Trans women are 49 times more likely to have HIV

GA Voice - - Health News -

Let me tell you about a woman I met. Let’s call her Trina. On the sur­face, we have some sim­i­lar­i­ties. A woman of color and a bot­tle blonde, Trina grew up feel­ing like she never fit in. Shuf­fled be­tween fam­ily mem­bers, she left home early in an ef­fort to be her­self, and ended up home­less at one point.

Like my hus­band, Trina is trans­gen­der. Un­like my hus­band, who grew up in a white mid­dle-class fam­ily and has a mas­ter’s de­gree, she doesn’t have in­sur­ance (yes, even in this age of Oba­macare), wor­ries about pay­ing for her hor­mones, and has had to do many things to be the per­son she is. That in­cludes turn­ing the odd trick or two. Trina has HIV. When she tested pos­i­tive last year, it wasn’t a sur­prise to her or to the other women in her trans sup­port group, which meets at her lo­cal LGBT cen­ter each Wed­nes­day night. It’s one of the few places Trina feels at home, ac­cepted, able to be hon­est. And many of the women are also HIV-pos­i­tive.

Trans­gen­der women are 49 times more likely to have HIV than the gen­eral pop­u­la­tion. We first heard this num­ber when The Foun­da­tion for AIDS Re­search (amfAR) re­leased a re­port in 2014, “Trans Pop­u­la­tions and HIV: Time to End the Ne­glect,” and this sum­mer, the World Health Or­ga­ni­za­tion did a new meta-anal­y­sis of data from

Novem­ber 27, 2015

15 dif­fer­ent coun­tries, which again showed that trans­gen­der women were nearly 49 times more likely to have HIV than the gen­eral pop­u­la­tion. Both stud­ies ar­gue that trans women are the most at-risk pop­u­la­tion on the globe. The num­bers are even worse for those who are women of color; 56 per­cent of black trans women have HIV.

Ac­cord­ing to the Cen­ters for Dis­ease Con­trol and Preven­tion, trans­gen­der women in­volved in sex work have HIV rates that are al­most twice that of trans women not en­gaged in com­mer­cial sex work. They’re also six times more likely to be liv­ing with HIV than other fe­male sex work­ers. Per­haps you’re ready to turn the prover­bial page be­cause you think women who do sex work de­serve it. They don’t.

My friend Trina gave blowjobs to help pay for the hor­mones she needs ev­ery two weeks. Go­ing off hor­mones would give her se­ri­ous med­i­cal is­sues. The wait­ing list to get into her lo­cal clinic was two months. She’s had bad ex­pe­ri­ences with doc­tors who re­fused to treat her be­cause she’s trans­gen­der. She’s not alone: The Task Force’s 2011 study, “In­jus­tice at Ev­ery Turn,” re­ports that ap­prox­i­mately one in five trans peo­ple in the United States has been de­nied med­i­cal care as a re­sult of their gen­der iden­tity. Trina has also shared in­jec­tion nee­dles—not for drugs, but at a pump­ing party, where trans women get low-cost fillers to cre­ate a more fem­i­nine look in their faces, breasts and hips.

As a once-home­less trans teen, Trina has had to do plenty of things that put her at risk for HIV. But like the ma­jor­ity of HIV-pos­i­tive peo­ple to­day, Trina be­came HIV-pos­i­tive dur­ing a re­la­tion­ship that she be­lieved was monog­a­mous. The man she loved was not monog­a­mous—and he was not aware that he had HIV. To­day Trina is on an­tiretro­vi­rals and sees a doc­tor at a clinic who knows how to treat trans peo­ple liv­ing with HIV. Those are few and far be­tween.

It’s time for all of us to wake up to this is­sue. As we re­vive the con­ver­sa­tion around gay and bi men and HIV, it’s time to end this epi­demic for trans peo­ple too.

In or­der for all of us—poz or not, trans or not, queer or not—to do right by trans women, we have to do more than tune in to “I Am Cait” once a week. We have to tear down and re­build the sys­tems that are here to care for trans and gen­der non­con­form­ing peo­ple in a way that really works. We have to re­move the stigma of be­ing trans, of be­ing pos­i­tive, of seek­ing to take an HIV preven­tion treat­ment. That’s only one step, and there are many needed, but sim­ply un­der­stand­ing and truly car­ing about trans peo­ple can take us quite a way.

Diane An­der­son-Min­shall is ed­i­tor-in -chief of Plus Mag­a­zine and ed­i­tor-at-large for The Ad­vo­cate mag­a­zine. This col­umn is a project of Q Syn­di­cate, the LGBT wire ser­vice.

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