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

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

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

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

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

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.

Contact Information www.transhealth.ucsf.edu Joanne.keatley@ucsf.edu 415-476-6146