April 18 marks National Transgender HIV Testing Day, a day to acknowledge the importance of routine HIV testing and status awareness, as well as preventive practices and care.
HIV, or human immunodeficiency virus, attacks the body's immune system by invading cells, which it then uses to make copies of itself. HIV is most commonly transmitted through condomless anal and vaginal sex, or through intravenous drug use. Other forms of transmission include blood, semen, preseminal fluid, vaginal fluid, rectal fluid, and breast milk. If left untreated, HIV may lead to AIDS, or acquired immune deficiency syndrome.
Those diagnosed with AIDS generally have badly damaged immune systems, putting them at risk for further medical conditions.
Currently, not much is known about how HIV/AIDS impacts the Transgender community, because the majority of studies consider Transgender people as their sex assigned at birth, and not what they currently identify as. Not only does this discount Transgender identities, but it also allows for the Transgender community to become invisible to public health officials.
What is known about how being Transgender relates to HIV/AIDS is that there are barriers to care and a lack of inclusiveness.
What the data show
According for the Centers of Disease Control and Prevention (CDC), 26,801 people in the United States and dependent areas received an HIV diagnosis in 2019. The number of HIV diagnoses decreased by 9% overall from 2015 to 2019, and the number of new HIV diagnoses were the greatest among those aged 25—34.
The CDC states that in 2019, Transgender people accounted for 2% of new HIV diagnoses, out of which male-to-female Transgender people accounted for almost all (93%), and female-to-male Transgender people accounted for 7%.
The agency recommends that everyone aged 13—64 get tested for HIV at least once as part of their routine healthcare. Those at greater risk of contracting HIV, such as Queer and Bisexual men, Transgender women, and those who use injectable drugs, should consider getting tested more often.
Preventive measures and medicine
To prevent an HIV diagnosis, health officials recommend wearing condoms during sex when a partner's status is unknown. Getting tested to confirm one's sexually transmitted infection status is also highly recommended.
Medication is also available for those seeking to further reduce HIV exposures. PrEP, which stands for pre-exposure prophylaxis, is a pill taken once per day that reduces the risk of acquiring HIV.
PrEP, commonly sold under the brand name Truvada, can reduce the risk of contracting HIV from sexual intercourse by 99% when taken as prescribed. It works by blocking the HIV virus from making copies of itself and spreading through the body. It also works for those receiving gender-affirming hormones.
A medication for those who have a high-risk event, such as condomless sex with a partner whose HIV status is unknown, is called PEP, which stands for post-exposure prophylaxis. Two to three medications are generally prescribed as part of a PEP regimen and must be taken as prescribed for 28 consecutive days. PEP has been shown to work, but it is not 100% effective.
Treatment
Treatment for HIV involves taking medication that reduces the amount of HIV in one's body, called ART, or antiretroviral therapy. According to the CDC, most individuals can get the virus under control within six months with the use of ART.
ART is recommended for all those living with HIV and should be taken as soon as possible to decrease one's viral load and prevent the development of AIDS.
Undetectable=Untransmittable (U=U)
Those who are HIV positive and adhere to antiretroviral therapy can reach undetectable viral loads. According to the CDC, undetectable viral loads mean that the virus cannot be transmitted to sexual partners, even without condom use.
Where to get tested in the Seattle area
For those interested in becoming up to date on their HIV status, several clinics in the Seattle area offer testing and treatment options.
Planned Parenthood locations offer STI testing and treatment options.
Gay City: Seattle's LGBTQ Center offers free STI testing for clients aged 14 and above. Testing services include HIV, syphilis, chlamydia, gonorrhea, and hepatitis C. Gay City also assists clients with finding PrEP and with medication costs.
POCAAN, which stands for People of Color Against AIDS Network, offers free HIV and STI testing and prevention for BIPOC individuals who are at risk of infection. POCAAN is located at 4437 Rainier Ave. S.
UTOPIA, located at 841 Central Ave. N. #C-106, is an organization led by Queer and Transgender people of color and offers HIV and STI testing, as well as PrEP navigation.