Cross-posted from Centers for Disease Control and Prevention

April 18, 2020

Dear Colleague,

As our country continues to battle the COVID-19 pandemic, it is now more important than ever that we continue to work together to ensure our health and safety, as well as the health and safety of our loved ones and neighbors. Today is National Transgender HIV Testing Day and an opportunity to acknowledge how the HIV prevention community and the transgender community have a long history of working side-by-side and lifting each other up in times of crisis. Much in the same way that advocates and activists were paramount in changing the course of HIV, the HIV prevention and transgender communities must come together today—facing a crisis with a different name—and resolve to do what is necessary to defeat the spread of this virus.

Although the risk of serious illness from COVID-19 for people with HIV is not known, people who are immunocompromised may be at higher risk.

• People with HIV should take everyday preventive actions to help curb the spread of the virus.
• For people who have HIV and are taking HIV medicine, it is important they continue their recommended treatment and follow the advice of their health care providers.
• For people with undiagnosed HIV, testing is the first step in maintaining a healthy life and reducing the spread of HIV. But life as we know it has been seriously disrupted by the pandemic and access to HIV testing and other services may be delayed or temporarily unavailable.

The Centers for Disease Control and Prevention (CDC) is currently examining options for how best to ensure the delivery of HIV prevention services in the context of this pandemic. During these unprecedented times, it is important that we come together not only to confront the pandemic but also to acknowledge National Transgender HIV Testing Day.

National Transgender HIV Testing Day, established by the Center of Excellence for Transgender HealthExit Disclaimer at the University of California, San Francisco, provides an opportunity to promote HIV testing, prevention, and treatment efforts for transgender communities and to work with transgender and gender non-binary people to reduce HIV-related health disparities and improve health. Transgender people are at high risk for getting HIV:

• From 2009 to 2014, of the 2,351 transgender people who received an HIV diagnosis in the United States, 84% were transgender women, 15% were transgender men, and less than 1% had another gender identity. Around half of transgender people who received an HIV diagnosis lived in the South.
• A 2019 systematic review and meta-analysisExit Disclaimer found that an estimated 14% of transgender women have HIV. By race/ethnicity, an estimated 44% of black/African American transgender women, 26% of Hispanic/Latina transgender women, and 7% of white transgender women have HIV.

Expanding culturally appropriate, focused HIV testing efforts is one key to eliminating these disparities and reducing HIV’s impact on transgender communities. As we approach National Transgender HIV Testing Day during this pandemic, the availability of HIV self-tests may help increase awareness of HIV infection for people who cannot otherwise get an HIV test at this time. HIV self-testing allows people to take an HIV test and find out their result in their own home or other private location. While HIV self-tests are available for retail purchase by consumers, CDC encourages health departments and community-based organizations to consider HIV self-testing as an additional testing strategy to reach persons most affected by HIV.

Everyone with HIV benefits from getting a diagnosis as early as possible and starting treatment right away. People with HIV who take antiretroviral therapy as prescribed and stay virally suppressed can live long, healthy lives and have effectively no risk of sexually transmitting HIV to partners. For transgender people at risk of getting HIV but who do not have the virus, testing can provide options for effective prevention like pre-exposure prophylaxis (PrEP).

Many transgender people face obstacles that make it harder to access HIV services—such as stigma and discrimination; inadequate employment, transportation, or housing; and limited access to welcoming, supportive health care. Addressing these barriers is essential to the health and well-being of transgender people and to meeting national health goals, including goals that are part of the federal initiative Ending the HIV Epidemic: A Plan for America. CDC is committed to working with partners to make sure all transgender people can get the tools they need to prevent HIV and stay healthy if they have HIV. Please see CDC’s fact sheet on HIV and transgender people for more information on CDC’s programs for community-based organizations, surveillance activities, prevention interventions, and communications campaigns focused on transgender populations.

As we continue to battle this pandemic together, CDC recommends that transgender and gender non-binary people with HIV continue to maintain a healthy lifestyle. This includes:

• Eating right,
• Getting at least 8 hours of sleep,
• Continuing to take medications to ensure viral suppression, and
• Finding ways to cope with stress.

During this year’s National Transgender HIV Testing Day, we encourage you to review CDC’s factsheet HIV and Transgender People and the HIV and COVID-19 FAQs. Please share these resources widely with your colleagues, friends, and family.

Thank you for the hard work you are doing to stop HIV in the transgender community. I wish you good health and ongoing support in these challenging times.

Sincerely,
/Eugene McCray/
Eugene McCray, MD
Director
Division of HIV/AIDS Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
www.cdc.gov/hiv

/Jonathan Mermin/
Jonathan H. Mermin, M.D., MPH
Rear Admiral and Assistant Surgeon General, USPHS
Director
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
www.cdc.gov/nchhstp