HIV is a virus that interferes with one’s immune system and can increase the severity of other infections and diseases. If not treated, HIV can progress to stage 3, an advanced stage known as AIDS. Transgender people are at greater risk of HIV and may not access the proper medical care.
According to the Centers for Disease Control and Prevention and the World Health Organization (WHO), trans people, especially trans women, are at higher risk of contracting the virus than the general population.
With simple interventions, there can be a significant reduction in the spread of HIV, and treatment can save lots of lives. However, due to low or lack of access to health services experienced by sexual minorities, the transgender community may not receive adequate help in the time of need.
Various factors such as discrimination, violence, legal barriers, and stigma may significantly affect the access to healthcare and HIV services for trans people.
Here, we will point out some challenges that trans people experience when seeking HIV services and possible ways to overcome them.
Estimates show that about 1.2 million people in the U.S. are currently living with HIV. Data from the CBC indicate that over 1 million people in the United States identify as trans people. Among them, 9.2% are living with HIV. The rate of affected trans women is 14.1% and 3.2% trans men. These numbers are shockingly high compared to the HIV commonness in U.S. adults, which is less than 0.5%.
The Department of Health and Human Services (HHS) shows that trans people of color, precisely black people face higher risks of contracting the virus due to oppression and socioeconomic factors. In 2018, 45.4% of black people living in the U.S counted for new HIV cases.
CDC shows that HIV is most common among black trans women, 44.2% being diagnosed with the virus. In this case, the percentage of black transgender women with HIV is higher than 25.8% of Latinx trans women and 6.7% of white trans women affected by the virus.
HIV Risk Factors
Some contributing factors that led to the increase of HIV among transgender people, including:
Lack of Access to Health Information
Health discrimination can make it difficult for trans people to access valuable information about general health, HIV prevention, and care. A 2020 survey found that 65%, which is the majority of trans women, are not familiar with pre-exposure prophylaxis (PrEP), the HIV prevention treatment.
Trans people are more likely to participate in behaviors that increase the chances of acquiring the virus. For instance, a survey reveals that trans people are most likely to use injectable substances and having unprotected sex.
Discrimination and stigma are some factors that may lead to this risk-taking. These sociological factors may lead to substance abuse and sex work. Low self-esteem can also make trans women engage in unprotected sex, increasing the chances of being infected with HIV.
There are many transgender issues in healthcare– experiencing high rates of health discrimination. It can be caused by doctors who are not aware of how to care for trans persons or abuse such as misgendering or refusing to use their preferred names. Some doctors go as far as avoiding caring for trans persons.
Research conducted by the National Center for Transgender Equality alongside National Gay and Lesbian Task Force shows that 1 in 5 trans people did not access medical care due to discrimination.
The report further shows that 28% of respondents postponed medical care due to discrimination, with the same percentage of respondents exposed to harassment in medical facilities.
Low HIV Testing
Due to lack or low testing among the trans community, most of them are unaware that they are affected. Therefore, most of them don’t take preventive measures to prevent the spread of the virus to other people. Trans people also experience difficulty finding employment, making it difficult to afford the testing fee and further care.
Most trans use hormones as a way of gender-affirming therapy, which mainly involves the use of injections. Without proper counseling on safe injecting practices, there are higher chances of transmission due to sharing needles with affected persons.
HIV Prevention Guide
- Minimize the number of sex partners: Having a limited number of sex partners can reduce the risk of contracting and spreading HIV.
- Use of protection during sex: Having sex while drunk and fear of rejection can lead you to have sex without protection. Using protection such as condoms can help in preventing the spread of the virus.
- Avoid injectable substances: It is wise to do away with these substances for good. However, if you must inject drugs, you should use a new needle for every injection and avoid sharing needles. It is advisable to get the hormone injection in a medical facility or be aware of safe ways of using needles.
- Medication: Taking (pre-exposure prophylaxis) PrEP before intercourse can reduce the risk of contracting the virus.
HIV Testing and Treatment
Although there is not much data on trans people’s access to HIV testing and treatment, the ones available indicate that trans individuals have difficulties in accessing the services compared to cisgender persons.
Those with medical cover can access free or low-cost HIV testing through a primary care provider as a part of an annual check-up. Those who do not have medical coverage and can’t afford testing can visit a free local clinic and get tested.
CDC is funding Project PrIDE to support health departments to implement public health strategies to reduce new HIV infections. The project will also increase access to care, improve health outcomes for affected individuals and reduce HIV-related and general health inequalities.
Although HIV does not have a cure, it is treatable. With the proper treatment, one can live a longer and better life. Treatment can also improve someone’s quality of life and reduce the risk of spreading the deadly virus. People exposed to unprotected sex should get tested regularly to avoid further spread.