Last week, the U.S. Conference on AIDS (USCA) was temporarily taken over by a group of #TransLivesMatter activists. Led by the fierce trans Latina activist Bamby Salcedo, the group held the stage for nearly 20 minutes to demand that transgender people receive the consideration they deserve in HIV policy and outreach.
The moment for the protest was strategically considered; it was the plenary session of the conference and many top officials were in the room, including Douglas Brooks, Director of the Office of National AIDS Policy (ONAP). It was ONAP’s recent new plan to tackle the HIV epidemic — ambitious as it is — that spurred the protest.
“In the previous HIV/AIDS strategy, the trans community was mentioned,” Salcedo told ThinkProgress. “Things were supposed to be implemented, but that never happened.” The new plan abandons the trans-specific strategies altogether, essentially erasing the unique experiences of transgender people with HIV, what Salcedo describes as “structural violence.”
That is why the protesters, a group of local D.C. activists and members of the TransLatina Coalition, chanted, “We are not gay men!” Under current plans and strategies, transgender women are lumped in with men who have sex with men (MSM).
The primary demand was thus to collect data specifically about the experience of transgender people with HIV.”We recommended collecting data on transgender people ten years ago,” Salcedo explained, noting that it still hasn’t happened. “We need to have ways of collecting data that are specific to our communities,” which continue to be marginalized. According to the 2011 National Transgender Discrimination Survey, trans people reported HIV infection at four times the national average, with rates even higher for trans people of color.
“Unfortunately, we live in a society where we play the numbers game. Trans people and people of color, our community is non-existent [in the data]. There’s no way to prove the needs of people. Numbers should be collected about our existence and our needs.”
For example, there is little research available about the experiences of transgender men. Many of them identify as gay or bi and engage in some of the same behaviors as other MSM, exposing them to the same risks of HIV infection even though they have a very different perspective.
There have similarly not been sufficient studies about the interactions of hormone therapies and HIV medications. Thus, clinics might prescribe a patient with both, unaware of any complications that might arise from taking them both.
Without this research, there can be no evidence-based interventions specific to trans people. “We have to intentionally invest in the lives of transgender people,” Salcedo said. “If there’s no research, we’re nonexistent.”
This is particularly true, she explains, because of the way trans women are forced to live in certain neighborhoods because of their experiences with discrimination. These “hotspots” make it easier for transgender people to be “criminalized by who we are and where we live.” A simple trip to the convenience store could involved being stopped by police and even arrested, profiled on the assumption of being a sex worker. This assumption is based on the reality that many trans women resort to sex work for survival when they cannot find other stable work, which puts them at a higher risk of HIV infection.
The protesters’ demands of ONAP seek to lay a foundation for recognizing these disparities and helping support trans people’s unique needs:
- Implement transgender-inclusive data surveillance with Health and Human Services and across all federal agencies, requiring states and territories to do the same if they receive federal funding.
- Hold consultations with transgender people living with or at risk of HIV to develop strategies that will address the needs of the trans community.
- Invest in community dialogues with specific outreach to transgender communities, including transgender people of color, individuals engaged in commercial sex, young people, and people with disabilities.
- Fund prevention and treatment interventions that are designed and focused specifically on transgender populations that will also help cultivate the professional growth of transgender leaders.
- Develop a comprehensive research agenda that will address the specific needs of the trans community.
- Work with the Department of Justice to end the criminalization of trans people, sex workers, and people with HIV.
Salcedo’s overarching demand is fairly simple: “HIV prevention programs need to be developed that look at the bigger picture.”