Erika Castellanos highlights advances in treatment while urging governments to protect healthcare access and vulnerable communities
AMSTERDAM: Transgender rights activist Erika Castellanos has warned that declining international funding and growing discrimination could reverse decades of progress against HIV, despite medical advances transforming the virus from a frequently fatal diagnosis into a manageable condition.
Castellanos, 50, was diagnosed with HIV in 1995 and initially received a life expectancy of six months. Born in Belize, she later moved to Mexico, where she worked as a sex worker and volunteered at an HIV hospice while treatment remained difficult to obtain.
She began receiving medication in 2000, initially relying heavily on donated medicines from Europe and the United States.
Castellanos said scientific progress has dramatically improved treatment, but social inequality and limited healthcare access continue to cost lives.
Medical Advances Transform HIV Treatment
Castellanos recalled experiencing discrimination from healthcare workers who blamed her identity and circumstances for her HIV diagnosis.
Today, she lives in the Netherlands and leads Global Action for Trans Equality, advocating improved healthcare access and human rights for transgender and gender-diverse communities.
Speaking at the AIDS 2026 conference in Rio de Janeiro, Castellanos said her experiences motivated her to campaign for treatment access and stronger representation for people living with HIV.
Meanwhile, UNAIDS has warned that expanding criminalisation and declining rights protections could undermine global HIV prevention.
Funding Reductions Raise Fresh Concerns
UNAIDS Executive Director Winnie Byanyima said discrimination, violence and fear of arrest discourage vulnerable populations from seeking testing, treatment and other essential services.
Furthermore, Castellanos warned that reductions in international assistance, including support previously provided through USAID and PEPFAR, could weaken clinics and community organisations.
UNAIDS has cautioned that the global objective of ending AIDS as a public health threat by 2030 could become increasingly difficult without renewed international cooperation.
Castellanos urged policymakers to place human dignity at the centre of HIV policies, stressing that effective healthcare requires respect alongside medical treatment.
