In the vast majority of studies, transgender people have only been counted as their sex assigned at birth, which not only discounts their identities, but leaves them relatively invisible to public health officials and advocacy organizations working toward prevention, treatment, and HIV-related health care. The few recent studies that consider transgender women and even fewer that consider transgender men as a specific group reveal alarmingly high HIV infection rates. While transgender men are less likely to be HIV positive than transgender women, their rates of infection are still higher than that of the general population.
Not only do transgender female sex workers have some of the highest rates of sexually transmitted infections STIhuman immunodeficiency virus HIVand experienced stigma, they also have higher likelihood of early sexual debut and some of the lowest levels of educational attainment compared to other stigmatized populations. Some of the most common interventions designed to reduce transmission of HIV and STIs seek to educate high-risk groups on sexual health and encourage condom use across all partner types; however, reaching stigmatized populations, particularly those in resource-limited settings, is particularly challenging. Considering the importance of condom use in stopping the spread of HIV, the aim of this study was two-fold; first to characterize this hard-to-reach population of transgender female sex workers in the Dominican Republic, and second, to assess associations between their HIV knowledge, experienced stigma, and condom use across three partner types.
Credit: Getty Images. Programs in San Francisco to prevent HIV among transgender women are helping to lower the rate of new infections, research finds. However, this vulnerable population—especially people of color or those with lower income—still needs better care and treatment, according to the study in the journal Sexually Transmitted Diseases.
The estimate in trans women is lower than previous calculations, but the new estimates still show that transgender people are a vulnerable population with a substantial risk of contracting HIV. There are approximately one million individuals in the United States who identify as transgender. CDC researchers wanted to update these estimates, examine differences in HIV prevalence between trans women and trans men, and understand the behavioral factors that impact risk of contracting HIV.
Recent data on the high burden of HIV among transgender women has stimulated interest in addressing HIV in this vulnerable population. This review situates the epidemiologic data on HIV among transgender women in the context of the social determinants of health and describes opportunities for effective interventions. Transgender women experience unique vulnerability to HIV that can be attributed to multi-level, intersecting factors that also influence the HIV treatment and care continuum.
Transgender women are the fastest-growing population of HIV-positive people in the country, according to Miss Major, a year-old transgender woman of color and the executive director of TGI Justice Project, a San Francisco—based advocacy organization that fights for the rights of transgender, intersex, and gender-variant people who are in prison or have served jail time. This kind of systematic mislabeling and ignorance is a grim reality for many trans women, says Major. The study also indicated that many transgender women may not know their HIV status, due to a series of cultural, social, and economic barriers.
Approximately 1. About 15 percent of them 1 in 7 are unaware they are infected. Gay, bisexual, and other men who have sex with men bear the greatest burden by risk group, representing an estimated 26, of new HIV infections per year.
Becasen JS, et al. Am J Public Health. Estimates for HIV prevalence and participation in sex work were higher for transwomen compared with transmen, Becasen and colleagues noted, but said evidence gaps remain concerning transmen and their relationship with HIV and risky behaviors. The researchers reviewed literature published between January and May regarding the transgender population in the U.
There are numerous prevention challenges that may impact the HIV health outcomes for some transgender people. These include:. CDC and its partners are pursuing a high-impact prevention approach to maximize the effectiveness of current HIV prevention methods among transgender people.