Transgender Women Vulnerable to HIV

Jun 23, 2015

Poison Ivy came out as a transgender woman to her family in January.

Her grandmother kicked her out of the house. 

“She didn’t want to see me transitioning,” said Poison Ivy, who asked that her real name not be used. “It’s just so hard for her to notice that her grandson, someone that has loved her for a long time is becoming a woman.”

So Poison Ivy moved in with friends. Some of them don’t know what the 18-year-old does for a living.

“I charge usually $160 and sometimes $200 dollars a session or sometimes an hour,” she said on a recent afternoon, sitting on a bench in a Miami park.

Poison Ivy is a dominatrix.

Some of her clients want to have sex. For that, she charges extra. She tells the men who offer to pay a lot more if she’ll have sex without a condom that she won’t do it. She knows the risks.

“I don’t know if you have HIV, you don’t know if I have HIV, so I’d rather have sex with a condom on,” she said.

Also, Poison Ivy is HIV negative. She said she gets tested regularly.

Florida’s transgender community, specifically trans women, are among the groups most at risk of contracting HIV. It’s estimated that a third of transgender women are HIV positive, according to limited studies from the U.S. Centers for Disease Control and Prevention.

Poison Ivy said in her personal circle, she knows of at least 17 transgender women who are HIV positive.

But no one has official numbers on HIV-infection on the local, state or national levels as trans people are not really being counted. Often, trans women are incorrectly counted in categories with men who have sex with men. And few medical surveys ask people about their gender identity, making it difficult to identify and count the community in data.

“We need to know people exist in order to get them funding for healthcare and the trans community is generally not counted,” said Dr. Sheryl Zayas who treats HIV positive transgender women at Care Resources, an HIV/AIDS service organization in Miami Beach.

Zayas said transgender people are invisible in medical data and in other ways, such as in the U.S. Census which does not count them. That makes it increasingly difficult to target HIV prevention efforts at the trans community.

Community Faces Extra Obstacles

Living as a transgender woman today means a life of discrimination, said Aryah Lester, director of Trans Miami. She calls what Poison Ivy does “survival sex work.”

“When you look at it in term of survival sex work, it’s the ostracism, the prejudice," Lester said. “That’s what leads trans people to be unemployed and having no way to sustain themselves.”

Back at the Miami park, Poison Ivy said she’s applied for a litany of jobs including Starbucks, Macy’s and Burger King. But she says that after turning in her applications, she never gets a call back.

“It’s hard as a trans woman trying to find a job and trying to be yourself at this job,” she said.

Poison Ivy said sex work is what she does to get by. And while she insists her clients wear condoms, sometimes men who are paying for sex think they don’t have to take no for an answer.

“It was in Homestead at like 3:00 in the morning and my client like tried to basically rape me,” she said. “When I go get my purse and dump it out, my Taser was there. So I grabbed my Taser and I tased him.”

Poison Ivy recently took a test to become an HIV/AIDS tester, hoping it can help her land a job working for a nonprofit agency in HIV prevention.

Sex Work Not the Only Risk

Economic insecurity puts transgender women at risk  far beyond  doing survival sex work.  Transgender people are four times as likely as the general population to be poor and can’t afford many of the procedures they need to complete their transition.

Arianna Lint, coordinator for transgender services at SunServe, a Broward County nonprofit, is a transgender woman who’s HIV positive.

Lint believes she became infected with HIV sharing needles while getting underground cosmetic surgeries. She says transgender women also are at risk when they share needles for hormones they purchase on the black market.

She’s says systemic prejudice and lack of federal protection for transgender people has a devastating effect, pushing trans woman to underground economies.

“Prevention for transgender people is not giving condoms,” Lint said.  “It’s giving opportunities.”

Nadege Green is a reporter for WLRN in Miami. WLRN is part of Health News Florida, which receives support from the Corporation for Public Broadcasting.