One Group of People Is Acquiring HIV in Record Numbers, But We Don't Talk About Them
By Nico Lang
4 hours ago
World AIDS Day
recognizes the everyday lives and particular struggles of people around
the world living with AIDS and HIV, but one population has been long
overlooked. According to recent findings from the World Health
Organization that analyzed data from 15 countries, transgender women
are nearly 49 times more likely than
the general population to contract HIV. This means that, just for being
who they are, they are part of the population at highest risk for
acquiring HIV.
But according to advocates, the transgender community's HIV problem remains an "invisible" epidemic, as trans women are too often ignored in health advocacy, stigmatized for their diagnosis or criminalized.
Mic
spoke to the Human Rights Campaign's Noël Gordon, a senior specialist
for HIV prevention and health equity, who argued that transgender women
"find themselves at the eye of a perfect storm" when it comes to
contracting HIV. "A number of factors are largely out of their control
that push them into situations where they're more likely to encounter
HIV and less likely to be able to treat it," Gordon told Mic. These factors include transphobia and poverty, as trans people are nearly four times more likely to earn less than $10,000 a year.
Employment and housing discrimination are major
factors that push transgender women below the poverty level. According
to statistics from the National Center for Transgender Equality,
trans people face widespread bigotry both in the workplace and from
landlords, as its survey indicates "26% of trans people lost a job due
to bias, 50% were harassed on the job [and] 20% were evicted or denied
housing." In many states in the U.S., it's still legal to fire or evict someone on the basis of sexual orientation or gender identity.
Gordon
explained that without employment and housing protections, many trans
women engage in survival sex work in order to support themselves.
"Through no fault of her own," Gordon said, "she's been pushed into a
situation where in order to support herself, she effectively has to put
herself at risk for contracting HIV."
Sheeneneh Smith, a transgender activists, speaks at a Boston rally held in honor of slain transgender community members. Source: Julie Jacobson/AP
Cecilia Chung, a senior strategist for the
Transgender Law Center, argued the issue isn't sex work itself but the
ways in which trans women's limited options continue to be criminalized.
Prostitution is outlawed in all 50 states in the U.S., except for some counties in Nevada, and in over 30 states, people living with HIV can be imprisoned for nondisclosure, according to Chung.
"That means that if someone has engaged in sex work and hasn't
disclosed their HIV status, they can potentially be charged with a
felony," Chung told Mic.
This sends a shameful message to transgender women
about what it means to be HIV positive. "The law tells us that HIV is a
weapon," Chung argued. According to her, this reinforces the idea that
contracting the virus is a punishment for people's behavior. Instead of
recognizing the structural factors that force people into difficult
situations, Chung said that we too often engage in further "shaming and
blaming," furthering widespread stigma.
These damaging ideas often silence transgender
women, keeping them in the closet about their status. "If I'm a
transgender woman living with HIV, I [might not] want my partner to know
because I fear prosecution from the police," Gordon, of the Human
Rights Commission, said. "I might withhold that information or withhold
it from a doctor."
But as Morgan M. Page, a trans activist working on
sex work and HIV issues, explained, the threat of imprisonment isn't the
only reason trans women living with HIV might not be receiving the care
they need. It begins with the lack of information and resources
available to trans women. "There are almost no HIV prevention materials
directed at trans women, and the ones that are might not be in the right
language for people who need them," Page told Mic. "There are very few available in Spanish and only two or three available in English."
According to
Page, the health care system is still struggling with how to treat
trans patients. "Unfortunately, a lot of physicians working today treat
trans women as though we're someone else's problem," Page argued. "They
don't know what to do with a trans person." According to Page, this
happens because medical schools lack comprehensive education or training
for trans-affirming care, which leads to a "lot of misinformation ...
because doctors refuse to educate themselves."
Due to the lack of supportive doctors and health
providers in too many areas of the country, "trans people have to be our
own doctors and our own experts," Morgan explained. "While we do share a
lot of important and valid information with each other, sometimes we
perpetuate ideas that have no scientific basis, simply because there
aren't any doctors there telling us that it's not true."
One of the most pervasive myths, both within the
medical community and among trans women, is that you can't take hormones
and HIV medication at the same time. "That's scientifically untrue," Page said. "There are only about two HIV medications you can't take hormones
with, of about 30 or more that are on the market. What ends up
happening is that a lot of trans women have to choose what's most
important to them. And at the end of the day, many trans women are going
to choose hormones over HIV medication."
But as Chung explained, many
health care providers, medical professionals and researchers continue to
ignore these lived realities of trans women; even the census has yet to include transgender women
in the survey. "It continues to tell us that we are second class, that
our lives don't matter," Chung said. "It's easy to understand why we
would feel angry to be in a room where nobody acknowledges us."
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