Transgender Inclusion Is Needed in HIV National Strategic Plans

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A New Report Promotes the Inclusion of Transgender Individuals in HIV National Strategic Plans
by Hank Trout

On June 7, 2021, amfAR, The Foundation for AIDS Research, the Elton John AIDS Foundation, and the trans-led organization GATE released new infographics highlighting transgender inclusion in national HIV planning documents from around the world.

HIV National Strategic Plans (NSPs) dictate a country’s overall response to the HIV/AIDS pandemic. Considered to be “epidemiologically sound,” NSPs ensure that all high-risk populations receive appropriately tailored programming and funding. Worldwide, transgender people are disproportionately impacted by HIV, but are historically absent from NSPs. Meaningful inclusion in an NSP requires inclusion in five sections: the plan’s narrative/background, epidemiological data, targets/indicators, activities, and budgets. Among the three dozen or so NSPs reviewed, only five countries’ NSPs mention transgender people in all five sections of their NSPs.

Asked about the sparse inclusion of transgender individuals in these countries’ NSPs, Jennifer Sherwood, Public Policy Manager at amfAR, told A&U, “Unfortunately, our world is still plagued by transphobia and homophobia that can get in the way of sound policy. The epidemiological data on high HIV risk among trans populations is clear, and if NSPs were solely based on epidemiological data we would see trans people included in every country’s plan. However, NSPs are political documents and often reflect the political priorities of a country. If trans people are not afforded equal rights, protections, or recognition in a country’s laws it is less likely that they will be a priority population in the HIV response.”

Fact sheet: Transgender Inclusion in HIV National Strategic Plans: Eastern and Southern Africa

The study examined NSPs from countries in five regions: Eastern Europe and Central Asia; Asia and the Pacific; Eastern and Southern Africa; Latin America and the Caribbean; and Western and Central Africa. Researchers found that:

• In Eastern Europe and Central Asia, only three of the seven NSPs reviewed mention transgender people in at least one key section; none mentioned them in all key sections.

• In Asia and the Pacific, eleven of the thirteen NSPs reviewed included transgender people in at least one section; only three mentioned them in all key sections.

• In Eastern and Southern Africa, eleven of the sixteen NSPs reviewed included transgender people in at least one section; but none mentioned them in all key sections.

• In Latin America and the Caribbean, eight of the nine NSPs reviewed mentioned transgender people in at least one section; only one mentioned them in all key sections; and

• In Western and Central Africa, six of the fifteen NSPs reviewed addressed transgender people in at least one section; only one mentioned them in all key sections.

The countries that included transgender folks in all five of the key sections are Pakistan, Fuji, Malaysia, Dominican Republic, and Democratic Republic of the Congo. They were far outnumbered by the countries that make no mention of transgender people in their NSPs.

The exclusion of transgender folks in these countries’ NSPs impacts the worldwide fight against the HIV/AIDS pandemic. Sherwood again: “The HIV response is hurt when we don’t follow the science. Transgender people are a key population in the fight against HIV—meaning that they face not only disproportionality high rates of HIV, but also criminalization and policy barriers to services. We won’t see the end of the HIV pandemic without reaching trans people with population-specific services that reaffirm their gender identity. Fully including trans people in NSPs is a good first step to indicate the political will to reach this goal.”

Effecting the inclusion of trans populations in all aspects of HIV/AIDS policy, research, and treatment will require local, state, national, and international collaboration. “First, the international HIV community can fund research for and by trans people around the world,” Sherwood told A&U. “Exclusion of trans people from NSPs is often justified by the lack of country-specific data, so making trans people visible in HIV data is a priority. Second, the international HIV community can support the trans advocates and activists who have been fighting for rights in their countries for a long time. Resourcing local or regional trans groups to interface with their government with international support can help effect change. Powerful international HIV funders such as PEPFAR, the Global Fund, and UNAIDS can also make their support of trans populations clear through funding allocations, strong statements of support, and making trans inclusion a key focus of their government relations work.”


A PDF file of the infographic “A Neglected Population: Transgender Inclusion in National HIV Plans” can be found at https://www.amfar.org/A-Neglected-Population/. For more information about the three organizations involved, log on to: www.amfar.org; https://gate.ngo/; and www.eltonjohnaidsfoundation.org.


Hank Trout, Senior Editor, edited Drummer, Malebox, and Folsom magazines in the early 1980s. A long-term survivor of HIV/AIDS (diagnosed in 1989), he is a forty-year resident of San Francisco, where he lives with his husband Rick.