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Developing Programs to Sensitize Providers to the Unique HIV and Health Needs of Transgender People JoAnne G. Keatley, MSW Center of Excellence for Transgender.

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Presentation on theme: "Developing Programs to Sensitize Providers to the Unique HIV and Health Needs of Transgender People JoAnne G. Keatley, MSW Center of Excellence for Transgender."— Presentation transcript:

1 Developing Programs to Sensitize Providers to the Unique HIV and Health Needs of Transgender People JoAnne G. Keatley, MSW Center of Excellence for Transgender Health: University of California, San Francisco, United States

2 Our mission is to increase access to comprehensive, effective, and affirming healthcare services for trans and gender-variant communities.

3 National Advisory Board We include community perspectives by actively engaging a national advisory body (NAB) of 12 trans identified leaders from throughout the country.

4 Primary Projects 1.CATCH 2.Transitions Project 3.Primary Care Protocols 4.International Project 5.Sheroes Intervention

5 Who We Are Globally Travestís, Transvestites, Transsexuals, Transgender, Hijra, Ali, Arvani, Kothis, Metis, Mak Nyahs, Mukhannis, Kathoey, Mahuwahine, Fa’afafine, Sistergirls, Waria, Muxhe, Mujeres Differentes

6 Transsexual Population Estimates Weitze C., & Osburg, S., 1996 Country Study & Year Overall Prevalence MtF Prevalence FtM Prevalence MtF/FtM Ratio

7 HIV Prevalence Estimates among Trans People in the US Herbst et al., 2008

8 Global Trans HIV Prevalence Estimates


10 Best Practices Course Created in order to address the urgent HIV prevention needs of trans people by building capacity of: – Health care professionals – Social services professionals

11 How did the CoE come up with the eight best practices?

12 Background (Cont’d) Literature & Internet Search Identified 24 Trans HIV Prevention Programs in California Contacted all programs Distributed questionnaire

13 Best Practices Course Theoretical Framework: – Adult Learning Theory – Social Cognitive Theory – Empowerment Model – Social Action Model

14 Best Practices Course: Learning Objectives

15 Best Practices for Transgender HIV Prevention

16 1. Ground Your Work in the Community Develop partnerships with trans people and organizations

17 2. Race & Ethnicity: One Size Does Not Fit All Like other groups, HIV risk in trans people is compounded by racial discrimination

18 3. Use Multidisciplinary Approaches

19 4. Get the Facts! Assess, Evaluate & Enhance

20 5. Look in All the Right Places Trans-specific recruitment and retention strategies

21 6. Increase Access to Health Care Collaborate with local health care providers who: – Have easily accessible or multiple locations – Provide services in multiple languages – Understand trans HIV and health care issues – Provide hormone therapy as part of primary care

22 7. Invest In Developing and Supporting Your Staff Prioritize staff development – Build staff capacity – Create opportunities for advancement

23 8. Advocate for Structural & Systemic Changes Advocate for policy changes alongside trans people. Examples Include:

24 Primary Care Protocol Project: Medical Advisory Board Marvin E. Belzer, MD, FACP, FSAM Jennifer Burnett, MD Maddie Deutsch, MD James Franicevich, NP R. Nick Gorton, MD Jennifer Hastings, MD Dan Karasic, MD Lori Kohler, MD Jennifer Vanderleest MD, MSPH

25 Patient Intake What is your current gender or gender identity? – Male – Female – Transgender Male/Transman – Transgender Female/Transwoman – Genderqueer – Other: please specify___________ – Decline to state

26 Patient Intake What sex were you assigned at birth? – Male – Female – Decline to state

27 Patient Intake What pronouns do you prefer? – Fill-in-the-blank – He, she; hir, ze, they, etc.

28 Challenges Encountered What challenges will/might/have you encounter(ed)? – Interpersonal – Individual – Community – Structural How would/did you resolve those challenges?

29 References Belza M, Llacer A, Mora R, de la Fuente L, Castilla J, Noguer I, & Canellas S. (2000) Social characteristics and risk behaviors for HIV in a group of transvestites and male transsexual engaging in street prostitution. Gaceta Sanitaria, 14(5), 330- 7. Galli M, Esposito R, Antinori S, Cernushi M, Gianelli F, Cargnel A, Quirno T, Innocenti M, & Marozzi F. (1991) HIV-1 Infection, tuberculosis and syphillis in male transsexual prostitutes in Milan, Italy. Journal of Acquired Immune Deficiency Syndromes, 4(10), 1006-7. Gattari P and Spizzichino L. (1992) Behavioural Patterns and HIV Infection Among Drug Using Transvestites Practicising Prostitution In Rome. AIDS Care, 4(1), 83- 87.Netherlands Inciardi, J., Surratt, H., Telles, P., & Pok. B. (1999) Sex, Drugs, and the Culture of Travestismo in Rio de Janeiro. International Journal of Transgenderism, 3 (1+2) January-June 1999. Available online at:

30 References Khan A, Bokhari A, Nizamani N, Rehan N, & Khan A (2006) Differences in Sexual Behaviors of Male Commercial Sex Workers (MSWs) and Transgenders/Transvestites (Hijras) In Pakistan. Poster discussion: AIDS 2006 - XVI International AIDS Conference: Abstract no. TUPDD07" Kumta S, Lurie M, Gogate A, Jerajani H, Weitzen S, Kavi A, Anand V, Makadon H, & Mayer K. (2006) Sexual risk behavior and HIV prevalence among male-to- female transgendered people seeking voluntary counseling and testing services in Mumbai, India. Oral abstract session: AIDS 2006 - XVI International AIDS Conference: Abstract no. MOAD0303. Modan B, Goldschmidt R, Rubenstein E, Vonsover A, Zinn M, Golan R, Chetrit A, & Gottlieb-Stematzky T. (1992) Prevalence of HIV Antibodcies in Transsexual and Female Prostitutes. American Journal of Public Health, 82(4), 590-2.

31 References Palwade P, Jerajani H, Ashok R, Shinde S, & Vivek A. (2004) Prevalence of HIV infection and sexually transmitted diseases amongst MSM population in Mumbai, India. CD Only: The XV International AIDS Conference: Abstract no. C10822. Pisani E, Girault P, Gultom M, Sukartini N, Kumalawati J, Jazan S & Donegan, E. (2004) HIV, syphilis infection, and sexual practices among transgenders, male sex workers, and other men who have sex with men in Jakarta, Indonesia. Sexually Transmitted Infections 80(6): 536-40. Ponnusamy, A. (2006) Behavioral research / interventions. AIDS 2006 - XVI International AIDS Conference: Abstract no. CDC0968 Tumer, A., Kilickaya, B., & Akturkoglu, E. (2010) HIV/AIDS research and testing among sex workers in Turkey. AIDS 2010 – XVIII International AIDS Conference: retrieved from:

32 References Van Veen M, Hofhuis A, van der Helm T, Götz H, Prins M, & van de Laar M. (2006) Substantial risk behaviour among transgender sex workers in the Netherlands. AIDS 2006 - XVI International AIDS Conference: Abstract no. MOPE0478. Weitze C. & Osburg, S. (1996) Transsexualism in Germany: Empirical Data on Epidemiology and Application of the German Transsexuals’ Act During Its First Ten Years. Archives of Sexual Behavior, 25: 419. Wimonsate W., Naorat S., Varangrat, A., Phanuphak, P., Kanggarnrua, K., McNicholl, J., Tappero, J., van Griensvn, F., Siraprapasiri, T., and the Thailand MSM Study Group (2005). Risk behavior, hormone use, surgical history and HIV infection among transgendered persons (TG) in Thailand, 2005. AIDS 2006 - XVI International AIDS Conference: Abstract no. MOPE0349

33 JoAnne Keatley, MSW

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