Challenge
Transgender women are at high risk for HIV infection and transmission with a seroprevalence rate reported as high as 28% (Herbst et al., 2008). Coupling the severe impact that this disease is having on this vulnerable population is the wide range of barriers facing transgender women when attempting to engage in HIV prevention, care, and treatment. These barriers include a lack of HIV testing sites that are considered trans-friendly, avoidance of medical care because of previously experienced transphobia from service providers, prioritization of hormonal treatment over antiretroviral medication, concerns about confidentiality, drug and alcohol use, and lack of social support and mental health services. Though gender-affirming healthcare, meaning a care environment that allows transgender people to feel safe, included, and welcome, has been identified as an important facilitator in engaging transgender women in health and social services, the lack of trans-competent providers leaves a critical gap in the ability for transgender women to seek these services.
Solution
Although the incidence of HIV is occurring at higher rates among transgender women than other populations, little research has been conducted to understand the unique complexities surrounding transgender women’s experiences related to HIV prevention, care, and treatment. To effectively address the HIV epidemic in this population, more must be known and understood about the nature of transgender women’s risks for HIV infection, and what evidence-based HIV prevention, care, and treatment strategies are available for transgender women. Qualitative research provides a unique opportunity to address these gaps; therefore, Atlas Research, along with Abt Associates Inc., is engaging in a study with the Centers for Disease Control and Prevention (CDC) to better understand the barriers and facilitators to HIV prevention, care, and treatment among transgender women.
Result
Atlas Research will collect qualitative data from 20 HIV-positive transgender women, 20 HIV-negative transgender women, and 10 healthcare providers who provide care to transgender women. This diverse sample will allow the CDC to explore barriers and facilitators to HIV prevention, care, and treatment among transgender women from multiple perspectives. As a part of this study, Atlas will partner with three community-based organizations in Atlanta, GA; Baltimore, MD; and Washington, DC to recruit transgender women to participate in the study. Data collection will rely on in-depth interviews and quantitative questionnaires to capture the unique perspectives of transgender women and healthcare providers. This qualitative research can provide crucial information to ensure that future HIV prevention, care, and treatment efforts are culturally competent and successfully reach and engage transgender women.