Erika Castellanos, a trans woman and advocate, reflects on surviving HIV and systemic stigma, while warning that political and funding rollbacks threaten decades of progress against the virus.

Erika Castellanos, a 50-year-old transgender woman from Belize, has outlived the estimated 35-year life expectancy for trans women in Latin America. Diagnosed with HIV in 1995, she survived despite limited medical access and pervasive stigma. Today, she leads the organization Global Action for Trans Equality (Gate) and advocates for improved healthcare access and human rights for trans and gender-diverse people.

The Evolution of HIV Treatment

Castellanos began HIV treatment in 2000 using donated medicines from Europe and the United States. She recalls a time when options were extremely limited and community members often died from the virus. While she notes that medical science has successfully transformed HIV from a death sentence into a manageable condition, she argues that political failures prevented many of her friends from accessing life-saving treatments that already existed.

Systemic Barriers and Criminalization

Throughout her life, Castellanos faced significant discrimination, including fear of humiliation by healthcare workers and laws in Belize that threatened imprisonment for her identity. According to the UNAids Global Aids Update, these barriers remain a global issue. In 2026, 14 countries criminalize trans people, 66 criminalize same-sex sexual relations, and 168 criminalize sex work, which UNAids executive director Winnie Byanyima says discourages people from seeking HIV services.

Risks to Future Progress

Castellanos warns that international funding cuts, specifically regarding USAID and Pepfar, threaten to reverse decades of progress. She cautions that reduced support could overwhelm clinics and force community organizations to fill gaps in care once again. The goal to end Aids as a public health threat by 2030 remains at risk unless global inequalities are addressed.