AEGiS-14IAC: Investigation of the high rate of HIV prevalence in the transgender African American community in San Francisco (USA).

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Investigation of the high rate of HIV prevalence in the transgender African American community in San Francisco (USA).

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. TuOrE1157)

Rose VK, Scheer S, Shafer KP, Balls J, McFarland WC
San Francisco Department of Public Health, San Francisco, United States

ISSUES: A recent study among the estimated 3000 transgendered people in San Francisco revealed a significantly higher HIV prevalence among the African American transgender population than other racial/ethnic transgendered groups. Sexual and drug use behavior was determined to be similar among transgendered people of all races; therefore, the higher HIV seroprevalence rate among African American transgendered people warranted further investigation of the reasons for the difference among this population.

DESCRIPTION: A rapid assessment methodology was undertaken to examine the issues related to HIV prevalence among African American transgendered people. Key informant interviews and focus groups were conducted, and a quantitative survey was administered.

ISSUES: Primary concerns of African American transgendered people center on mental health issues unrelated to HIV infection. Among the myriad of concerns faced by this marginalized population, including employment and housing discrimination based on race and gender identification; HIV did not register as a high priority. Sex work, incarceration and survival sex confer significant risk for HIV infection. Partner selection and partner sharing may contribute to the unexplained differences in HIV prevalence.

RECOMMENDATIONS: HIV prevention programs using ecological theory and principles are more likely to attract transgendered people than programs that do not consider the context of transgendered people's lives. Health and mental health care providers need enhanced sensitivity training to understand the multitude of issues facing African American transgendered people, and to combat the stigma associated with their lives and behaviors. Issues of self-esteem and social capital should be addressed in provider training. Risk assessment methods should be strengthened to document the behaviors that increase risk for HIV transmission and other sexually transmitted diseases.

Keywords: AEGIS, Prevalence, Sex Behavior, HIV Infections, African Americans, HIV Seroprevalence, Sexually Transmitted Diseases, Acquired Immunodeficiency Syndrome, San Francisco, HIV Seropositivity, Ethnic Groups, epidemiology

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TuOrE1157