1. SOCIOPOLITICAL IMPLICATIONS FOR HIV PREVENTION, TREATMENT, AND COMPREHENSIVE HEALTH CARE FOR TRANSGENDER SEX WORKERS The Debates over Mexico Citys HIV/AIDS Clinic: ORALIA GÓMEZ-RAMÍREZ, U. OF BRITISH COLUMBIA XIX INTERNATIONAL AIDS CONFERENCE 2012 – WASHINGTON, D.C.

2. BACKGROUND 2008: Trans Law is approved in Mexico City Allows name and sex change in birth certificates 2009: Trans health program begins in Mexico Citys HIV Clinic Goals: Hormonal treatments Psychological counselling HIV and STIs treatment and prevention Limits: No access to surgeries or comprehensive health care

3. METHODS Ethnographic research August 2009 – September 2009 May 2010 – August 2011 Documentary research Analysis: Qualitative bottom-up approach Emphasis on sociocultural dimensions: perceptions and attitudes MtF trans activists and sex workers points of view

4. RESULTS Trans activists diverging points of view Transphobia vs. visibilization Comprehensive health care vs. HIV and STIs-specific health care Stigma predicament Vulnerability to HIV Pathologization of trans conditions Sociocultural and health dimensions go hand in hand

5. RESULTS Trans sex workers attitudes and points of view Assessment of precarious labour opportunities HIV clinic, at times, as source of condom provision Generalized reluctance to go to the HIV clinic for hormonal treatments and/or HIV and STIs testing Fear that formal hormonal treatments may jeopardize their ability to satisfy clients Uneven and heterogeneous distribution of sociocultural capital

6. CONCLUSIONS Predicament between transphobia/stigmatization and visibilization/attention to HIV-vulnerability still a pending challenge Local sociocultural and political dimensions need to be fully considered when envisioning HIV-specific programs Broader focus of social and health justice movements Struggles for trans peoples rights should keep in mind the health, social and political struggles around HIV/AIDS HIV/AIDS-related health policies and programs should take into account the fight for trans rights and recognition

7. ACKNOWLEDGEMENTS