HIV and Transgender People: What CDC Is Doing

Español (Spanish) | Print

CDC is pursuing a high-impact HIV prevention approach to maximize the effectiveness of HIV prevention interventions and strategies for transgender people. Funding state, territorial, and local health departments and community-based organizations (CBOs) to develop and implement tailored programs is CDC’s largest investment in HIV prevention. This includes longstanding successful programs and new efforts funded through the Ending the HIV Epidemic in the U.S. initiative. In addition to funding health departments and CBOs, CDC is also strengthening the HIV prevention workforce and developing HIV communication resources for consumers and health care providers.

In 2022, CDC will fund organizations to work in clinics that serve transgender people and partner with transgender-serving CBOs to develop community-to-clinic models for integrated status-neutral HIV prevention and care services and gender-affirming services, including hormone therapy and primary health care.
In 2021, CDC released a National HIV Behavioral Surveillance (NHBS) report [PDF – 2 MB] that used NHBS methods to conduct a behavioral interview and HIV testing among transgender women (NHBS-trans).
In 2020, CDC released national HIV surveillance reports by gender which include data for transgender people for three Ending the HIV Epidemic in the U.S. core indicators: diagnoses of HIV infection, linkage to HIV medical care, and viral suppression. CDC will continue to provide core indicators by gender in future surveillance reports.
Under the integrated HIV surveillance and prevention cooperative agreement, CDC awards around $400 million per year to health departments for HIV data collection and prevention efforts. This award directs resources to the populations and geographic areas of greatest need, while supporting core HIV surveillance and prevention efforts across the US.

In 2019, CDC awarded $12 million to support the development of state and local Ending the HIV Epidemic in the U.S. plans in 57 of the nation’s priority areas. To further enhance capacity building efforts, CDC uses HIV prevention resources to fund the National Alliance of State and Territorial AIDS Directors (NASTAD) with $1.5 million per year to support strategic partnerships, community engagement, peer-to-peer technical assistance, and planning efforts.
In July 2019, CDC awarded $4.5 million from the Health and Human Services’ Minority HIV/AIDS Fund to jumpstart key HIV prevention and treatment activities in Maryland (Baltimore City), Georgia (DeKalb County), and Louisiana (East Baton Rouge). In addition, CDC awarded Jumpstart Sites an additional $1.3 million of sexually transmitted disease (STD) prevention funds in September 2019 to rapidly scale-up HIV prevention services in STD specialty clinics. The lessons learned from these sites should inform CDC and other jurisdictions regarding the early activities that could be implemented to ensure success in ending the HIV epidemic in each participating local jurisdiction.
In 2020, CDC awarded $109 million to 32 state and local health departments that represent the 57 jurisdictions across the United States prioritized in the Ending the HIV Epidemic in the U.S. This award supports the implementation of state and local Ending the HIV Epidemic in the U.S. plans.
Under the flagship community-based organization cooperative agreement, CDC awards about $42 million per year to community organizations. This award directs resources to support the delivery of effective HIV prevention strategies to key populations, including transgender people.
In 2017, CDC awarded nearly $11 million per year for five years to 30 CBOs to provide HIV testing to young gay and bisexual men of color and transgender youth of color, with the goal of identifying undiagnosed HIV and linking those who have HIV to care and prevention services.
In 2019, CDC awarded a cooperative agreement to strengthen the capacity and improve the performance of the nation’s HIV prevention workforce. New elements include dedicated providers for web-based and classroom-based national training, and technical assistance tailored within four geographic regions.
Through a new demonstration project, CDC will fund organizations to work in transgender clinics and partner with transgender-serving CBOs to develop community-to-clinic models for integrated status-neutral HIV prevention and care services and gender-affirming services, including hormone therapy and primary health care.
CDC’s Prevention Research Synthesis (PRS) Project identifies evidence-based interventions and best practices through ongoing systematic reviews. The PRS Project has identified several interventions for transgender people in its Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention:
- The Couples HIV Intervention Program is designed for transgender women and their primary cisgender male partners to reduce HIV risk behaviors, improve relationship communication, and enhance partner interpersonal dynamics.
- Project LifeSkills empowers young transgender women to build a sense of community, develop the motivation to protect oneself, and promote behavioral skills.
- Link LA (Linking Inmates to Care in Los Angeles) intervention improves linkage to HIV care, retention in HIV care, and viral suppression among gay and bisexual men, heterosexual men, and transgender women with HIV who are released from jail.
- weCare Social Media Intervention improves retention in HIV care and viral suppression among hard-to-reach racially and ethnically diverse young gay and bisexual men and transgender women with HIV.
CDC provides support and technical assistance to health departments, CBOs, and providers to support interventions for transgender people (e.g., condom distribution, community mobilization, HIV testing, and coordinated referral networks and service integration).
CDC funded 12 health department demonstration projects to provide PrEP support services and data-to-care activities prioritizing gay and bisexual men and transgender people at substantial risk for acquiring HIV, particularly people of color.
CDC funded two qualitative research studies focused on transgender people. These studies are designed to better understand issues of health care utilization among transgender women and their health care providers, and of HIV service utilization among young gay and bisexual men and young transgender people of color in the southern US. CDC is also funding two intervention studies to examine locally developed combined HIV prevention approaches for transgender women.

To raise awareness about the importance of routine HIV testing and status awareness among transgender and nonbinary people, CDC supports National Transgender HIV Testing Day.

CDC’s HIV Nexus clinician portal includes the Transforming Health website featuring information and materials for health care providers, whole-care teams, and social service providers who work with transgender patients. Resources include patient-centered care strategies, free online training programs, and data collection recommendations for sexual orientation or gender identity.
Through its Let’s Stop HIV Together campaign, CDC equips communities, partners, and health care providers with the resources they need to reduce HIV stigma, and promote HIV testing, prevention, and treatment and care. The campaign materials are tailored for specific audiences, including transgender people. The Let’s Stop HIV Together campaign is part of the Ending the HIV Epidemic in the U.S.