In a recent study of ten low-income and middle-income countries, the prevalence of HIV in transgender women was found to be incredibly high, at nearly 18%. Transgender women who engage in sex work are especially vulnerable, and most in need of prevention, treatment, and care.
This World AIDS Day, if we truly want to close the gap, we must work together to put the needs of our most vulnerable communities at the forefront of the fight.
In the Dominican Republic, a small island nation situated in the Caribbean – the region with the second highest HIV prevalence in the world after sub-Saharan Africa – the Transgender and LGBT communities face harsh structural stigma and discrimination, making it nearly impossible for them to access health services or lead “normal” lives.
Like in much of the developing world, homosexuality continues to be criminalized in the Dominican Republic. Not only that, but the stigma associated with being gay is still exceptionally harsh. For example, in a local newspaper earlier this year, one headline read, “Two women kiss on the boardwalk as if they were in their own home, provoking curious stares”.
As we know, if a community of people isn’t accepted by broader society – either because of their identity or sexual practices or behaviour – they are driven further underground, further marginalized and pushed to the fringes of society. This not only means that there are fewer structures to protect them and their human rights, but also that it is far more difficult to access health services – especially for people with HIV, who are doubly stigmatized.
If you identify as transgender, for example, attending university or finding a job are extremely difficult, simply because faculty or employers won’t accept you as you are, and you become the subject of ridicule, rejection, or hate speech. Nearly 30% of gay or transgender people in Santo Domingo experience workplace discrimination, and over 45% experience rejection in school or at university, over 20% in the family, and over 16% in health services.1
It’s for this reason – that it’s so often impossible to find a job or attend university while maintaining one’s identity – that Transgender women turn to sex work as an alternative. This, in turn, leads to increased vulnerability when Trans women must put themselves in dangerous situations.
Between December 2013 and October 2014, there have been 17 cases of transgender human rights violations reported to the Human Rights Observatory for Vulnerable Groups, indicating multiple cases of arbitrary arrest, police violence, and extortion.2
In one instance, two police officers verbally and physically assaulted a Transgender sex worker named Maria. The police detained the sex worker’s client and then asked for Maria’s money. When she refused, they tied her hands with a belt and beat her until she was unconscious. Afterwards, they took her to a hospital and then detained her until the next day at a police station.3
In order to banish HIV, we need to first banish fear of difference. We need to work with institutional power bearers, governments, and law enforcement officials – those who are designated with the responsibility of protecting the most vulnerable members of our communities – to sensitize them to people who are different, but who are just as deserving of respect and human rights.
When these women are pushed underground, they do not seek the health services and treatment they need, and if they don’t seek the treatment they need, then we will never see an end to the HIV epidemic.
What’s more: when Transgender women are told again and again that who they are is bad, different and shameful, it not only pushes them further underground, but it destroys their self-worth. As privilege holders, it’s our duty to clear a space for them to come into the light. Not only so that the human rights of Trans women may be recognized, but so that they themselves may be recognized as people worthy of dignity and respect.
1 CONAVIHSIDA (2012), p.54, Tabla GTH7: Violencia, stigma y discriminación según provincial de residencia
2 Human Rights Observatory for Vulnerable Groups, Discrimination and violence towards Transgender women in the Dominican Republic, p.4
3 Human Rights Observatory for Vulnerable Groups, Discrimination and violence towards Transgender women in the Dominican Republic, p.7