No More Lip Service: A Demand for PrEP Access from the Transgender Community
By Brian Kanyemba
For the first time ever, the program for the International AIDS Conference has included a pre-conference focused on transgender people called No More Lip service: Trans Access, Equity and Rights, Now! The program brought together global trans people and activists from Peru, Malaysia, Thailand, United States, India and many other countries in Africa and around the world. JoAnne Keatly, USA, and Amitava Sarkar, India, served as co-chairs for the meeting, which included an entire day of focus on the needs, update research, and capacity building. The co-chairs, representing the IRGT, the Global Network of Trans-Women and HIV, introduced a new delivery model for transgender-focused HIV prevention, care and treatment. The program, called the TRANSIT Service Delivery Model, was designed for advocacy, strategic planning, program design, and provider training and quality improvement. A one of a kind program, TRANSIT builds on the WHO Key Populations Consolidated Guidance recommendations, including those about the use of PrEP.
At an early afternoon session, several speakers addressed the access and acceptability of PrEP in trans populations. In general, speakers discussed the lack of data among trans people relate to PrEP use. They articulated how trans people are excluded from many studies of PrEP involving men who have sex with men. Speakers also mentioned that many trans women have voiced concerns to them about the effect of using PrEP may have on their use of hormones. Asa Radix from the Callen-Lorde Community Health Center in New York, NY, presented data from a study she led on the use of PrEP by trans women. Positive outcomes though form this community were highlighted in the presentation from the transcomunity itself. One individual pointed out “ If I had to take a pill a day forever and its 10% more safety that I have now, I wold do it. I don’t trust myself.” In practical terms the trans community is ready to take PrEP as prevention measure however, as related to other Key Populations, social mobilization need to be done to create demand within the community.
Michelle Ross co-Founder of cliniQ and Co-lead on service developments presented a paper on the Inclusive PrEP implementation: Understanding the needs and views of HIV negative trans and non-binary people in the UK. She affirms that “ … people are invisible and therefore you don’t count. If you’re already a stigmatized community, it reinforces this. What’s really important is seeing someone you can relate to, hearing about health issues that relate to you.” When designing studies it is ideal to include the community affected, as they understand the real issues happening in their own communities.