HIV and Transgender People

In 2019, the Centers for Disease Control and Prevention (CDC) reported that transgender people made up 2% of the nearly 37,000 new HIV diagnoses in the United States and dependent areas (Centers for Disease Control and Prevention, 2022). To address these concerning statistics, AIDS United brought together four transgender leaders of color on National Trans HIV Testing Day. These leaders are actively working to address the HIV epidemic in their communities by supporting transgender communities as they navigate the HIV continuum of care and the HIV prevention continuum.

What is National Transgender HIV Testing Day?
National Transgender HIV Testing Day (NTHTD) is a day set aside to recognize the importance of HIV testing and continue to focus on HIV prevention and treatment efforts among transgender people. It is observed annually on April 18 and was established in 2016 by the Centers for Disease Control and Prevention (CDC) and the University of California, San Francisco, Center of Excellence for Transgender Health.

HIV and transgender people
According to the latest available surveillance data, transgender people, in particular, transgender women of color, especially Black and Latinx women, have a disproportionately high HIV prevalence and experience less access to culturally competent care. As of 2021, nearly 2 percent of new HIV diagnoses in the United States occurred among transgender people, and transgender women accounted for 89 percent of new diagnoses in all transgender people (Centers for Disease Control and Prevention, 2022). Research has found that race was a significant mediating factor in HIV status among trans women; meaning that race influences one’s likelihood of acquiring HIV, and it is critical to acknowledge that the effects of interpersonal and structural racism, not race alone, influence these outcomes.

Daniela Simba, Executive Director of Trans Power in Diversity, an Atlanta-based organization supporting transgender communities accessing HIV services, notes that such as transphobia or HIV-related stigma and discrimination may hinder access to HIV services for transgender people. Simba, believes a connection with a trusted provider who is also linked to a collaborative network of other providers can open doors to multiple avenues of HIV care and prevention, such as mental health care, case management, legal services, employment services, housing, and social support networks.

Listen to Simba describe the factors that influence health outcomes for transgender people.

While HIV is a concern to many transgender people in their daily lives, HIV prevention and treatment may not be high priorities due to other competing needs. Understanding the social determinants of health for transgender people better informs efforts designed to support transgender people in prioritizing HIV prevention and treatment.

There are many HIV prevention strategies available, including condoms; pre-exposure prophylaxis (PrEP); post-exposure prophylaxis (PEP); as well as interventions focused on linkage to, retention in, and re-engagement in care, according to Tania Jimenez, Executive Director of Asheboro Latinx Services, the transgender Latinx communities she supports in rural North Carolina includes people who undocumented, speak limited English or engage in sex work, which can inform their ability to seek HIV testing services.

Listen to Jimenez describe the challenges faced by members of her community.

Turning the tide
By reducing the systemic challenges that transgender people experience in the care and prevention continuums, the possibility that transgender people will be better able to avail themselves of options that will improve their health and the health of their communities increases. In Houston, leaders like Daron Yanes Perez, Executive Director of Trans Men Empowerment, are thinking about creative solutions to expand access to care through collaborations with affirming services and trusted partners. Ashley Figueroa, Consulting Deputy Director of Arianna’s Center, believes their person-centered approach to making prevention and healthcare visits with providers accessible via telehealth and home visits has bolstered the Center’s ability to reach transgender communities across Florida and Puerto Rico.

Listen to Yanes Perez describe the ways Trans Men Empowerment is working to address the issues faced by their community.

Listen to Figueroa describe the Arianna Center’s approach to inclusive and accessible care.

It’s time for action
The work these individuals and others are doing in communities nationwide has great effects on HIV outcomes and the well-being of those living with HIV in their communities. They believe to end the epidemic, we must address the compounding issues that have prevented some transgender people from getting the HIV care and treatment they need; therefore, we must each take action.

Help us raise awareness
April 18 was National Transgender HIV Testing Day (NTHTD), but the work never stops. Share these social media posts to help spark conversations about HIV testing and status awareness, as well as HIV prevention and treatment for transgender and nonbinary people. You can also share Let’s Stop HIV Together campaign resources for transgender people (in English and Spanish) as well as HIV testing resources (in English and Spanish).