Skip to main content

On December 9, 2013 the Centers for Disease Control released a report entitled HIV Among Transgender People.

Two days ago Leela Ginelle, communications and development intern for TransActive Education and Advocacy wrote an Op-Ed at the Advocate:  Why the CDC's Latest HIV Report Is So Alarming.

The CDC report says an estimated 27% of transgender women are HIV positive, which is nearly 50 times as high as the rate for other adults.  A New York City study found that more than 90% of newly diagnosed transwomen are African-American or Latina, and more than half are in their 20s.

Ginelle asks the question, "Why?"

The New York City study exposed the fact that 51% of newly diagnosed HIV+ transgender women had documented substance abuse, commercial sex work, homelessness, incarceration and/or sexual abuse, compared with only 31% of newly diagnosed HIV+ non-transgender women.  Other "behaviors" listed in the report include attempted suicide, unemployment, lack of familial support, violence, stigma, discrimination, limited health care access, and negative health care encounters.

Transgender activist Dean Spade and others have outlined the cycle:  a young trans woman is kicked out of her home by unaccepting parents, and because she is legally still male, she is barred from appropriate shelters and services.  She therefore becomes homeless and the social stigma of being transgender prevents her from finding employment.

When trans women aren’t able to find jobs because of direct or indirect discrimination, they turn to street economies to feed themselves and to pay for the health care they need, and street work often places trans people at greater risk of contracting HIV and violence, especially for trans women of color who face racism, sexism and transphobia.

--Transgender Law Center attorney Sasha Buchert

Eventually this leads to incarceration, which makes it more difficult to find housing and employment and the cycle begins again.
Societal prejudice toward trans women is still widespread, affecting access to housing, education and employment.  The report notes that trans women are more likely to live in transient housing than other populations, and to be less educated.
Other reports in the past have noted that transgender people tend to be more educated.  My take away from this is that those who are more likely to become HIV+ are less educated.

HIV+ trans women are as likely to have health care coverage as other HIV+ people, but less likely to be on anti-retroviral therapy, which probably indicates a need for better education of health care providers.

Social service agencies could help by becoming more competent in working with transgender clients.  Often, rather than enduring the stigmas they face at such places, trans women will simply forego the assistance, and miss the opportunity to check their HIV status or learn tools to reduce the likelihood of obtaining the virus.

--Buchert

Jaxon Mitchell, an HIV Prevention Specialist with the Cascade AIDS Project, says this is a structural problem.
Historically, HIV prevention and sexual/reproductive health services in general, have been organized by gender.  For trans folks, gendered spaces almost always carry social and structural barriers. HIV prevention and testing services geared toward women frequently fall under the greater umbrella of reproductive health, which lacks the cultural competency to attend to the needs of trans women and carries many additional barriers.

--Mitchell

And then there is law enforcement compounding the problem by profiling young transgender women as sex workers and viewing possession of condoms by transgender women as evidence of criminal activity.
This use of condoms as per se evidence of illegal activity has already been struck down by the Supreme Court as a violation of privacy in Griswold v. Connecticut, which involved the use of condoms as evidence to prosecute for using contraception in 1960.  [The practice] is likely a constitutional violation of privacy, and it is an unconscionable public health hazard to use condoms as the basis of evidence of illegal activity.  The impact of prosecuting individuals based on possession of a condom can only have a chilling effect the use of protection, and will create a larger public health threat for everyone, and especially for transgender women.

--Buchert

The CDC details a "high-impact prevention approach" in an attempt to reverse the current trends.  The approach involves providing support for community groups which distribute condoms, conduct HIV testing, and operate referral networks and services.  The CDC also announced plans to update the National HIV Surveillance System so that transgender people are better identified within it (it has been the CDC's pracrtice in the past to identify transwomen as MSM (Men who have Sex with Men).
For years, transgender women have been misclassified as MSM, or Men Who Have Sex With Men, which has created a situation where trans folks in general have not been counted.

Without broad research demonstrating what we all know empirically — that HIV infections among trans women, especially trans women of color, are unconscionably high — funding for programs designed to meet trans women’s unique needs will never be a priority.

--Mitchell

The CDC also says it will award grants to researchers developing new HIV prevention interventions like Project Life Skills and Girlfriends and any other group that will provide effective HIV prevention to "young transgender people of color and their partners" for more than five years.

Originally posted to TransAction on Fri Jan 10, 2014 at 04:00 PM PST.

Also republished by HIV AIDS Action, Voices on the Square, and LGBT Kos Community.

EMAIL TO A FRIEND X
Your Email has been sent.
You must add at least one tag to this diary before publishing it.

Add keywords that describe this diary. Separate multiple keywords with commas.
Tagging tips - Search For Tags - Browse For Tags

?

More Tagging tips:

A tag is a way to search for this diary. If someone is searching for "Barack Obama," is this a diary they'd be trying to find?

Use a person's full name, without any title. Senator Obama may become President Obama, and Michelle Obama might run for office.

If your diary covers an election or elected official, use election tags, which are generally the state abbreviation followed by the office. CA-01 is the first district House seat. CA-Sen covers both senate races. NY-GOV covers the New York governor's race.

Tags do not compound: that is, "education reform" is a completely different tag from "education". A tag like "reform" alone is probably not meaningful.

Consider if one or more of these tags fits your diary: Civil Rights, Community, Congress, Culture, Economy, Education, Elections, Energy, Environment, Health Care, International, Labor, Law, Media, Meta, National Security, Science, Transportation, or White House. If your diary is specific to a state, consider adding the state (California, Texas, etc). Keep in mind, though, that there are many wonderful and important diaries that don't fit in any of these tags. Don't worry if yours doesn't.

You can add a private note to this diary when hotlisting it:
Are you sure you want to remove this diary from your hotlist?
Are you sure you want to remove your recommendation? You can only recommend a diary once, so you will not be able to re-recommend it afterwards.
Rescue this diary, and add a note:
Are you sure you want to remove this diary from Rescue?
Choose where to republish this diary. The diary will be added to the queue for that group. Publish it from the queue to make it appear.

You must be a member of a group to use this feature.

Add a quick update to your diary without changing the diary itself:
Are you sure you want to remove this diary?
(The diary will be removed from the site and returned to your drafts for further editing.)
(The diary will be removed.)
Are you sure you want to save these changes to the published diary?

Comment Preferences

Subscribe or Donate to support Daily Kos.

Click here for the mobile view of the site