CDC: 4 in 10 Transgender Women Tested Positive for HIV in Major Cities

ISTOCK.COM/PrathanChorruangsak

 

Connecting state and local government leaders

The report shows the unequal toll HIV still exerts — with particular consequence for Black women and Latinas.

About 42 percent of transgender women tested positive for HIV as of early 2020, per a new government study run across seven major U.S. cities, and Black women have been particularly impacted. The staggering figure is one of the few snapshots into the unequal toll the virus continues to exert. 

Among Black trans women, 62 percent tested positive for HIV, according to the report, which was collected and analyzed by the Centers for Disease Control and Prevention. About 35 percent of Latinas reported the same. But among White trans women, 17 percent tested positive — still far higher than the general U.S. population, but lower than any other racial group. 

Among American Indian/Alaska Native women who were tested, 65 percent were HIV-positive, as were 20 percent of Asian women. Both groups came from particularly small sample sizes, however: American Indian/Alaska Native women made up 1 percent of all the people studied, and Asian women made up 2 percent.

The data comes from HIV surveillance testing conducted between 2019 and early 2020, in Atlanta, Los Angeles, New Orleans, New York City, Philadelphia, San Francisco and Seattle. The paper looked at 1,608 women across those cities and was conducted in an effort to better understand how HIV affects trans women in particular. 

The dataset involved, which was collected through the CDC’s National HIV Behavioral Surveillance program, looks specifically at populations and areas with elevated HIV risk. That means the findings may not reflect HIV prevalence among transgender women of color generally, said Ilan Meyer, a distinguished senior scholar of public policy at the UCLA-affiliated Williams Institute. And other analyses, including a 2018 meta-analysis, suggested lower HIV rates — closer to 14 percent — among transgender women of all races.

Still, Meyer said, “These numbers are definitely alarming and call for renewed efforts to distribute [HIV prevention medication] and other preventive strategies among transgender women of color.”

Historically, there has been little national data probing racial and geographic disparities among transgender women. The new CDC report offers a first step in that direction, though advocates and experts note that it’s still only a first step toward addressing the disparities.

“A lot more efforts are needed to study representative samples of transgender populations to give us better population-wide estimates,” Meyer said.

HIV rates varied among cities. In Atlanta, 58 percent tested were HIV-positive. In New York City, 52 percent tested positive; 51 percent did so in Philadelphia and 45 percent in New Orleans. In San Francisco, 41 percent of surveyed women had a positive HIV test, compared to 33 percent in Los Angeles and 21 percent in Seattle.

“These data provide a clear and compelling picture of the severe toll of HIV among transgender women and the social and economic factors — including systemic racism and transphobia — that are contributing to this unacceptable burden,” said Dr. Demetre Daskalakis, director of CDC’s Division of HIV/AIDS Prevention, in a statement.

The data — collected before the COVID-19 crisis — takes on even greater significance now, as experts worry a potential fourth wave of the virus could emerge. Untreated HIV weakens the immune system and is a risk factor for COVID-19 complications. 

In the United States at large, about 1.2 million people are living with HIV, per government statistics. It has long been clear that — when it comes to the dual burden of both contracting the virus and facing barriers to treatment — Black people, transgender people, and gay and bisexual men are at greatest risk. People who live in the South are particularly vulnerable, per CDC analyses. 

The disparities, experts believe, stem from overlapping layers of discrimination against transgender people, and particularly transgender people of color. That includes employment discrimination, higher rates of poverty, and increased barriers to both health insurance and competent medical care. 

“It’s income, it’s violence, it’s education. All the social determinants of health that affect everyone else — it’s intensified when you add in the element of trans women not being accepted in certain spaces,” said Coleman Goode, a community organizer at the AIDS Foundation Chicago. “There’s so much that plays into the higher rates of HIV among trans women of color.”

The economic gaps have only grown in the past year. Early data suggests that transgender people were more likely to have suffered because of the pandemic-induced recession. Transgender people of color were at particularly high risk: 26 percent had lost work as of last summer, per research published by the Human Rights Campaign. 

All that makes it harder to access the HIV prevention pill (known as PrEP), which is at least 90 percent effective and recommended for daily use in people who are at greater risk of HIV exposure. Without health insurance, the pill can cost close to $2,000 a month.

Beyond finances, there are other concerns.

The CDC report found that while 92 percent of HIV-negative women knew about PrEP, barely a third — 32 percent — were taking the pill. Many cited worries about how the pill might interact with hormones, along with mistrust of the health care system due to experiences with transphobia and lack of trans-inclusive marketing surrounding the HIV prevention pill. 

“A lot of people considered it a white male gay drug,” Goode said. “Among white gay men, their numbers have been dropping dramatically. But the numbers in black communities are going up — they’re the highest they’ve been. And there were doctors that didn’t want to prescribe it, because they felt like it’s a gay or white thing, or you don’t need that.”

Shefali Luthra is a reporter at The 19th.

FEATURED CASE STUDIES
Powered By The Atlas
St. Louis Uses Interactive Kiosks as a Critical COVID-19 Communications Platform
St. Louis, MO, USA
Corpus Christi Deploys COVID Management System to Improve Data & Eliminate Time-Consuming Tasks
Corpus Christi, TX, USA
Safer Holiday Celebrations Connect Residents and Support Local Business in Franklin, TN
Franklin, TN, USA

NEXT STORY: A First-of-its-kind Investment in Home Care is in the Works. But Will it be Enough?

X
This website uses cookies to enhance user experience and to analyze performance and traffic on our website. We also share information about your use of our site with our social media, advertising and analytics partners. Learn More / Do Not Sell My Personal Information
Accept Cookies
X
Cookie Preferences Cookie List

Do Not Sell My Personal Information

When you visit our website, we store cookies on your browser to collect information. The information collected might relate to you, your preferences or your device, and is mostly used to make the site work as you expect it to and to provide a more personalized web experience. However, you can choose not to allow certain types of cookies, which may impact your experience of the site and the services we are able to offer. Click on the different category headings to find out more and change our default settings according to your preference. You cannot opt-out of our First Party Strictly Necessary Cookies as they are deployed in order to ensure the proper functioning of our website (such as prompting the cookie banner and remembering your settings, to log into your account, to redirect you when you log out, etc.). For more information about the First and Third Party Cookies used please follow this link.

Allow All Cookies

Manage Consent Preferences

Strictly Necessary Cookies - Always Active

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data, Targeting & Social Media Cookies

Under the California Consumer Privacy Act, you have the right to opt-out of the sale of your personal information to third parties. These cookies collect information for analytics and to personalize your experience with targeted ads. You may exercise your right to opt out of the sale of personal information by using this toggle switch. If you opt out we will not be able to offer you personalised ads and will not hand over your personal information to any third parties. Additionally, you may contact our legal department for further clarification about your rights as a California consumer by using this Exercise My Rights link

If you have enabled privacy controls on your browser (such as a plugin), we have to take that as a valid request to opt-out. Therefore we would not be able to track your activity through the web. This may affect our ability to personalize ads according to your preferences.

Targeting cookies may be set through our site by our advertising partners. They may be used by those companies to build a profile of your interests and show you relevant adverts on other sites. They do not store directly personal information, but are based on uniquely identifying your browser and internet device. If you do not allow these cookies, you will experience less targeted advertising.

Social media cookies are set by a range of social media services that we have added to the site to enable you to share our content with your friends and networks. They are capable of tracking your browser across other sites and building up a profile of your interests. This may impact the content and messages you see on other websites you visit. If you do not allow these cookies you may not be able to use or see these sharing tools.

If you want to opt out of all of our lead reports and lists, please submit a privacy request at our Do Not Sell page.

Save Settings
Cookie Preferences Cookie List

Cookie List

A cookie is a small piece of data (text file) that a website – when visited by a user – asks your browser to store on your device in order to remember information about you, such as your language preference or login information. Those cookies are set by us and called first-party cookies. We also use third-party cookies – which are cookies from a domain different than the domain of the website you are visiting – for our advertising and marketing efforts. More specifically, we use cookies and other tracking technologies for the following purposes:

Strictly Necessary Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Functional Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Performance Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Social Media Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Targeting Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.