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Reflections on National Transgender HIV Testing Day

JoAnne Keatley headshot

JoAnne Keatley

The inaugural National Transgender HIV Testing Day (NTHTD) on April 18 marked a milestone for members of the trans community, who face high HIV impact. Almost a year in the making, this awareness day is the result of efforts led by JoAnne Keatley, Director, Center of Excellence for Transgender Health at the University of California, San Francisco (UCSF), with her CBA (Capacity Building Assistance) team (project coordination was led by Jenna Rapues, MPH), numerous community and other leaders.

As JoAnne, one of the trans community’s leading voices, prepares for retirement from UCSF we want to share an important conversation about her key role related to NTHTD.

Here is what we heard from JoAnne about NTHTD, the critical need for gender-affirming, comprehensive health services for trans women, and how increased HIV awareness can help overcome stigma.

Why is NTHTD important  – for the transgender community and for the general public?

HIV is an issue that really impacts so many trans women, yet it has not been well understood in our community until now. Owing to a lack of data, and faulty gender identity markers, few HIV interventions exist for our community. Despite the high impact we face, trans people have not felt that testing led to services tailored for them. We hope NTHTD will lead to higher levels of HIV testing, but–just as important–also lead to linkages to care services if they test positive, or preventive services if they test negative.

NTHTD is also an opportunity for non-trans people to understand how heavily our community is impacted, in order to better respond to our service needs. The day can provide an opportunity to have conversations about many issues that affect trans women, including both HIV-related and other types of stigma, employment, and dating. These conversations can help non-trans people to be more sensitive to all the challenges we face.

Essentially, both trans and non-trans people need better tools to have conversations about HIV, and I believe NTHTD is a good starting point.

What were some of the highlights and challenges with launching NTHTD?

The three significant challenges we faced as we worked to launch NTHTD were structural. First, with large gaps in reliable data, it was hard to meaningfully describe the impact of HIV and the need for testing among trans women – of all races. Then, creating a new HIV awareness day and inserting it into the framework of existing awareness days requires national-level buy-in from multiple stakeholders, both from within and outside the trans community. When you launch something, it’s on you to get buy-in, and we worked hard to achieve that! Lastly, along with conversations about the impact of HIV on trans women also comes our fear of creating more stigma for trans women. It has been a delicate balance – to create conversations about HIV but not exacerbate the stigma.

When I reflect on the launch of  NTHTD, I feel our successes were multi-fold! We were very pleased to see the level of willingness from federal partners to work with us. Multiple branches of the CDC came together to help make this happen, and HRSA was very willing to share the information and get the word out. We had support from some of our CBA partners.

State and local health departments really came on board and took their own lead to promote the awareness day in their communities. We were so pleased with that level of buy-in. And social media created great opportunities to extend the conversation; the Twitter chat participants and the women from I AM Cait created a very public discussion about the needs of trans women by trans women. And getting trans and HIV community buy-in was important for me. There are a lot of competing priorities and to me the greatest success was how people made NTHTD their own. It made our team feel that raising awareness of the need for  testing was on people’s minds.

You can learn more and continue conversations around HIV testing for trans women here. The Center of Excellence for Transgender Health will be creating an  NTHTD summary report. Stay tuned!

Editor’s Note: AIDS.gov is proud to support efforts to create awareness for National Transgender HIV Testing Day. Today is National HIV Testing Day, and we are reminded of the importance of knowing one’s HIV status by getting tested. For more information, visit the NHTD page on AIDS.gov. We also encourage you to use and share the HIV Testing and Care Services Locator on and around NHTD.