How does HIV affect transgender females?What are the prevention challenges for transgender females?What can transgender females do?How does HIV affect transgender males?What are the HIV prevention challenges for transgender males?What can transgender males do?

How does HIV affect transgender females?

There is very little known about the rates of HIV and STDs among transgender females. Efforts are underway to collect better information about transgender females and in the future more will be known. Nationally, there is also little information but there are studies that give some information.

A 2008 review of 29 studies of transgender females in the US, found they have been greatly impacted by the HIV epidemic. In four of the studies, 27.7% of transgender females tested HIV positive, compared to 11.8% who self-reported HIV positive in the remaining 25 studies. This suggests that many transgender females may not be aware of their HIV status. Highest HIV rates were among African American transgender females (56.3%).

In this review, a large percentage of transgender females reported engaging in unprotected receptive anal intercourse, multiple casual partners and sex work.

What are the prevention challenges for transgender females?

The stigma and discrimination experienced by many people merely for being transgender heightens risk behavior for transgender females. It is greater for transgender females of color, who experience stigma and discrimination due to ethnicity as well. Substance use immediately before and during sexual activity increases HIV risk. One study of transgender females in San Francisco, CA, found that their male sexual partners often use crack cocaine before sex to ease inhibitions.

Transgender females face complicated power and gender dynamics in their sexual relationships. There is a perception that there are few people who are willing to be in committed relationships with transgender females, which compromises disclosure of HIV status, sexual negotiation and condom use. Some transgender females have sexual partners who provide a sense of love and acceptance, but who also request unsafe sexual behaviors.

When people are transitioning, they often take hormones so that they may start to physically resemble the other gender.  For example, transgender females often take hormones that stimulate breast growth.  While some hormones may be taken orally (swallowing pills), others are taken intravenously, meaning that they are injected into the body with a syringe/needle. If you are considering hormone therapy, consult a doctor who is familiar with the different treatments available.  Only your health care provider can prescribe the right hormone treatments for you.  Buying hormones off the street is illegal and extremely dangerous.  Certain STDs such as HIV, and Hepatitis B and C can be transmitted by sharing needles for drugs or hormone treatments with an infected person.  You may not know if the person you are sharing needles with is infected.  To reduce your risk: Never share needles!

What can transgender females do?

Transgender females around the country are doing many things to support their community to reduce their risk of becoming infected with HIV and other STDs and to support those transgender females that are infected. Some of the projects include:

-Education and employment - Finding and keeping jobs is a key step in reducing risk for transgender females.

-Training for healthcare providers - Quality, sensitive healthcare is important for transgender females.  Transgender persons deserve respect and quality care from a doctor who understands their healthcare needs. This means that you may want to research some of the health care providers, such as doctors, nurse practitioners, clinicians, etc., in your area who are trans-friendly providers, meaning that they are educated about trans-health issues and do not discriminate against patients based on gender identity or sexual orientation. 

-Mentoring - Youth and others who are transitioning need role models to help them envision a successful life for themselves. 

Get educated!  Educate yourself about the different ways that you can acquire HIV and then all the ways to protect yourself. Learn your status so that you can protect yourself and your partners.  Teach those around you about how HIV can be transmitted and how you can protect yourself from infection.  Work in your community to improve awareness.  You and your partner should get tested for HIV and other STDs so that you are aware of each other's status before you have sex.  Talk about HIV and other STDs with each partner before you have sex.  Ask your partners if they have recently been tested for HIV; encourage those who have not been tested to do so. Use a latex condom and lubricant every time you have sex.  Get tested for HIV once a year.

Note: Source information for this section includes the University of California San Francisco

How does HIV affect transgender males?

There is very little known about the rates of HIV and STDs among transgender males.  Efforts are underway to collect better information about transgender males and in the future more will be known.  Nationally, there is also little information but there are studies that give some information.  A 2008 review of 29 studies of transgender persons found the prevalence of HIV among transgender males is fairly low.

What are the HIV prevention challenges for transgender males?

The stigma and discrimination experienced by many people merely for being transgender heightens risk behavior for transgender males.  It is greater for transgender males. of color, who experience stigma and discrimination due to ethnicity as well.  Substance use immediately before and during sexual activity increases HIV risk.

Transgender males face complicated power and gender dynamics in their sexual relationships.  There is a perception that there are few people who are willing to be in committed relationships with transgender males, which compromises disclosure of HIV status, sexual negotiation and condom use.  Some transgender males have sexual partners who provide a sense of love and acceptance, but who also request unsafe sexual behaviors.

When people are transitioning, they often take hormones so that they may start to physically resemble the other gender.  For example, transgender males take hormones that stimulate hair growth on the face and other parts of the body.  While some hormones may be taken orally (swallowing pills), others are taken intravenously, meaning that they are injected into the body with a syringe/needle.  If you are considering hormone therapy, consult a doctor who is familiar with the different treatments available.  Only your health care provider can prescribe the right hormone treatments for you.  Buying hormones off the street is illegal and extremely dangerous.  Certain STDs such as HIV, and Hepatitis B and C can be transmitted by sharing needles for drugs or hormone treatments with an infected person.  You may not know if the person you are sharing needles with is infected.  To reduce your risk: Never share needles!

What can transgender males do?

Transgender males around the country are doing many things to support their community to reduce their risk of becoming infected with HIV and other STDs and to support those transgender males that are infected.  Some of the projects include:

-Education and employment - Finding and keeping jobs is a key step in reducing risk for transgender males.

-Training for healthcare providers - Quality, sensitive healthcare is important for transgender males.  Transgender persons deserve respect and quality care from a doctor who understands their healthcare needs.  This means that you may want to research some of the health care providers, such as doctors, nurse practitioners, clinicians, etc., in your area who are trans-friendly providers, meaning that they are educated about trans-health issues and do not discriminate against patients based on gender identity or sexual orientation. 

-Mentoring - Youth and others who are transitioning need role models to help them envision a successful life for themselves. 

Get educated!  Educate yourself about the different ways that you can acquire HIV and then all the ways to protect yourself.  Learn your status so that you can protect yourself and your partners.  Teach those around you about how HIV can be transmitted and how you can protect yourself from infection.  Work in your community to improve awareness.  You and your partner should get tested for HIV and other STDs so that you are aware of each other's status before you have sex.  Talk about HIV and other STDs with each partner before you have sex.  Ask your partners if they have recently been tested for HIV; encourage those who have not been tested to do so.  Use a latex condom and lubricant every time you have sex.  Get tested for HIV once a year. 

Note: Source information for this section includes the University of California San Francisco.