2026/01/18 by Sarah Sarandos, Leigh Ann van der Merwe, Joseph Daniels
Social Sciences · Psychology · Health Professions · #African Sexualities and LGBTQ+ Issues #LGBTQ Health, Identity, and Policy #Adolescent Sexual and Reproductive Health
paper · doi:10.1080/26895269.2026.2615647
Background Transgender women experience the highest rate of gender-based violence (GBV) and intimate partner violence (IPV) than any other gender or sexual minority in South Africa. Experiencing both GBV/IPV and HIV-positive status intensifies intersectional stigma for transgender women, compounding their marginalization and discrimination. Increased social support from loved ones, however, can provide a buffer toward how transgender women manage these stigmatizing experiences.Methods Semi-structured qualitative interviews with trans women living with HIV-positive status (n = 21) were conducted in South Africa. Questions addressed experiences of GBV/IPV and the influence of loved one’s support. Interviews were recorded, transcribed, and inductively analyzed. Emergent themes were re-coded, clustered, and refined for the final thematic analysis.Results Three main themes were identified: GBV/IPV dynamics and trauma’s effects on trans women; fear of discrimination and HIV disclosure; and how loved one support influences risky behaviors and coping. Those without support faced greater challenges managing HIV and were more prone to risky sex or alcohol use, with intimate partner violence more prevalent. Supportive loved ones helped participants feel safer expressing themselves and facilitated conversations about gender identity and HIV status. These findings support Bandura’s Social Cognitive Theory, which emphasizes how personal, behavioral, and environmental factors interact to shape trans women’s relationships.Conclusions Support from loved ones helps trans women with self-identification and boosts their confidence in sharing their HIV status with trusted individuals. Weak support systems can cause social isolation, poor HIV management due to non-disclosure, and unhealthy coping strategies like increased alcohol use. This isolation may also compromise the safety of trans women, heightening the risk of GBV/IPV from close contacts. Future research should determine which social supports are most valuable to trans women and examine how loved ones contribute to (or withhold) support. These insights can guide interventions to lower GBV/IPV rates and enhance HIV outcomes.