Access to HIV Care and Support Services for African American Transwomen Living with HIV

ABSTRACT

Low access to HIV care and support has led to survival rates for transwomen that are half that of other populations at risk for HIV. Within the population, HIV disproportionately impacts African American transwomen. Interventions to increase access to HIV care and support are needed to better serve those most affected and vulnerable within the population. We conducted a study of barriers to care and support services for African American transwomen to fill a gap in the literature to improve access for this population. A total of 10 in-depth interviews were conducted with African American transwomen with HIV who lived outside the metro area of San Francisco. Three overarching thematic topics emerged—gender stigma, peer, and institutional distrust—giving insight into African American transwomen's barriers to HIV care and support services. A number of factors within these themes impacted access, such as whether organizations offered gender-related care, the geography of organizations as it relates to safe transportation and location, confidentiality and trust of peers and organizations, and trauma. Specific instrumental, institutional, and emotional supports are recommended for increasing access to care and support services for African American transwomen living with HIV.

KEYWORDS:

• Culture/cultural competence
• gender
• ethnicity
• HIV/AIDS
• marginalized population
• relationships
• research
• qualitative
• stigma
• transgender

ACKNOWLEDGMENTS

We would like to thank Tri-City Health Center and Tiffany Woods of the Transvision program, who enabled the recruitment of participants, and the organization Women Responding to Life-Threatening Diseases, who brought the need for these data to the attention of the primary author.