“Due to stigma, neglect, and institutionalized discrimination, the HIV response has failed to address the needs of trans people”
(Trans Populations and HIV: Time to End the Neglect).
The rate of HIV infection among trans people is higher than other most-at-risk groups, such as men who have sex with men (MSM), people who inject drugs, and sex workers, yet most tracking systems do not record data on trans people. Limited evidence suggests that, globally, trans women are 49 times more likely to be living with HIV than the general population. Trans women engaging in sex work were 6 times more likely to be living with HIV than cis female sex workers, and no data is yet available for trans men engaged in sex work.
In the HIV-related policy discourse, trans people have often been treated as a subset of men who have sex with men (MSM). This approach is fundamentally at odds with the gender identity of trans women and typically fails to take account of the needs and experiences of trans men who have sex with men.
“The high vulnerability and specific health needs of transgender people necessitates a distinct and independent status in the global HIV response.”
“Countries should work toward decriminalization of behaviours such as drug use/injecting, sex work, same-sex activity and nonconforming gender identities, and toward elimination of the unjust application of civil law and regulations against people who use/inject drugs, sex workers, men who have sex with men and transgender people”
“This method uses assigned sex at birth and current gender identity to cross-classify respondents as transgender (discordant sex and gender responses) or non-transgender (concordant sex and gender responses). It also allows diverse gender identities to be captured.”
“Use of a two-step approach to standardise data collection in health—modified for the specific geographical context, language, and locale—will allow researchers, policy makers, and transgender people themselves to monitor and evaluate efforts to achieve health equity.”
Trans Populations and HIV: Time to End the Neglect (amfAR The Foundation for AIDS Research; April, 2014)
Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations (WHO; July 2014)
Global health burden and needs of transgender populations: A review (Lancet 2016; 388: 412–36)
HIV epidemics among transgender populations: The importance of a trans inclusive-response (Journal of the International AIDS Society, Volume 19, Supplement 2; July 2016)
Implementing Comprehensive HIV and STI Programmes with Transgender People: Practical Guidance for Collaborative Interventions (New York: United Nations Development Programme; 2016.)
On the fast track to end AIDS: UNAIDS 2016–2021 Strategy
HIV risk and preventive interventions in transgender women sex workers (Lancet 2015; 385: 274–86)