16 Days of Activism Against Gender-Based Violence | Interpersonal Violence Among Women and Transgender Women Living With HIV: The Role of Systemic Violence and Racism

Women and transgender women living with HIV face exceptionally high rates of interpersonal violence, shaped not only by intimate relationships but also by broader systems of marginalization. Interpersonal violence—including physical, sexual, and psychological harm—both contributes to HIV vulnerability and intensifies after diagnosis. For many, the experience of violence is inseparable from structural forces such as systemic racism, transphobia, discrimination in healthcare, and economic insecurity.

Interpersonal violence is frequently a precursor to HIV acquisition. Women and transgender women who experience forced or coerced sex face increased biological risk of infection, while abusive partners may refuse condom use or sabotage prevention methods. Dynamics of control, fear, and emotional manipulation restrict the ability to negotiate safer sex, disclose risk, or access testing and treatment. These vulnerabilities are heightened for women of color and transgender women of color, whose lives are shaped by racialized poverty, housing instability, and limited access to affirming healthcare.

After an HIV diagnosis, the risk of violence often increases. Disclosure can trigger blame, stigma, or physical assault from partners, family members, or community members. For transgender women, the threat is compounded by transphobia and societal hostility toward gender diversity. Many experience violence not only from intimate partners but also from strangers, law enforcement, and service providers. These overlapping forms of interpersonal and institutional violence create environments where safety is precarious and social support is limited.

Systemic racism and transphobia play central roles in producing these vulnerabilities. Racism shapes where people live, the resources available to them, and the quality of services they receive. Women of color and transgender women of color disproportionately face under-resourced neighbourhoods, discrimination in employment, and higher rates of criminalization. These conditions increase dependence on partners for financial stability or housing, making it harder to leave abusive relationships. In addition, racial bias and transphobia in healthcare can lead to misgendering, dismissal of symptoms, or breaches of confidentiality—experiences that deter many from seeking HIV care or reporting violence.

Economic marginalization further deepens exposure to harm. Transgender women—especially Black and Latina transgender women—often encounter barriers to employment, leading some to rely on survival economies such as sex work. While sex work itself is not inherently harmful, criminalization and policing practices heighten vulnerability to violence and reduce access to HIV prevention and treatment services. Structural stigma also discourages reporting of violence due to fear of arrest, discrimination, or loss of income.

Ultimately, interpersonal violence against women and transgender women living with HIV is deeply interconnected with systemic violence: racism, transphobia, poverty, and institutional neglect. Addressing these issues requires more than individual-level interventions; it demands structural change. Improved access to trauma-informed, gender-affirming healthcare; economic supports; anti-racist policies; and decriminalization efforts are essential for safety and wellbeing. Only by acknowledging and addressing these layers of violence can meaningful progress be made in improving the lives of women and transgender women living with HIV.

Sophie Strachan

Sophia Forum, Director

#16Days

#ACTToEndViolence

#NoExcuse