1. Engaging with Trans Women living with HIV
JoAnne G. Keatley, MSW
Center of Excellence for Transgender Health
Director and Co-Principal Investigator
© University of California, San Francisco Center of Excellence for Transgender Health

3. Background
In the U.S. and the world, transgender (‘trans’) women are disproportionately impacted by HIV
Highest percentage of newly identified HIV-positive tests in the United States (CDC)
Trans women of color also experience barriers to HIV care including
Limited access to, and avoidance of healthcare due to transphobic stigma and past negative experiences with providers
Prioritizing gender-related health care over HIV care
Concerns regarding adverse interactions between ART and hormone therapy

4. The TWOC Initiative
In 2012, the Health Resources and Services Administration (HRSA) under the Special Programs of National Significance (SPNS) funded
Evaluation and Technical Assistance Center (CoE)
Plus 9 demonstration sites nationwide
Tasked with developing and implement model interventions to improve engagement and retention in HIV care among transgender women of color

5. Facilitators
Competent, sensitive, culturally aware providers serve as a strong link to the community
Structural interventions needed (ie. violence reduction efforts, Identity laws and documents, job training, housing, behavioral health services)
More research needed on csHT and ARV drug interactions
Disaggregated data is crucial
Specific funding stream for trans programming

6. GAPS
Continued exclusion of trans people in planning at the country level
Involvement of trans people themselves in design and implementation of programs
Funding not reaching trans led organizations
A trained professional health care workforce free of bias and with skills specific to trans affirming sensitive health care
Recognition of trans identities and accurate data counts regionally

7. Next Steps TRANSIT roll out, translation and scale up support
Technical assistance provision at the regional level to build capacity of trans organizations on the ground
Replication or adaptation of effective programs for reaching, engaging with, and retaining trans women and men into care.

8. Contact Information