South Africa: 'I Left Everything Behind Just to Survive' - a Transgender Woman's Journey Through Stigma, Survival and HIV

Tovhowani Makondo, 34, from Hakhakhu Tshifume in South Africa’s Limpopo province, has spent years battling HIV, a diagnosis rooted in systemic rejection and survival desperation. Born male but identifying as a woman from childhood, Makondo faced bullying, family rejection, and social exclusion in her rural community. By age 14, she left home, traveling between cities like Polokwane, Thohoyandou, and Gauteng to escape stigma, though she struggled with homelessness and emotional distress. In 2014, at 20 years old, Makondo was hospitalized at Weskoppies Psychiatric Hospital in Pretoria after heavy drinking. There, she learned she was HIV-positive—a diagnosis she attributed to transactional sex, a survival tactic driven by poverty and lack of shelter. She admitted she exchanged sex for money to afford food and temporary accommodation, though she lacked awareness of HIV transmission risks at the time. The World Health Organization reports transgender women are 13 times more likely to contract HIV than other adults, while South Africa’s sex worker population faces elevated prevalence rates. Makondo’s story reflects broader challenges: LGBTQI+ individuals in rural areas often lack support networks, increasing vulnerability to stigma and exploitation. Murulane Precious, director of Vhembe LGBTI+, highlights how isolation and discrimination exclude transgender people from housing, healthcare, and community life. Despite progress in HIV awareness, Makondo’s experience underscores lingering gaps in education and support for marginalized groups. She now advocates for better resources, emphasizing that stigma and poverty force many into high-risk behaviors. Her journey reveals how systemic barriers—from family rejection to economic instability—drive health crises among transgender communities in South Africa.