The Health Resources and Services Administration (HRSA) has announced two new grant competitions focusing on connecting HIV-positive transgender women of color with health care services, including primary care and HIV-related care.
The first grant opportunity, which is designed to improve the overall quality of HIV care for transgender women of color, will award each of up to eight grantees $300,000 annually for five years. The demonstration sites will develop, implement, and evaluate innovative programs designed to connect these women with timely and appropriate care. These programs will also help them stay in touch with providers who can provide a range of primary and HIV-related services.
The second opportunity will fund an Evaluation and Technical Assistance Center that will coordinate capacity-building activities, provide technical assistance in clinical and cultural competence around care for HIV-positive transgender women of color, and oversee the dissemination of findings from the demonstration sites.
The new grants are part of a growing number of initiatives by the Department of Health and Human Services that specifically focus on the transgender population. In September 2011, HRSA awarded a grant to Fenway Health, an LGBT community health center in Boston, to establish a National Training and Technical Assistance Center that will help other community health centers serve the LGBT population. Also in 2011, the Centers for Disease Control and Prevention awarded $55 million over five years to 34 community-based organizations to expand HIV prevention services for transgender youth of color, as well as young gay and bisexual men of color.
More such initiatives are sorely needed. Transgender people frequently encounter discrimination in aspects of everyday life such as employment, education, and housing, and research indicates that they are less likely than the general population to have access to health insurance and culturally competent health care. Though no national surveys currently ask about gender identity or transgender status, the limited research on transgender health that exists demonstrates that transgender people, particularly people of color and those who are poor, young, sex workers, or homeless, experience substantial health disparities. Estimated HIV prevalence rates among the transgender population range from 14 to 69 percent, with reported rates among African American transgender women in excess of 56 percent.
In addition to improving data collection on the demographics and health needs of the transgender population, more research is needed into every aspect of transgender health. Research priorities include the overall health of transgender people across the lifespan, further demonstrations of the safety and medical necessity of transition-related care, and investigations into the role that discrimination plays in driving disparities such as high rates of HIV and AIDS.
Eligible entities for the new HRSA grants include non-profits, community-based organizations, institutions of higher education, community health centers, state and local governments, and Indian tribes. Both programs are funded by the Ryan White HIV/AIDS Program as Special Projects of National Significance (SPNS). Applications are due by April 16, 2012.