Biden admin calls for program to help provide more gender-affirming care for trans people with HIV

transgender healthcare database
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To mark the 12th anniversary of the Affordable Care Act (ACA), the Department of Health & Human Services (HHS) is hosting a weeklong celebration to praise its accomplishments. But in the name of health equity for transgender people, who are adversely affected by HIV/AIDS, HHS is also asking for more.

In a letter shared exclusively with LGBTQ Nation, the HIV/AIDS Bureau (HAB) of the Health Resources and Services Administration (HRSA) is asking the Ryan White HIV/AIDS Program (RWHAP) to leverage its existing infrastructure and resources to not only continue providing direct HIV/AIDS care to transgender people, but to provide gender-affirming care as well.

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Established thirty years ago, RWHAP serves low-income people with HIV. Today, approximately 50% of those diagnosed with HIV receive support through it annually.

Rates of HIV viral suppression among transgender patients of RWHAP are lower than the organization’s overall average – 84.5 percent versus 89.4 percent. As such, the letter says more must be done to ensure transgender people are not left behind.

“HRSA’s HIV/AIDS Bureau sent this to Ryan White HIV/AIDS Program service providers to reaffirm the importance of providing culturally-affirming health care and social services to the transgender community as a key component to improving the lives of transgender people with HIV and eliminating health disparities,” Dr. Laura Cheever, Associate Administrator of the HRSA HIV/AIDS Bureau, told LGBTQ Nation.

“While not a new policy or approach to the services delivered by the program, The letter builds on initiatives that support patient-centered, trauma-informed, and inclusive environments of care for Ryan White HIV/AIDS Program clients. The goal is to help reduce medical mistrust and other barriers to antiretroviral therapy adherence for transgender people with HIV.”

The letter asserts that “providing gender-affirming care is an important strategy to effectively address the health and medical needs of transgender people with HIV.” The program, it says, already serves about 11,600 trans people (2.1% of those served overall) that would benefit from these services.

It goes on to say that funds directed toward RWHAP are allowed to be used for certain types of gender-affirming care and support, including hormone therapy, behavioral and mental health services for those experiencing discrimination and/or gender dysphoria, and cost-sharing assistance for insurance coverage, which would give trans people greater access to the care they need. It also said several RWHAP AIDS Drug Assistance Programs already provide access to hormone therapy.

Because it is an outpatient ambulatory health care program, though, the letter says RWHAP cannot provide surgeries or inpatient care.

The letter also urges RWHAP to provide other types of support to transgender people living with HIV/AIDS, such as housing, case management, and treatment services for substance abuse.

The letter, signed by Cheever, emphasizes the need to “provide affirming, whole person care to transgender people with HIV.”

“This is true especially of Black and Hispanic/Latino/a transgender women who are disproportionally impacted by HIV and other intersecting social and health challenges,” it says.

“While transgender Ryan White HIV/AIDS Program clients receiving HIV medical care have reached higher viral suppression rates than the national average, we recognize that we need to do more to support this community,” Cheever said in a press release.

“To help achieve the goals of the National HIV/AIDS Strategy, including achieving health equity and ending the HIV epidemic, we will continue to support and share evidence based, evidence informed, and emerging interventions that focus on the specific needs of this community to improve the health and lives of transgender and gender diverse people with HIV.”

Also in recognition of the 12th anniversary of the ACA, HHS is hosting a weeklong celebration, with each day focusing on different communities the ACA has reached.

Today’s focus is “Celebrating Health of LGBTQI+ and Communities of Color.” According to HHS, the ACA has reduced the number of uninsured LGBTQ people by almost 50% since 2010.

Since taking office, the Biden administration has also restored an ACA provision banning discrimination in its health care programs on the basis of sex, which includes sexual orientation and gender identity.

HHS also said the ACA has also helped community organizations dedicate more resources to HIV/AIDS care through RWHAP.

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