4 in 10 transgender women in seven major US cities have HIV: CDC

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[–]GConly 8 insightful - 1 fun8 insightful - 0 fun9 insightful - 1 fun -  (9 children)

The report which the CDC labeled as one of the most comprehensive surveys of transgender women in the U.S., found 62 percent of Black transgender women and 35 percent of Hispanic or Latina transgender women had HIV. Meanwhile, 17 percent of white transgender women have the disease.

Almost two-thirds of the respondents reported living at or below the poverty level, and 17 percent had no health insurance. More than 4 in 10 experienced homelessness over the past year and 17 percent had been in prison.

And 20% inside are registered sex offenders.

This article isn't looking at the demographics of them. There are a disproportionate number of black transwomen, and they get involved in prostitution and drugs at a way higher rate than is normal. There's also a very high level of mental illness in this group (as a comorbity) that lead to higher poverty and victimisation rates.

[–]MarkTwainiac 11 insightful - 1 fun11 insightful - 0 fun12 insightful - 1 fun -  (8 children)

More than 4 in 10 experienced homelessness over the past year and 17 percent had been in prison.

Are they saying that 17% had been in prison over the last year too? Or at any time in the past? (I posted the full report here yesterday but haven't looked through all the details yet.)

Trans advocacy organizations usually say that 50% or more of black & Hispanic TIMs have served time in prison in the past, and they usually say that about 10% have done so in the past year.

There are a disproportionate number of black transwomen, and they get involved in prostitution and drugs at a way higher rate than is normal.

Amongst the TIM population who are gay & bi in the US, a disproportionate are black & other racial minorities. But in the US, black & other minority race TIMs do not make up a disproportionate number of the TIM population overall.

The biggest risk for getting HIV is being a MSM who has condomless anal sex with other MSM, & the risk is FAR higher for those who "bottom."

For each condomless act with an untreated HIV-positive partner, the risk of infection has been estimated at 1.38% (one in 72 chance) and 0.11% (one in 909 chance) for the receptive and insertive partners respectively.

https://www.aidsmap.com/about-hiv/anal-sex-and-risk-hiv-transmission

Most males who have anal sex and "bottom" with other men for money also do it by choice for free, and many are promiscuous in the personal lives with many, many partners by choice. Whether a particular instance of sex is consensual or the result of prostitution doesn't make more or less risky in terms of virus transmission - the nature & roughness of the acts involved are what matter.

Unless the men they choose to have sex with always wear condoms, are on PrEP or have produced current negative HIV tests, and in "sex work" anything goes, I'd be very hesitant to leap to the conclusion that the only or principal way these men contracted HIV was when having sex for money. After all, not all of them do "sex work" - and those that do, don't necessarily do it FT; for many it's a PT or occasional thing, done only when they are especially hard up. Nor do men who work as prostitutes customarily do sex for hire exclusively. The sexual behavior patterns of males who do "sex work" is very different to the pattern of females who are prostituted.

Another big risk factor for HIV IV drug use. Which a lot of guys in this population do.

In addition, the risk of contracting HIV goes way up if the partner recently contracted the virus himself. Coz viral loads are much higher in the early phase of HIV infection.

[–]GConly 7 insightful - 1 fun7 insightful - 0 fun8 insightful - 1 fun -  (1 child)

A US gov prison data study had ever incarcerated at about 17%. So probably that.

The biggest risk for getting HIV is being a MSM who has condomless anal sex with other MSM, & the risk is FAR higher for those who "bottom."

And that's what male recklessness unbridled by sensible female caution leads too. Risky unprotected sex with stupidly high numbers of sex partners.

IIRC the odds of a black gay man getting HIV is 50/50. So the odds for a black TIM are higher, but not massively so.

I'm bloody horrified they are now allowed to donate blood, and are given the same risk as women.

Having hit Google though, the HIV rate for black women is 20 times higher than for white, yikes.

HIV incidence among Black women is more than 20 times that among White women and more than 4 times that among Hispanic women.

So, a little more:

some studies suggest that Black women are more likely to have risky sex partners and STDs. We also found that Black men are less likely to disclose their same-sex behavior to female partners.

Yikes again.

Looks like the rate of new black heterosexual women infections is about 1/3 that of black man, higher than black het men.

That can't be right, can it?

Yet more yikes.

[–]MarkTwainiac 8 insightful - 1 fun8 insightful - 0 fun9 insightful - 1 fun -  (0 children)

Yes, those rates amongst black women in the US are correct. Black men in the US and the rest of the world who have sex with other men often do so on "the down low" and do not disclose their same-sex activity (or IV drug use) to their female partners. Moreover, the relationships many men who are at high risk for contracting & spreading HIV tend to have with female people is often not healthy or mutual - rather, these relationships involve lots of male-to-female- coercion, rape & other forms of IPV assault.

In addition, in Africa many men believe that raping young virgins will cure men of HIV. Which is one of the myriad reasons why HIV has spread so fast amongst girls & young women in much of the world, why more than half the persons on the globe with HIV today are girls & women, & why girls & young women in many places are at much higher risk of contracting HIV than males of their same ages. In Africa, HIV is now considered a predominantly female disease.

https://www.un.org/africarenewal/magazine/october-2004/women-face-aids-africa

https://www.avert.org/professionals/hiv-social-issues/key-affected-populations/women

[–]JulienMayfair 5 insightful - 1 fun5 insightful - 0 fun6 insightful - 1 fun -  (5 children)

Efforts to control the spread of HIV have run into these same factors for the last 40 years. HIV educators and community activists managed to get the HIV transmission rate WAY down from its peak in the early 1980s, but at a certain point, the rate leveled out and has remained stubbornly flat. Nothing seems to change it, especially in the U.S. South where lack of education is a major factor. So really, none of this is new information. This was "Safer Sex" guidelines from 1987. It's like cigarette smoking or anything else like that. A certain percentage of people will not change their behavior no matter how you try to present the information to them or intervene in other ways. You can talk about the factors that have contributed to making people unreachable, but once that's the case, you can't necessarily do anything about it. You can't force people to listen to you or force them to change their behavior unless you want to implement a total police state.

[–]MarkTwainiac 11 insightful - 1 fun11 insightful - 0 fun12 insightful - 1 fun -  (4 children)

Yes, I know. I remember the 80s very well. The point I was trying to make is that the current HIV rates can't be attributed to TIMs doing sex work alone or even primarily, as some on this & other forums keep saying. Black TIMs in the US today, especially in the South & from the South, are at high risk because they engage in a variety of risky behaviors that intertwine. On top of that, they're loathe to get tested, & if/when they do find they are "poz," they are often non-compliant with treatment regimens & lax about taking precautions not to infect others. The usual excuse given is that they can't afford health care, & that the health care system will misgender & mistreat them. But in fact, a great many opportunities have been created to help them get tested & treated, & to get them PrEP as well. Moreover, the new delusion that "transwomen are women" seems to be adding to the resistance... But the upshot is, as you say, like with drugs, booze & gambling, there's always a certain percentage of people who will carry on heedless regardless of what outreach, education & free health care are made available to them.

[–]pacmanla 5 insightful - 1 fun5 insightful - 0 fun6 insightful - 1 fun -  (2 children)

Are there many black TIMs in the south? I would guess they're higher in liberal coastal cities (particularly California). Only place I could guess is Atlanta? As a black male, with family in the south, most black trans identified men I meet are in Liberal enclaves not the south.

[–]JulienMayfair 6 insightful - 1 fun6 insightful - 0 fun7 insightful - 1 fun -  (0 children)

Are there many black TIMs in the south?

They certainly exist. They tend to be gay black male crossdressers as opposed to AGP white males. The thing is, you probably move in different social circles. I've read several studies over the last decade about the challenge of trying to slow HIV transmission among black communities in the Deep/rural South. HIV educators have been trying to target prevention strategies to these communities for 30 years without a great deal of success.

[–]MarkTwainiac 6 insightful - 1 fun6 insightful - 0 fun7 insightful - 1 fun -  (0 children)

In the US, a lot of black TIMs are gay boys & men born & raised in the South who come from very conservative & homophobic Christian households & communities, often very small towns and rural areas. Those who have the money & wherewithal to leave tend to migrate to urban areas elsewhere in the south, such as in Florida, or to cities in the north like NYC or LA. The Jacksonville & Miami areas in Florida, as well as Dallas and Houston Texas, are just a few of the places in the US South that come to mind that are known to have sizable contingents of black TIMs.

This black TIM's journey from Georgia to NYC shows a typical TIM migration pattern: https://www.nytimes.com/2015/12/13/us/kricket-nimmons-transgender-surgery.html

[–]JulienMayfair 4 insightful - 1 fun4 insightful - 0 fun5 insightful - 1 fun -  (0 children)

I think we're on the same page.