In recent years, there have been major advances in HIV care. Effective therapies can prevent transmission, and new injectable treatments may replace the need for daily oral meds.

Overall, the rates of HIV are down in the United States. From 2014 to 2018, there was a 7 percent reduction in the number of new HIV diagnoses. Plus, people with HIV are living longer and healthier lives.

Even with this good news, many people aren’t getting the care and attention they need to manage HIV. Transgender communities still experience significant discrimination in many areas, and they have higher rates of HIV compared with the country’s total population.

We can’t celebrate how far we’ve come until everyone has equal access to HIV prevention and care. Keep reading to learn how HIV affects trans communities.

Researchers estimated that 1.2 million people in the United States were living with HIV at the end of 2018. It’s also estimated that 1 in 7 of these people were unaware of their HIV-positive status.

Studies done between 2006 and 2017 show that trans people have much higher rates of HIV. It’s estimated that 14.1 percent of trans women and 3.2 percent of trans men live with HIV. In comparison, less than 0.5 percent of the total adult U.S. population is estimated to live with HIV.

Transgender communities have higher rates of HIV for several reasons.

One is that trans people face major challenges when accessing healthcare.

When a person doesn’t feel welcome in a doctor’s office, it becomes a huge barrier to care. Often, healthcare professionals may not receive the proper training on the needs of trans people. It’s important for doctors to use a person’s preferred name and pronouns.

A research review from 2007 found that an average of nearly 77 percent of trans people felt unsafe or uncomfortable in public settings. It can be intimidating — even dangerous — for trans people to do everyday activities, such as going to a doctor.

In addition, the review estimated that 20.6 percent of trans people have experienced sexual assault. Sexual assaults are often unreported, meaning there’s no follow-up care.

Trans people need safe spaces to report sexual violence. Emergency treatments can prevent HIV infection, but they need to be used within 72 hours. Without access to these services, people are at greater risk of HIV infection.

Another risk factor is lower employment rates and income for many trans people.

Without job opportunities, due to stigma and discrimination, transgender people are more likely to be in sex work, according to the Human Rights Campaign advocacy group. This puts them at greater risk of HIV.

Knowledge and management of HIV has come a long way since the 1980s. There are effective ways to prevent HIV infection.

HIV can be transmitted through the following bodily fluids:

  • blood
  • semen and pre-seminal fluids
  • vaginal fluids
  • rectal fluids
  • breastmilk

HIV can spread if these fluids from a person with HIV come into contact with another person’s mucous membranes. Mucous membranes are found in the mouth, vagina, anus, and the opening of the penis.

HIV can also be spread when fluids containing HIV get into the bloodstream.

There are effective ways to reduce the spread of HIV. But they will only work if everyone has access to the right care.

The following are ways to prevent HIV transmission:

  • Condoms or other barrier methods. These physically prevent contact between body fluids and mucous membranes.
  • Antiretroviral therapy (ART). ART is a treatment for people living with HIV. These medications lower the amount of HIV in the body. This is also known as the viral load. People with an undetectable viral load have almost no risk of transmitting HIV to someone else.
  • Post-exposure prophylaxis (PEP). This is used in emergency situations, like sexual assault. PEP treatment needs to be taken within 72 hours of possible HIV exposure.
  • Pre-exposure prophylaxis (PrEP). This is ongoing treatment to prevent HIV infection. People can take this if they have a partner who is HIV-positive or are likely to be exposed to HIV.

It’s possible to prevent and manage HIV, but stigma and discrimination among transgender people are major barriers to accessing HIV testing and care.

Trans people need more safe spaces to report sexual violence and access PEP treatment. Compassionate, safe, and expert care needs to be available for all.

To improve income and opportunities, trans folks need better access to education and jobs. Workplaces need to be safe and inclusive.

It’s important to find a health clinic that is transgender-friendly and understands your needs. Here are a few organizations that can be a starting point:

  • Planned Parenthood. This low cost health clinic is available in several regions throughout the United States. It advocates that everyone deserves equal access to quality care.
  • GLMA. This organization fights for health equity for LGBTQIA+ communities. There is a directory on its website, where you can search for a health professional in your area.
  • CenterLink Community. This is a site where you can search for a local LGBTQIA+ community center. It also provides several resources on its website.

There are many other organizations out there, too. An online search may help you find other transgender or LGBTQIA+ health clinics in your area.

While the overall rates of HIV infection are down in the United States and there are effective ways to prevent and manage HIV, not everyone is benefiting from these advances.

People in transgender communities have much higher rates of HIV. Stigma and discrimination affect their safety, job outlooks, and income, and present barriers for them to access care.

Reducing stigma, educating others, and providing compassionate care is key to helping trans people get the care they need for HIV.