Trans Empowered: Trans Women Share HIV Experiences in Video Series

Video still from _Empowered: Trans Women and HIV
Greater Than AIDS

Blossom, a straight-A student, had great scores on college entrance exams. But the African-American trans woman from Jackson, Mississippi, was denied admission by all six nursing schools to which she applied. As one of the people featured in a new video project from Greater than AIDS, she explains there's three strikes against her and her peers who are women of color, transgender and living with HIV. But, she's speaking out so other will hear that "HIV is not the end of the road. It should be just the beginning."

More than a quarter of transgender women in five high-income countries are living with HIV, yet less than half know they have the virus, according to the U.S. Centers for Disease Control and Prevention. These numbers reflect the stigma and discrimination faced by transgender people says AVERT, a global HIV/AIDS organization based in the United Kingdom.

The women in Empowered: Trans Women and HIV emphasize that one can live a healthy life as a transgender person with HIV.

Series moderator JoAnne Keatley relates the experience of one of her friends whose doctor told her that she could not be on gender-confirming hormones and antiretrovirals at the same time, which is not true. The friend chose to forego HIV treatment and subsequently died from HIV-related complications. Keatley, who leads the University of California, San Francisco Center of Excellence in Transgender Health, was originally brought in as an expert advisor to the project, but later also became the moderator and shared her own story in one of the videos.

Phoebe, another participant in the video series, recalled three friends who had died from HIV-related complications because they did not take their antiretroviral medications due to the stigma surrounding the virus. She decided to join the project as a way to deal with that loss.

"I felt as though getting my story out might not only aid in my healing, but even in someone else's," she said. "It is my hope that when they see women that look like them being so honest and open, that they would gravitate towards us and learn more about their options."

Preventing the acquisition of HIV in the first place is the best option, of course, but this is not always possible. Vivianne explained in a video that during her stint in a county jail, she "knew what [she] had to do to survive" as a trans woman. According to the U.S. Bureau of Justice Statistics, in 2011-2012 almost 40% of transgender persons in prison reported being sexually assaulted or abused during the prior year.

There are other situations when insistence on condom use may not be feasible, Phoebe pointed out. When she was working as an escort due to a lack of income alternatives, condoms were not always available. She considers pre-exposure prophylaxis (PrEP) to be "one more shield" in her "arsenal" against acquiring HIV.

Globally, transgender women are almost 50 times more likely to have HIV than cisgender persons (people whose current gender corresponds to the one they were assigned at birth), a meta review of studies through late 2011 reported. The availability of health care services that are sensitive to transgender people is key to dealing with the virus, Keatley points out, adding, "I've lost many close friends to the disease and have seen how damaging the lack of gender-affirming health care can be for transgender people living with HIV."

The video series was produced by the Kaiser Family Foundation, which works on all Greater Than AIDS campaigns. "Trans women are at high risk for HIV, and yet even as other trans issues are gaining more attention, HIV/AIDS has been notably absent. With Trans Empowered, we wanted to give trans women a platform to share their narratives about how [HIV] is affecting them and their needs," explained Tina Hoff, senior vice president, Media Partnerships & Health Communications, Kaiser Family Foundation.

The team at Greater Than AIDS received plenty of responses to a national call for trans women affected by HIV. Five women were ultimately selected to represent the ethnic diversity and varying HIV experiences in the transgender community.

"The representation also highlights the disproportionate impact [of HIV] on women of color," Keatley explained. While there are no plans at this time for a series on transgender men, "we ... are always on the lookout for those with stories to share for future efforts," added Hoff.

Empowered: Trans Women and HIV also tries "to help allies and health care providers better understand the needs of the community and the critical role they play in providing supportive and gender-affirming care to trans people," she says.

Greater Than AIDS partners with AIDS service and community organizations and provides a community toolkit to support outreach and screening efforts. If your group is interested in a partnership with the campaign, contact greaterthan@kff.org.

Watch the videos: