Ludwika Vega, a transexual from Nicaragua and one of the founding members of the Asociación Nicaragüense de Transgéneras (ANIT), exposes that being trans in Nicaragua is a difficult situation, but that they are fearless in spite of being victims of discrimination and social, physical and psychological violence. Their own families, the people around them and even the police discriminate and attack them.
Regarding the access to health care, Ludwika said that there has been some progress. It is important to emphasize the increase in the number of health care facilities where treatment is provided to people with hiv. And also the criminalization of any act of discrimination carried out by the medical staff or any negative to give proper medical care to transgender, gay or lesbian patients. In spite of this good news, there are still some doctors that give them a religious speech and because of this, some of them have stopped going to health care facilities, a decision that carries serious consequences for their health.
Ludwika explained that out of the 15 trans deaths occurred during the last year, 10 were a consequence of opportunistic diseases related to hiv and the other 5 deaths were due to problems such as kidney failure, suicide and hate crimes. According to Ludwika, discrimination accelerates the death of the trans because they get depressed and they stop eating. There are some of them that stop taking antiretrovirals due to lack of income.
In the ANIT, there are 15 transgenders with hiv and 5 of them do not receive treatment because of financial problems. Many of them are sex workers and as a consequence, it is difficult for them to negotiate the use of condom.
The transgender organizations have established that a trans woman with hiv goes with another to the health care facilities as a strategy to improve health care access. They also have support groups and they invite them to listen to the experiences of other trans with hiv because most of them have a lack of knowledge regarding this topic. In the same way, it is important to mention that a ruling that forces doctors to call them by their social name rather than their birth name was passed. In the same way, it is important to remark that they participate actively in the police political space, in forums with the Ministry of Health and they have a representative in The Mecanismo Coordinador de País (MCP).