Around the globe, black trans folks are minimized within oppressive political climates, healthcare systems which default to excluding the LGBT folks; capitalist economic and binary social structures, and legislative policy frameworks that seek to the community’s rise to some semblance of liberation. The World Health Organization (WHO) posits that “Transgender women are around 49 times more likely to be living with HIV than other adults of reproductive age with an estimated worldwide HIV prevalence of 19 per cent; in some countries the HIV prevalence rate in transgender women is 80 times that of the general adult population.”
As many of you might know, the Caribbean is generally composed of black and indigenous LGBT folks across spread across different physical, political, social, cultural, economic and legislative contexts that result in the proliferation of HIV transmission among key populations, unemployment, homelessness/displacement, stigma and discrimination and violence. UNAIDS through its data collection mechanism reports that the Caribbean is second to sub-Saharan Africa in the prevalence of HIV, despite great strides made in 2019 to reducing new HIV infections and AIDS-related deaths.
Within the National HIV Response in Jamaica, most of the focus of the health needs of the trans community has generally been on transgender women as a key population for HIV prevention, treatment, care and support, supported by international and donor agencies (UNAIDS, UNFPA, Global Fund, PEPFAR, WHO, among others). The HIV prevalence rate among black trans women stands at 51%, with little data about transmasculine and gender non-binary folks.
In Jamaica, a wide range of CSOs, NGOs in addition to the public healthcare system provides healthcare services that meet the needs of the community across HIV/AIDS prevention, treatment and care including services such as condom distribution, PrEP, HIV Counselling, HIV-related legal services and more. There are also spaces that offer gender affirming medical care including access to HRTs; mental healthcare; housing and access to legal aid.
As a local community we are stuck between surviving and living in a system that forces some of us to engage in sex work for survival to access basic things that should be afforded to all human beings, such as food and a place to lay our heads.
This Black AIDS Day, I call for the Jamaican government and by extension the Caribbean heads of government, NGOs, healthcare workers to wake up and recognize the need for further structural interventions that meet the needs of trans persons living in Jamaica to free us from meaningless solutions and strategies that reduce us to just statistics.
Here’s how we can rethink HIV programming in our national HIV responses based on TransWave’s National Health Strategy designed to guide the Jamaican health system:
- Develop the organizational capacity of CSOs offering trans-inclusive healthcare and HIV prevention, treatment and care.
- Address the growing number of human rights violations and archaic laws which oppress trans folks.
- Develop legislation to affirm, protect and include us in policy and structural frameworks, data collection.
- Scale up structural interventions to address the social needs of trans folks including access to gender affirming medical care
It’s time to do less talk and get solutions based for 2021 around HIV/AIDS.
Happy Black AIDS Day!
In love and liberation,
MX Leo Williams.