New USAID-supported Tool Improves HIV Prevention Programs for Transgender People

A transgender sex worker in the red light district of Tijuana, Mexico.
A transgender sex worker in the red light district of Tijuana, Mexico. Transgender women and gay men have the highest HIV infection rates of any group in Tijuana and often have difficulty accessing treatment and care.
Photo credit: Malcolm Linton


April 6, 2016

A new U.S. Agency for International Development (USAID)-supported tool was launched today to enable governments, public health officials, program managers, non-governmental organizations, and health workers to create and improve HIV prevention programs for transgender people.

The tool, Implementing Comprehensive HIV Prevention Programmes with Transgender People, also known as TRANSIT, provides guidance on delivering services, especially for HIV and sexually transmitted infection (STI) prevention, diagnosis, treatment, and care specifically for transgender populations.

TRANSIT was developed with contributions from more than 90 experts from around the world, including many transgender people. It captures issues such as the need to empower communities of transgender people; address the stigma, discrimination, and violence that they face; provide comprehensive healthcare services that are accessible and acceptable to transgender people; and manage effective programs.

A key feature of the tool are examples of promising practices drawn from programs around the world that have tackled challenges and found creative solutions to programming in environments with limited resources or where legal or social obstacles make it especially difficult to provide services to transgender people.

Transgender women are significantly and disproportionately affected by HIV globally. Oftentimes, discrimination, violence, and criminalization stop transgender people from getting the services they need to be healthy and stay healthy. This tool ultimately aims to help program advocates, funders, planners, and implementers create accessible and acceptable HIV prevention programming.

TRANSIT also strives to empower the transgender community to take an active role in their HIV prevention services. JoAnne Keatley, Co-chair of International Reference Group on Transgender Women and HIV/AIDS and Director of the Center of Excellence for Transgender Health at the University of California, San Francisco, explains that "community empowerment is foundational to the tool. Our communities know best what services they need and how these should be delivered. Empowering communities is a way to make services more effective and cost-efficient."

TRANSIT is the third in a series of tools on implementing HIV and STI programs with key populations. It follows the 2013 publication of a similar tool for HIV and STI programs with sex workers in addition to a tool focused on men who have sex with men in 2015. An implementation tool for programs with people who inject drugs is currently being developed.

The TRANSIT tool follows the guidelines on HIV prevention, diagnosis, treatment, and care published by World Health Organization in 2014. The publication was developed by the United Nations Development Programme in partnership with IRGT: A Global Network of Transgender Women and HIV/AIDS, the United Nations Population Fund, UCSF Center of Excellence for Transgender Health, Johns Hopkins Bloomberg School of Public Health, the World Health Organization , the Joint United Nations Programme on HIV/AIDS, USAID, and the U.S. President's Emergency Plan for AIDS Relief.

Access to comprehensive HIV prevention and treatment without fear or discrimination is a basic human right. Ultimately, the TRANSIT tool has the potential to benefit some of the world's most vulnerable populations by eliminating some of the common barriers to healthcare access for transgendered people.

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