Numerous global studies have indicated that transgender women face an elevated risk of acquiring HIV compared to cisgender women, often encountering stigma and discrimination when seeking healthcare in mainstream facilities. This research aimed to evaluate the healthcare requirements of transgender women concerning HIV prevention, treatment and care, as well as their interactions with mainstream healthcare services.

A qualitative approach was employed to investigate transgender women’s healthcare needs, experiences in mainstream healthcare and alternative HIV healthcare strategies. Ten participants were purposively sampled based on their first-hand encounters with mainstream healthcare. Data was gathered through individual interviews guided by a semi-structured format.

The study identified a lack of gender-affirming care in primary healthcare settings in the Ekurhuleni district. It highlighted a prevalent reliance on alternative strategies among this demographic, including seeking services from transfriendly NGOs and resorting to traditional healers, private healthcare and self-medication for gender-affirming and HIV treatment needs. It exposed a lack of LGBTQ+ community-focused initiatives and educational programmes.