Trans persons have not benefited equally in the HIV response, having the lowest global viral suppression (44%) of all key populations in 2022 and the highest HIV prevalence in all but two global regions (up to 39.4% in the Caribbean). HIV continues to have a disproportionate impact on trans persons, yet trans men and other gender diverse persons assigned female at birth (AFAB) are still excluded by omission across the HIV response globally. The persistent belief that trans men and other AFAB gender diverse persons are at low risk of HIV has long been used to justify the lack of inclusion of this community in the global HIV response, driven further by a lack of data and inconsistent population size estimates. However, emerging data shows that trans men and other AFAB persons are almost seven times more likely to have HIV than individuals in the general population.
The International Working Group on Transmasculine People & HIV, coordinated by GATE, seeks to address this exclusion by producing and disseminating critical knowledge on trans men and HIV and developing strategies to increase the meaningful engagement of this group in the global HIV and other health responses.
The Working Group is a community-led initiative and currently consists of 31 trans men and trans masculine activists, researchers and public health experts from 22 different countries across all global regions.
The formation of this project began at the World AIDS 2018 Conference in Amsterdam, during which a group of trans men and trans masculine people working in the areas of sexual health and HIV research and service delivery met to discuss their frustrations at the persistent exclusion of trans men from the international HIV response. This led to a silent protest during the Closing Plenary of AIDS 2018 and an announcement by GATE’s then Director of Programs, now Executive Director, of our intention to form a working group on trans men and HIV. The project commenced in 2019 and continues to be a good practice example of community-driven advocacy for access to healthcare.
The Working Group seeks to make positive change by increasing awareness among donors, global health institutions and policymakers about the realities of trans men and AFAB gender diverse persons concerning HIV, sexual and reproductive health and other health-related issues, including challenges, gaps, and best practices going forward.
The working group adopts an Inclusive feminist approach, highlighting the importance of the current focus on trans women and HIV, and argues that not only are the resources currently devoted to trans women inadequate and thus should be increased, but that, furthermore, additional resources should be allocated for the inclusion of trans men and other AFAB trans persons.
The Working Group’s projects include knowledge creation and raising awareness on international platforms. At the AIDS 2020 Virtual Conference, the Working Group organized a satellite session titled “Transgender Men & HIV: Experiences Vulnerabilities, why we should care, and where to go from here,” making history as the first-ever transmasculine-led session at an IAS Conference.
In 2023, the Working Group developed and launched the Trans Men in the Global HIV Response Policy Brief and Factsheet, which are the first comprehensive advocacy resources aimed to present a case for the inclusion of trans men, trans masculine persons, and gender diverse persons assigned female at birth (AFAB) in the global HIV response and broader development goals. The policy brief, aimed at high-level stakeholders, provides foundational knowledge and comprehensive recommendations on the importance of including trans men and gender diverse people assigned female at birth (AFAB) in the HIV response. The factsheet is an accessible document aimed at the trans and gender diverse (TGD) community and debunks the misconceptions about trans men and AFAB gender diverse persons and HIV.