HRSA's HIV/AIDS Bureau has multiple initiatives underway to support transgender individuals living with HIV, who comprise about 1.1% of Ryan White HIV/AIDS Program (RWHAP) clients, according to the RWHAP Annual Client-Level Data Report, 2015. Transgender client HIV care needs parallel those of the broader RWHAP client population in that they reflect challenges faced by economically disadvantaged minorities who often must grapple with housing issues as well lack of access to health insurance.

Clinical Outcomes

RWHAP transgender clients have lower rates of viral suppression and retention in care as compared to the overall RWHAP client population. According to the 2015 RSR report:

• Transgender adults and adolescents (Tables 16a/b): Overall, retention in care (78.7%) for transgender adults and adolescents was consistent with the national RWHAP average (80.6%), while viral suppression (77.3%) was lower than the average (83.4%).
• Transgender women (transgender male-to-female clients) have the lowest percentages of viral suppression across gender subpopulations. In 2015, 77.0% of transgender women had achieved viral suppression (Table 13a), which reflects a 12 percentage point increase from 2011 through 2015.

HRSA Transgender Initiatives

Special Projects of National Significance

Beginning in 2012, HRSA embarked upon a Special Projects of National Significance initiative to investigate innovations in HIV care for transgender individuals. That effort, Enhancing Engagement and Retention in Quality HIV Care for Transgender Women of Color Initiative is a multi-site demonstration and evaluation of HIV service delivery interventions for transgender women of color." Based at the University of California, San Francisco, the Transgender Evaluation and Technical Assistance Center (TETAC) for the initiative is also coordinating 2017 National Transgender HIV Testing Day (NTHTD) activities, which include campaign materials for NTHTD as well as a Toolkit with facts, research and best practices.

National Transgender HIV Testing Day is April 18

Transgender Health

His Health is a HRSA-funded project that brings together healthcare providers and advocates to improve the standard of care for Black gay men. One of their continuing education online programs is focused on Transgender Health. Learn more.

 

Building Care/Prevention Capacity: HIV Care Continuum in Southern Metro Areas

This new project, started in 2016, is funded under the Secretary’s Minority AIDS Initiative Fund, which will implement innovative models of service delivery to improve minority population health along the HIV care continuum. The focus will be on men who have sex with men (MSM), youth, cisgender and transgender women, and people who inject drugs (PWID).

Leadership Training for People of Color Living with HIV

Called BLOC, this project also started in 2016 and is training people of color living with HIV to participate in RWHAP planning bodies, medical and support care teams, boards of directors, and other mobilization efforts to address the goals of the National HIV/AIDS Strategy: Updated to 2020. The project will also support leadership development for transgender women of color and support expansion of the capacity of HIV prevention and care delivery systems.

The Southern Metro Area and BLOC projects described above were among a handful of new technical assistance and training projects funded by HRSA's HIV/AIDS Bureau in late 2016. These efforts include a focus on populations hit hardest by HIV, including transgender individuals. Learn more about these projects.