For transgender Floridians, stigma and fear could lead to new HIV crisis

There’s another public health crisis laying in the shadows of COVID-19, and it’s completely preventable: HIV. More than 20,000 people are living with HIV in Fort Lauderdale – and more than 100,000 across Florida. New HIV infections have been increasing in Florida every year since 2013, and the state’s budget for combating HIV increased 15% between 2015 and

2018.

HIV currently has a disproportionate impact on certain communities. Only one in four people in Fort Lauderdale are Black, but they represent nearly half the city’s population of people living with HIV. Latinas are twice as likely as white women in Fort Lauderdale to be living with HIV. Transgender people are 49 times more likely than cisgender people to have HIV.

Transgender people also face high rates of violence, with transgender people of color being particularly impacted. In 2019, more than 20 transgender people were killed, virtually all of them Black or Latinx. Far too often, their names don’t make the news, names like Tony McDade or Bree Black, both of whom were killed in Florida this year.

Transgender people of color, and in particular transgender women of color, face layers of stigma. Transphobia, racism, and sexism all take a toll on a person and make them more vulnerable in many aspects of their life, including being more likely to contract HIV.

We have the tools and knowledge to stop HIV in its tracks. Taking simple precautions greatly minimizes transmission. Testing can offer quick results. And drug regimens can treat people living with HIV and prevent it from spreading. But a lack of understanding and prejudice against people living with HIV prevents us from taking advantage of these tools. Money is not the issue – the law is.

Florida’s very tough HIV criminalization laws have made a bad situation worse. In Florida, having consensual sex, donating blood or organs, or engaging in sex work without disclosing one’s HIV status is a third-degree felony, which could lead to five years in prison and a $5,000 fine. The law doesn’t take into account whether protection is used, if people maintain a drug regimen that virtually eliminates any chance of passing on the disease, or the fact that blood is screened – for many diseases, including HIV – before being donated.

Not only are HIV criminalization laws antiquated and discriminatory, they have a devastating impact on public health and the perception of HIV. When our own state government is labeling those living with HIV as criminals, it perpetuates stigma. It creates a fear of basic education, getting tested or talking about HIV, even with friends and family. It’s hard to blame them considering five years in jail is a possibility.

Our state has created a vicious cycle: people choose to not know their status out of fear of repercussions. Therefore, they don’t receive treatment, leading to more people unknowingly spreading the disease. Criminalizing and stigmatizing HIV only leads to more HIV infections.

Earlier this month, the results of the “GLAAD-Gilead State of HIV Stigma Survey” were published, measuring attitudes towards HIV, and the results showed we still have a long way to go. Nearly 6 in 10 Americans wrongfully believe that “it is important to be careful around people living with HIV to avoid catching it.” That’s not true and the medical community has known this for decades. But when it’s difficult to educate people on the disease, misinformation spreads and has a damaging impact on public health.

Knowing that transgender people are more likely to be affected by HIV, at TransInclusive, we spend a considerable amount of time reaching out to that community. When you add the stigma transgender people face to the stigma that surrounds HIV, it makes our outreach efforts that much harder. Moreover, it becomes even more difficult to ensure transgender people have the resources needed to prevent the spread of HIV.

The survey found that one in two Americans would be uncomfortable with a partner or spouse living with HIV, which only increases the disproportionate impact HIV has on transgender people, considering they have the highest rates of infection. Ignoring these disparities will only continue to harm the communities most at risk of contracting HIV.

Training and resources from allies are part of the solution. Grants from privatesector partnerships like the Gilead COMPASS Initiative have helped us build a grassroots effort to prevent the spread of HIV by going into the Fort Lauderdale community to educate people and hosting group sessions where individuals can learn without fear of judgment. During the social distancing measures of the COVID-19 pandemic, we’ve held our “Open Night Thursday” series virtually to allow people from our community to talk to one another, learn about the resources available to them, and feel a sense of belonging.

But we must reach beyond our community, and to our lawmakers, to make the impact we need.

Changing misperceptions has to happen on the frontlines of health care and in the halls of state houses. Stigma will not go away if laws that criminalize HIV remain. Florida can’t end the HIV epidemic overnight, but the state can take steps now to stop the rise of HIV infections and avoid another health crisis. Ending the criminalization of HIV and educating our state about how to prevent its spread will help fight the pervasive stigma that still exists – and gets us that much closer to ending HIV in Florida.