A new study spanning 15 countries, including the United States, has highlighted that transgender women are nearly 50 times more likely than the general population to be at risk of an HIV infection while another has cited a dearth of HIV-surveillance data on women with surgically created vaginas.
The first study, conducted by Dr. Stefan Baral, director of the key populations programs in the Center for Public Health and Human Rights at Johns Hopkins School of Public Health, and colleagues, and reported in The Lancet Infectious Diseases, examined data from 15 countries with male-predominant HIV epidemics. The countries included the U.S., six from the Asia-Pacific area, five in Latin America, and three in Europe. The findings come after nearly four decades of grappling with the AIDS epidemic.
"Our findings suggest that transgender women are a very high burden population for HIV and are in urgent need of prevention, treatment, and care services," said Dr. Baral and his team in the discussion of their findings.
"… The meta-analysis of HIV infection rates are remarkable for the severity and consistency of disease burdens across these populations. This was true in all regions including Europe, Central and South America, Asia-Pacific, and the USA," added the researchers.
According to this report, since the start of the AIDS epidemic, transgender women were never classified as a separate case-reporting category and were perhaps lumped with the data collected on homosexual men. As a result, they were also rarely, if ever identified as a separate risk category for HIV surveillance.
"These arbitrary decisions have long masked the burden of HIV infection in transgender women and have had a negative effect on prevention, research and programming," noted the report.
It further pointed out that postoperative transgender women who did not practice anal intercourse have also been excluded from participation in biomedical HIV-prevention trials.
"A history of neovaginal intercourse (ie, intercourse involving the surgically created vagina) was not sufficient for enrolment in any of the antiretroviral chemoprophylactic HIV-prevention studies that have been done in men and women around the world so far," said the report.
"… Our present knowledge of the prevention of neovaginal acquisition and transmission of HIV infection in the event of pre-exposure prophylaxis, post-exposure prophylaxis, and antiretroviral treatment for prevention is almost non-existent," as a result, explained the report.
For Baral's study, transgender women were defined as people who were born male but identify as women.
"As of 2012, there remains a poor understanding of the burden of HIV among transgender women because of the limited inclusion of these populations in national HIV surveillance systems. In the few countries where epidemiological data for transgender women have been obtained, results have shown a disproportionate risk for HIV infection," noted Baral and his team.
In an interview with The Christian Post on Monday Baral explained that he hopes the findings of his study will be a catalyst for better research projects and better HIV-surveillance on transgender women whose population is currently estimated as one out of every 1,000 men born in the U.S.
"I think from our perspective transgender women have really been excluded out of the whole sort of HIV agenda in many ways. They are a more hidden population in many ways … the issue is that from a surveillance perspective we're not learning a lot about their needs as they don't identify as men. We haven't learned a lot about what their needs are," he explained.