‘Reaching 50 is a success story’: how one trans woman survived HIV and stigma in Latin America

A Half-Century of Resilience: Trans Woman’s Journey Through HIV, Stigma, and Advocacy

Wanderstayfinder.com – For Erika Castellanos, celebrating her fiftieth birthday represents far more than a personal milestone—it embodies a triumph over statistics that have claimed countless lives across Latin America. While the average transgender woman in the region survives to approximately thirty-five years of age, Castellanos has navigated three decades of medical uncertainty, social prejudice, and political turbulence to reach this remarkable age.

“I am 50 years old. A lot of trans women are killed very early in life, either because of HIV or because of transphobia, so reaching 50 is a success story,” she reflects, acknowledging the dual threats that have historically shortened trans lives in her homeland.

From Belize to Mexico: A Life in Transition

Born and raised in Belize, Castellanos relocated to neighboring Mexico during the early 1990s, seeking a place where she could live more openly as a transgender woman. The journey was far from straightforward. She sustained herself through sex work while simultaneously volunteering at an HIV hospice in southern Mexico—a period she describes as both challenging and formative.

“We barely had anything [at the hospice]. My mother paid for the snacks at our meetings. It was a time when treatment options were extremely limited. We were caring for people who were dying. We were giving comfort because there wasn’t much else we could do,” she recalls.

Her medical journey began in earnest when HIV was diagnosed in 1995. Physicians at the time offered a grim prognosis, estimating she had merely six months remaining. Yet Castellanos would go on to witness one of medicine’s most dramatic transformations firsthand.

Three Decades of Medical Evolution

By 2000, Castellanos began receiving antiretroviral treatment, relying primarily on medications donated to hospitals from Europe and the United States. The pharmaceutical landscape has shifted dramatically since those early days of scarcity.

“When I was diagnosed, we were taking whatever came our way. Most of it came as donations from Europe and the United States. Science has come such a long way. Every time we’re getting closer to a cure, closer to a vaccine,” she observes.

Today, the medical community has developed sophisticated treatment protocols that allow people with HIV to live near-normal lifespans. However, Castellanos notes that scientific advancement alone has not guaranteed equitable outcomes for all communities.

“I have lived through more than 30 years of promises, breakthroughs and funerals. I have watched medicine transform HIV from a death sentence into a manageable health condition but I have also watched people including my friends die while those medicines existed. Science did not fail my friends. Politics did.”

Confronting Stigma in Healthcare Settings

Beyond the virus itself, Castellanos faced persistent discrimination within medical institutions. She describes harboring nearly equal fear of hospitals and HIV, uncertain whether healthcare professionals would treat her with respect or contempt.

“There was a lot of stigma at the time. [Hospital staff] would tell me, ‘You have HIV because you chose this life,’ but I don’t have HIV because I chose anything; I have HIV because there was no system that allowed me to protect myself. I was forced into situations that carried risks. Nobody would ever choose this,” she explains.

Legal barriers compounded these challenges. Growing up in Belize, she lived under legislation that criminalized people like her, potentially sentencing individuals to ten years in prison simply for their identity. This legal framework created a paradoxical situation where patients feared honesty with their physicians.

“When I was young, there was a law that could send me to prison for 10 years simply because of who I was. You wanted to tell your doctor the truth because you wanted the best care, but you were also afraid that being truthful could put you at risk,” she says.

Global Leadership and Human Rights Advocacy

Currently residing in the Netherlands, Castellanos channels her experiences into leadership at Global Action for Trans Equality (Gate), an organization dedicated to advancing trans and gender-diverse rights worldwide. Her advocacy priorities center on healthcare access, human rights advancement, and bolstering community organizations combating discrimination.

At the Aids 2026 conference held in Rio de Janeiro last month, she articulated how her personal history shaped her professional mission.

“My experience motivated me to fight for treatment and to create spaces where people living with HIV could have a voice.”

Criminalization and the Global Rollback

Castellanos identifies criminalization as a persistent barrier to effective HIV prevention and treatment globally. Her concerns align with findings from the UNAids Global AIDS Update, authored by executive director Winnie Byanyima, which documents a worldwide regression in human rights protections.

The 2026 data reveals troubling patterns: 168 countries have criminalized sex work, 66 nations penalize same-sex sexual relations, and 14 countries specifically criminalize transgender individuals. These legal frameworks directly impact public health outcomes.

“You cannot end Aids while criminalising people living with and most at risk of HIV,” Byanyima asserts. “When people fear arrest, violence or discrimination, they stay away from HIV services. Human rights are not separate from the HIV response – they are essential to its success.”

Funding Cuts Threaten Progress

Looking ahead, Castellanos warns that recent reductions in international financial support pose significant risks to decades of advancement. The scaling back of assistance through USAID and PEPFAR programs threatens to push communities backward toward an era characterized by limited treatment availability, overwhelmed clinics, and community organizations forced to compensate for institutional gaps.

Her story illustrates how individual resilience intersects with broader political and economic forces. While medical science has made extraordinary strides in HIV management, Castellanos emphasizes that achieving equitable outcomes requires addressing the systemic barriers—legal, social, and financial—that continue to marginalize vulnerable populations worldwide.