Keiva Lei Cadena works at Life Foundation in Honolulu Hawaii -- the oldest, and longest running HIV/AIDS organization in Hawaii. Keiva works as their Linkage to Care Coordinator, linking newly diagnosed individuals into care and support services. She facilitates support groups, conducts outreach among people living with HIV and their partners, supports a transgender service program titled the Kua'ana Project which, along side Case Management and outreach services, conducts capacity building for other agencies relating to transgender cultural competency.
This Monday, April 17 is National Transgender HIV Testing Day. We caught up with Keiva to learn more about the significance of this day and about her work in Hawaii.
What are you organizing for National Transgender HIV Testing Day?
In our culture, we love to come together and have community events where we can spark conversations and build relationships. Amongst the transgender community here it really is an ohana -- a family. We are all sisters, mothers, or aunties. For National Transgender HIV Testing Day, we are creating a community event at one of our matriarch's home. Girls are going to come together, share a meal, and talk about HIV testing, specifically how to get young girls tested more often and engaged in services at Life Foundation. Also, being that NTHTD coincides with our 26th Annual AIDS Walk, we will be creating a video of community members sharing their reasons why this day is so important. We'll be streaming those videos on our website just like we did last year. We are making sure that our girls know that there actually is a national HIV testing day just for us, what that means, and why it's there.
Why is this awareness day so important?
When I was a young transgender person, we didn't have these national days or community events centered towards us. I remember not getting testing for HIV because I honestly didn't think that I was at risk because I had sex with straight men. I grew up in a time when HIV was still widely talked about as a gay disease and as transgender women, we really try to separate ourselves from being identified as homosexual. It deterred me from being tested for years and years. I found out I was HIV positive at a time where my body was already breaking down because of it. I could have avoided a lot of health issues had I been tested and drawn into care sooner.
Having a national day just for my community means that young girls are going to know that this is my day, my opportunity to be tested. Maybe I would have been tested earlier had I had National Transgender HIV Testing Day back in 2004.
What are some of the barriers to testing and care that transgender people face in Hawaii?
For Hawaii in particular, it is such a small community. We are familiar with most other transgender girls, we know the same people and run in the same circles. So, a lot of girls who may be at high risk for HIV may not want to come and get tested by us because they think that they are going to get in trouble or read by their sister. People don't want to reach out to services for fear of being outed.
Culturally, in Hawaii, Western medicine is still not something that Polynesians look towards -- we do things more on a spiritual level. So that sometimes deters us from going to the doctor or seeking any kind of testing or even checkups.
How do you address these barriers and make your agency a safe space?
When someone comes in to our agency we have conversations amongst colleagues to determine who would be the best fit to provide the service. And we always make sure that our services are mobile, so we can meet someone at their home, at a park, at a coffee shop -- wherever they're comfortable. That makes people feel better about working with us -- they don't have to walk through our doors to seek services. Instead we can go mobile and meet them where they're at.
Harm reduction is a huge tool in order to keep the transgender community connected to services. If we are talking about a person who injects drugs, is a commercial sex worker, or who might be chronically homeless, you must make sure that you are not creating barriers for people to reach out for services. Here at Life Foundation, we firmly believe that no matter what our client is going through, we have to meet them at their level and provide services that don't set them up for failure. If someone is coming in with the experience of commercial sex work and unprotected sex which can be a high risk lifestyle, it's my job to provide them risk reducing ideas and tools. It is not my job to scold or make them feel bad or wrong about their choices.
Can you share more the Positive Organizing Project at Life Foundation?
A lot of the work in this field is done by people who are not living with HIV. Through the Positive Organizing Project, we want to support greater involvement of our community by creating an advisory board amongst our clients. We are holding meetings to train and empower our clients, and increase their capacity to have discussions around HIV policy, medical advancements, and to have a say in what happens in our organization. Our state is also currently reorganizing their community planning group. This is a perfect opportunity to have our members to have a voice in the statewide group as well. We are really excited to see how it works out!
How can community advisory boards help reduce barriers to testing and other services?
As community service providers, I don't think that there is ever any bad intention, but I also don't think that anyone else can understand what a community needs besides the community itself. If someone else is making decisions for a community, that community will always be underserved. We have a lot of great allies, especially in the LGBT community, but you don't get the honest story unless you go direct to the source. That's why community advisory boards or community planning groups are important.
I remember as a young transgender person doing needs assessments for agencies -- how many times have you slept on the street, had sex for money, etc. I didn't understand what the information was for. Now, I understand and realize that I never answered those questions in the way that the agencies would have wanted me to. All that to say, when you're collecting data without community input, you're going to miss key points and barriers. But when you have people living with HIV and transgender people engaged, you have that voice and those ideas from a mind who is right there in the struggle.
Can you speak to the importance of organizations hiring transgender people?
It is imperative that organizations hire transgender people. I am one of 5 transgender women on staff at Life Foundation. All of us come from the community and have some background in what one would consider the "clichéd transgender lifestyle" -- commercial sex work, incarceration, substance use, and things of that nature. We can't or wouldn't cast judgment on alternative ways of survival; we know that life as well.
Our community is cynical and we have a jaded view on what the world is able to provide us. We've been let down, pushed down, outed, bashed in the streets. There is that guard that a lot of transgender people have. When they see someone that is just like them standing on the other side of the desk -- someone who empathetically understands their struggle, their sadness, or happiness -- I think that is the key to keeping them connected. If you come into a place and there is just a bunch of white jackets, professional language, and paperwork, it is impersonal. Because transgender people have experienced so much negativity, it is really important for us to have relationships with the people who we're seeking services from. People want to seek services where they feel like they can trust someone.
Thank you Keiva, for this conversation and your important work!