Transform what? A snapshot of HIV/AIDS among Transgender People JoAnne G. Keatley, MSW Director and Co-Principal Investigator Center of Excellence for Transgender Health University of California San Francisco

 Sharing of best practices in addressing comprehensive transgender healthcare – including HIV.  Current advancements, resources and challenges will be shared as “building blocks” for the development of a road map to ensure access in a variety of settings.

 We will hear from a variety of civil society stakeholders, including care providers, researchers and activists as well as a representative from the WHO.  Each speaker will have 10 minutes and then two minutes for Q and A  Remainder of time for discusssion at the end.

 Higher rates of employment, housing and educational discrimination  Avoidance of medical providers from fear of identity disclosure  Unique health care priorities (access to gender affirming healthcare)  High rates of transwomen working in the sex industry  Effect of changing physiology on HIV/STD prevention & risk reduction  Self-identification by gender identity, not sex assigned at birth

 15countries including USA, six Asia-Pacific countries, five in Latin America, and three in Europe. N= 11,066 transgender women  HIV prevalence was 19·1%  The odds ratio for being infected with HIV compared with all adults of reproductive age across the countries was 48·8 (95% CI 21·2–76·3) and participants were;  Less likely to have access to and utilization of HIV services. 6 (Stefan D Baral, Tonia Poteat, et al; Lancet Infect Dis 2013; 13:214-22

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3% to 68% MTFs 0% to 2% FTMs North America 27.6% to 37.1 % South America 11.5% - 57% Europe 2% to 45.2% South Asia

 Trans women disproportionately affected by HIV/AIDS  Stigma and discrimination impact access to services at every point in care continuum  Governments have been slow to respond  Global organizations can support efficacious responses that include a human rights framework.

JoAnne G. Keatley, MSW Tele:

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 How can we take full advantage of the multiple recommendations, instruments, guidelines and best practices that are being produced at all levels and ensure their sustained implementation?  What should be done to align health and social services for transgender persons with other existing initiatives, plans and programs?