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JoAnne G. Keatley, MSW Center of Excellence for Transgender Health:

Developing Programs to Sensitize Providers to the Unique HIV and Health Needs of Transgender People. JoAnne G. Keatley, MSW Center of Excellence for Transgender Health: University of California, San Francisco, United States.

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JoAnne G. Keatley, MSW Center of Excellence for Transgender Health:

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  1. Developing Programs to Sensitize Providers to the Unique HIV and Health Needs of Transgender People JoAnne G. Keatley, MSW Center of Excellence for Transgender Health: University of California, San Francisco, United States

  2. Our mission is to increase access to comprehensive, effective, and affirming healthcare services for trans and gender-variant communities.

  3. National Advisory Board We include community perspectives by actively engaging a national advisory body (NAB) of 12 trans identified leaders from throughout the country.

  4. Primary Projects • CATCH • Transitions Project • Primary Care Protocols • International Project • Sheroes Intervention

  5. Who We Are Globally Travestís, Transvestites, Transsexuals, Transgender, Hijra, Ali, Arvani, Kothis, Metis, Mak Nyahs, Mukhannis, Kathoey, Mahuwahine, Fa’afafine, Sistergirls, Waria, Muxhe, Mujeres Differentes

  6. Transsexual Population Estimates Overall Prevalence MtF Prevalence FtM Prevalence MtF/FtM Ratio Country Study & Year Weitze C., & Osburg, S., 1996

  7. HIV Prevalence Estimates among Trans People in the US Herbst et al., 2008

  8. Global Trans HIV Prevalence Estimates

  9. Best Practices Course • Created in order to address the urgent HIV prevention needs of trans people by building capacity of: • Health care professionals • Social services professionals

  10. How did the CoE come up with the eight best practices?

  11. Background (Cont’d) • Literature & Internet Search • Identified 24 Trans HIV Prevention Programs in California • Contacted all programs • Distributed questionnaire

  12. Best Practices Course • Theoretical Framework: • Adult Learning Theory • Social Cognitive Theory • Empowerment Model • Social Action Model

  13. Best Practices Course: Learning Objectives

  14. Best Practices for Transgender HIV Prevention

  15. 1. Ground Your Work in the Community • Develop partnerships with trans people and organizations

  16. 2. Race & Ethnicity: One Size Does Not Fit All • Like other groups, HIV risk in trans people is compounded by racial discrimination

  17. 3. Use Multidisciplinary Approaches

  18. 4. Get the Facts! Assess, Evaluate & Enhance

  19. 5. Look in All the Right Places • Trans-specific recruitment and retention strategies

  20. 6. Increase Access to Health Care • Collaborate with local health care providers who: • Have easily accessible or multiple locations • Provide services in multiple languages • Understand trans HIV and health care issues • Provide hormone therapy as part of primary care

  21. 7. Invest In Developing and Supporting Your Staff • Prioritize staff development • Build staff capacity • Create opportunities for advancement

  22. 8. Advocate for Structural & Systemic Changes • Advocate for policy changes alongside trans people. Examples Include:

  23. Primary Care Protocol Project: Medical Advisory Board Dan Karasic, MD R. Nick Gorton, MD James Franicevich, NP Marvin E. Belzer, MD, FACP, FSAM Lori Kohler, MD Maddie Deutsch, MD Jennifer Hastings, MD Jennifer Burnett, MD Jennifer Vanderleest MD, MSPH

  24. Patient Intake • What is your current gender or gender identity? • Male • Female • Transgender Male/Transman • Transgender Female/Transwoman • Genderqueer • Other: please specify___________ • Decline to state

  25. Patient Intake • What sex were you assigned at birth? • Male • Female • Decline to state

  26. Patient Intake • What pronouns do you prefer? • Fill-in-the-blank • He, she; hir, ze, they, etc.

  27. Challenges Encountered • What challenges will/might/have you encounter(ed)? • Interpersonal • Individual • Community • Structural • How would/did you resolve those challenges?

  28. References Belza M, Llacer A, Mora R, de la Fuente L, Castilla J, Noguer I, & Canellas S. (2000) Social characteristics and risk behaviors for HIV in a group of transvestites and male transsexual engaging in street prostitution. Gaceta Sanitaria, 14(5), 330-7. Galli M, Esposito R, Antinori S, Cernushi M, Gianelli F, Cargnel A, Quirno T, Innocenti M, & Marozzi F. (1991) HIV-1 Infection, tuberculosis and syphillis in male transsexual prostitutes in Milan, Italy. Journal of Acquired Immune Deficiency Syndromes, 4(10), 1006-7. Gattari P and Spizzichino L. (1992) Behavioural Patterns and HIV Infection Among Drug Using Transvestites Practicising Prostitution In Rome. AIDS Care, 4(1), 83-87.Netherlands Inciardi, J., Surratt, H., Telles, P., & Pok. B. (1999) Sex, Drugs, and the Culture of Travestismo in Rio de Janeiro. International Journal of Transgenderism, 3 (1+2) January-June 1999. Available online at: http://www.symposion.com/ijt/hiv_risk/inciardi.htm

  29. References Khan A, Bokhari A, Nizamani N, Rehan N, & Khan A (2006) Differences in Sexual Behaviors of Male Commercial Sex Workers (MSWs) and Transgenders/Transvestites (Hijras) In Pakistan. Poster discussion: AIDS 2006 - XVI International AIDS Conference: Abstract no. TUPDD07" Kumta S, Lurie M, Gogate A, Jerajani H, Weitzen S, Kavi A, Anand V, Makadon H, & Mayer K. (2006) Sexual risk behavior and HIV prevalence among male-to-female transgendered people seeking voluntary counseling and testing services in Mumbai, India. Oral abstract session: AIDS 2006 - XVI International AIDS Conference: Abstract no. MOAD0303. Modan B, Goldschmidt R, Rubenstein E, Vonsover A, Zinn M, Golan R, Chetrit A, & Gottlieb-Stematzky T. (1992) Prevalence of HIV Antibodcies in Transsexual and Female Prostitutes. American Journal of Public Health, 82(4), 590-2.

  30. References Palwade P, Jerajani H, Ashok R, Shinde S, & Vivek A. (2004) Prevalence of HIV infection and sexually transmitted diseases amongst MSM population in Mumbai, India. CD Only: The XV International AIDS Conference: Abstract no. C10822. Pisani E, Girault P, Gultom M, Sukartini N, Kumalawati J, Jazan S & Donegan, E. (2004) HIV, syphilis infection, and sexual practices among transgenders, male sex workers, and other men who have sex with men in Jakarta, Indonesia. Sexually Transmitted Infections 80(6): 536-40. Ponnusamy, A. (2006) Behavioral research / interventions. AIDS 2006 - XVI International AIDS Conference: Abstract no. CDC0968 Tumer, A., Kilickaya, B., & Akturkoglu, E. (2010) HIV/AIDS research and testing among sex workers in Turkey. AIDS 2010 – XVIII International AIDS Conference: retrieved from: http://pag.aids2010.org/Abstracts.aspx?AID=8319

  31. References Van Veen M, Hofhuis A, van der Helm T, Götz H, Prins M, & van de Laar M. (2006) Substantial risk behaviour among transgender sex workers in the Netherlands. AIDS 2006 - XVI International AIDS Conference: Abstract no. MOPE0478. Weitze C. & Osburg, S. (1996) Transsexualism in Germany: Empirical Data on Epidemiology and Application of the German Transsexuals’ Act During Its First Ten Years. Archives of Sexual Behavior, 25: 419. Wimonsate W., Naorat S., Varangrat, A., Phanuphak, P., Kanggarnrua, K., McNicholl, J., Tappero, J., van Griensvn, F., Siraprapasiri, T., and the Thailand MSM Study Group (2005). Risk behavior, hormone use, surgical history and HIV infection among transgendered persons (TG) in Thailand, 2005. AIDS 2006 - XVI International AIDS Conference: Abstract no. MOPE0349

  32. www.facebook.com/transhealth JoAnne Keatley, MSW JoAnne.Keatley@ucsf.edu www.transhealth.ucsf.edu

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