Effective and Meaningful Inclusion of Trans and Gender Diverse People in HIV Prevention

Trans and gender diverse populations are being increasingly recognised by international bodies as a key priority population in the global HIV response. However, in Australia, surveillance systems developed to inform the public health apparatus and community responses, have failed to accurately capture HIV prevalence among trans and gender diverse populations. Trans and gender diverse people also face specific and unique HIV risks, including the physical effects of hormones on their susceptibility to HIV, risk of sexual assault, criminalisation, and transphobia, which can contribute to social and economic disadvantage and affecting people’s capacity to negotiate safer sex practices. Transphobic attitudes and practices in health care settings mean that trans populations face barriers to safe, appropriate and relevant care. Trans and gender diverse experiences, histories and identities necessitate administrative changes to the existing process of data collection and knowledge management. This paper discusses the available evidence and makes a number of policy recommendations to strengthen the HIV response for trans and gender diverse people in NSW. We call to amend the HIV surveillance system and to reform the legal, social and funding environments that affect access to HIV prevention, treatment and care. We recommend the establishment of national clinical guidelines on trans-Inclusive care and that trans and gender diverse people be recognised as a population at high risk, with unique needs, in the NSW HIV Strategy and Australia’s National HIV Strategy