Survival Strategies of HIV ategies of HIV-Positive Transgender W ansgender Women During omen During the Covid-19 Lockdown in a South African Rural Community

Abstract

South Africa, as a country where there is a gross gap between the rich and poor, has seen the worsening of inequality during the Covid-19 lockdown. The lockdown impacted different groups in various ways including transgender women living with HIV. This interpretative phenomenological analysis study presents the experiences and survival strategies of HIV positive transgender women during the Covid-19 lockdown in a South African rural community. Data were collected through in-depth individual telephone interviews from ten transgender women selected through the snowballing technique. Data were analysed guided by Interpretative Phenomenological Analysis framework. The findings revealed that transgender women living with HIV faced homelessness and starvation during the Covid-19 lockdown. In order to avert starvation and homelessness, some of the transgender women engaged in risky behavior such as providing commercial sex without condoms to obtain more money, caring for people who tested positive for Covid-19, staying in abusive relationships, and illegally using their shacks as brothels and bottle stores. Consequently, these behaviors have increased their risk of being infected with HIV and contracting other sexually transmittable infections and predisposed them to arrest. All these occurred due to a lack of support. Recommendations are made to improve advocacy and support for transgender individuals from the foundation up to tertiary educational institutions to reduce stigma and discrimination. These include adapting infrastructure such as toilets and classroom settings to be gender neutral to accommodate transgender individuals. Parents, government structures, and communities need to be educated about transgender individuals in order for them to accept and support the gender non-conforming individuals instead of humiliating them. Transgender individuals need targeted support regarding employment. The transgender community needs targeted relief, especially those living with HIV.