"I was born a boy but in my mind I'm a girl. People need to be open, stop judging us, let us wear (clothes) the way we feel so that we can be comfortable and enjoy our lives." These are the words of Flavirina Naze, a transgender woman sex worker who attended the AIDS 2016 conference in Durban last week, which highlighted that in some countries transgender women are the fastest growing population of HIV positive people.
The topic of transgender rights and HIV was addressed at a press conference examining how discriminatory laws and policies in many parts of the world hinder access to HIV prevention and treatment of the populations most at risk of HIV infection.
Discrimination and stigma are known to fuel the HIV epidemic, and for vulnerable groups such as transgender people and men who have sex with men, ending this discrimination is critical; not just for dignity but for reducing the spread of HIV. Transgender women have the problem of integrating in society and their community because of prejudice about their identity.
Chris Beyrer AIDS 2016 international chair and president of the International AIDS Society said in a press release: "Protecting human rights is not just a moral issue, it is a scientific issue. Research presented at this conference will demonstrate that exclusion and discrimination help fuel the spread of HIV.
"We will not end AIDS without addressing the needs of the most vulnerable individuals and communities, yet far too many are currently being left behind," he added.
Evidence shows that transgender women are at high risk of HIV infection. Among the 3.3 million HIV testing events reported to Centers for Disease Control and Prevention in 2013, the highest percentages of newly identified HIV-positive people were among transgender people. In 2013, a meta-analysis (Baral et al.) reported that the estimated HIV prevalence among transgender women was 22 per cent in five high-income countries, including the United States. It was also reported that many transgender women living with HIV do not know their HIV status.
Why are HIV rates increasing among transgender people? One reason is that the lack of legal recognition of gender identity can result in the denial of educational, employment, and housing opportunities. Transgender women are sometimes forced to leave school because teachers want them to dress like men and do not let them mix with girls at school. Many leave school to take up sex work because they are treated better, they feel valued and they have their place as women in their communities. Some transgender people who experience poverty rely on sex work to meet their basic survival needs. Sex work puts them at greater risk of HIV.
Many transgender people are frightened to go to clinics for HIV services, because there is a lot of stigma, and they are not informed enough about HIV transmission and prevention. One service provider at the transgender stand at the Durban International Convention Centre noted the cultural blocks in Africa which prevent transgender women from accessing services. She said: "Instead of responding to their needs, we start judging them with prejudice."
Zana Chetty a 24-year-old transgender woman from South Africa said: "We are human, we need more rights." Abhina Aher, a transgender woman from India expressed her concern and said: "We don't want to be left behind."