One of the most comprehensive reports on transgender health in America shares striking statistics: 42% of transgender women in seven major U.S. cities live with HIV.
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In April, the Centers for Disease Prevention and Control (CDC) released a report on HIV infection, risk, prevention, and testing behaviors among 1,608 transgender women who participated in a national study to monitor HIV behavior. HIV in 2019 and early 2020.
Internal medicine specialist James Hekman, MD, says these statistics show what many health care providers already knew and feared: “In terms of risk factors, trans women face a significant number of complex health challenges. he says.
Dr. Hekman delves into the topic of HIV infection, testing, and prevention for transgender women.
The report, which shares data from the study of 1,608 trans women in Atlanta, Los Angeles, New Orleans, New York, Philadelphia, San Francisco and Seattle, shows significant racial differences in the health of trans women across the lines racial.
Statistics revealed that 62% of black transgender women live with HIV, compared with 35% of Hispanic / Latino transgender women and 17% of white transgender women.
Socio-economic status also plays an important role. The report shows that 1 in 6 respondents (63%) lived at a lower or lower federal poverty level and that 42% had experienced homelessness in the last year.
Sex work is an important risk factor
High levels of poverty and unemployment are directly related to the struggles trans women face in a heteronormative society, says Dr. Hekman, who often leads them to engage in high-risk behaviors, such as sex work. in order to reach the end.
“Employment options for trans women may be limited, based on discrimination and society’s bias,” she says. “Having limited resources available to maintain their socioeconomic survival, they can resort to high-risk situations such as sex work for survival, to avoid homelessness.”
And sex work can increase the likelihood of unsafe sexual practices, including less condom use. “We know that many times, exchanging sex for drugs or money is a risk factor for HIV itself,” says Dr. Hekman.
Trans people face barriers to attention
Pre-exposure prophylaxis (PrEP) – a once-daily medication for people who do not have HIV but may be at high risk for contracting it – is a vital tool for HIV prevention in the LGBTQ community. +. And it’s incredibly effective, as it has been shown to reduce the risk of contracting HIV from sex by more than 90%.
But the study identifies the factors that may influence transgender women to take PrEP.
Medical distrust after transphobia experiences
The use of PrEP is more common in trans women who have access to trans-competent health care providers, but they are not always easy to find.
“There is a shortage of healthcare providers who know how to provide culturally competent care for trans people,” says Dr. Hekman. “There is also a lack of resources available for trans people.
The lack of trans-inclusive PrEP marketing
Marketing for PrEP is primarily aimed at gay and bisexual men – messaging that doesn’t resonate with trans women. Although the most recent data from the study show that knowledge of PrEP is high among trans women (92%), it was found that only a third take it.
Concerns about the negative interaction of PrEP with hormone replacement therapy
Transgender women who are in hormone replacement therapy (HRT) are concerned that PeEP intake may interfere. “This is a long-standing concern,” says Dr. Hekman, “and unfortunately there’s not much study in this area, so there’s not much to guide people.”
The key, she says, is for trans women suffering from HRT to talk to their doctors about these concerns. “You can do yourself a favor if you go to your sexual health at a clinic where you are also receiving hormone therapy,” he says.
Your doctor will work with you to make sure you can maintain the correct levels of HRT and protect yourself from HIV.
Why do you need to know your HIV status?
“Knowing your condition is vital to a person’s self-care,” Dr. Hekman says. “It’s also an advantage for the community that people know their status and don’t pass it on without knowing it.”
Only by knowing your HIV status can you take steps to make sure you do not transmit it. Therefore, it is vital that people who learn that they are HIV-positive are linked to a treatment that will help them control their disease and prevent its transmission.
How to get tested for HIV
The actual process of HIV testing is simple. You can get tested at many medical offices and community organizations that offer confidential and anonymous HIV testing.
Medical professionals may perform a test that involves a finger puncture or a venous puncture (blood collected through a vein, usually inside the elbow or upper hand) or a mouth swab (tamponade the inner part of the cheek).
Quick tests can provide results in as little as an hour, although you may need additional tests to confirm their accuracy. Non-rapid test lab tests are available in a few days and require you to return to the office to receive your results.
When you participate in an HIV test, you may be tested for other sexually transmitted diseases (STDs) at the same time. You will receive information on how to protect yourself from HIV and, if you test positive for HIV, you will receive advice to help you find out what to do next.
“With proper care, it is very unlikely that a person with HIV will transmit it,” says Dr. Hekman. “When you’re tied to care, you can get the help you need.”
Prevent HIV exposure
Dr. Hekman encourages all patients to take steps to prevent exposure to HIV. In particular, for trans women, these steps include:
- Ask your doctor to start PrEP.
- Use of condoms during all sexual situations.
- Seek help and support for other situations and behaviors that may increase your risk, such as abuse and mental health issues. “If these hinder your protection, we, as health care providers, can relate you to treatments, services, and care that can help you find a way out of these situations,” says Dr. Hekman.
If you think you have been exposed to HIV, for example, if your condom breaks, you should look for post-exposure prophylaxis (PEP), an HIV prevention treatment for HIV-negative people who have been exposed to the virus.
“If you go into an emergency room or clinic in 72 hours, you can start therapy that drastically reduces the likelihood of HIV,” Dr. Hekman explains. “But beyond 72 hours, there’s no benefit.”
Seeking transcompetent health care
Dr. Hekman reminds transgender patients that, like everyone else, they deserve competent and compassionate health care, and that such care exists. If you’re not sure where to find it, local LGBTQ + support organizations are a good place to start connecting with doctors in your community.
“We want trans patients to know that they are seen and valued and that healthcare professionals have improvement skills to meet their needs,” he says. “We welcome them, value them and are here for them.”