WASHINGTON (TrustLaw) - Transgender people are at high risk of HIV infection but data on this vulnerable group is lacking because of the hidden lives they lead, a group of experts said.
“A person without an identity does not exist,” said Marcela Romero, vice-president of the Argentine Federation of Lesbian, Gay, Bisexual and Transgender people. “So, legal recognition of one’s gender identity is critical because that’s the only way we will be able to access the services we need.”
Romero, a trans-woman, spoke on a panel discussing the impact of HIV on transgender communities at the 19th International AIDS Conference, which ends a six-day run here on Friday. Trans-women are male by birth and present as women.
The global numbers on the prevalence of HIV among transgender people are not complete. No major studies of the transgender population have yet been done because of the major challenges involved in collecting data, said JoAnne Keatley, director of the Center of Excellence for Transgender Health at the University of California, San Francisco, who chaired the panel.
Keatley, a trans-woman, said obstacles to research include the fact that many potential subjects fear social stigma, and much of the data is trans-women-centric - because of the high impact of HIV on trans-women and because trans-males are relatively invisible.
One case study found that transgender people represented about 2 percent of all newly diagnosed cases of AIDS between 2004 and 2008, and in 2008 represented about 7 percent of AIDS-related deaths, Keatley said.
HIV infection is a particular risk for trans-women working in the sex trade.
HIV infection rates among trans-women sex workers in Thailand is 13.5 percent, 41 percent in India and 24 percent in Indonesia, according to Khartini Slamah, a founding member of the Asia Pacific Transgender Network (APTN) which advocates for transgender women.
Slamah, a trans-woman and leading transgender activist, joined the panel by video from a sex workers festival in Kolkata, India. The festival was held at the same time as the International AIDS conference in Washington, to emphasise that many sex workers could not attend the conference because of U.S. restrictions on visas for sex workers.
The drivers of HIV infection among transgender people operate on three levels, Keatley said. They suffer from low self-esteem, depression and risk from injecting drug use. Risks within society include social stigma, family rejection, peer harassment and interaction with high-risk partners. Institutionally, transgender people may be mistreated by healthcare workers, harassed by police, subject to religion-based persecution, denied employment and housing, and face violence in prisons.
These factors can contribute to a transgender person becoming more vulnerable to situations in which infection may occur and they are less likely to get testing and treatment.
“The best intervention you can apply to transgender people in terms of HIV is to employ them. We need jobs,” Keatley said, noting that jobs lead to health insurance, housing and social stability.