for dedicated spaces within hospitals—such as a single room or a few beds—specifically for transgender patients to allow them to seek treatment with dignity and peace of mind.
Additionally, she raised concerns about the economic vulnerability of HIV-positive transgender persons. “Many are unable to earn due to their illness. The government must ensure food support and consider a monthly stipend for transgender individuals undergoing treatment,” she urged, adding that one community member had received a spoiled food package and others faced similar neglect.
Alarmingly, she revealed that three transgender individuals living with HIV had been killed, and one more is currently facing threats to their safety—underscoring the critical need for protection alongside care.
Inclusion is prevention
As KP continues to battle rising HIV infections, civil society actors stress that a health response that excludes its most vulnerable communities cannot succeed. Without a provincial strategy and legal protections tailored to the needs of transgender people, efforts to prevent, treat, and manage HIV will fall short.