First South African study looking at HIV prevalence in transgender women contributes to global 90-90-90 target

CATEGORY: HIV/AIDS, STIs and TB
DATE: 10 January 2018

Pretoria, Wednesday 10 January 2018 – The first South African study to look at HIV prevalence in transgender women was today launched in East London. 

Initiated and supported by the United States Centers for Disease Control and Prevention (CDC) with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR), the Human Sciences Research Council (HSRC), will lead the first South African integrated biological and behavioral survey on HIV in transgender women. This study will be supported by various South African and international academic and civil society partners and will commence later this month at three identified sites.

Speaking about the significance of this study in South Africa, the HSRC’s Deputy CEO: Research, Professor Leickness Simbayi said, “Through this study, we hope to contribute towards a deeper understanding of how HIV is affecting the transgender women population in South Africa. Globally, transgender women have been shown to be at high risk for HIV infection.”

Indeed, global statistics show that transgender women are nearly 49 times more likely to be infected with HIV than other adults of reproductive age.  Despite this, there is currently very little information in South Africa about the specific HIV vulnerabilities of transgender women.  In addition, HIV prevalence amongst transgender women also remains undocumented and as a result transgender women remain underserved .

Professor Simbayi continued, “Transgender women have often been neglected in South Africa’s response to HIV.  This study is therefore an important first step in ensuring that transgender women have a voice – both in terms of how HIV affects transgender women but equally about what can be done to help transgender women to protect themselves.  Our public health campaigns must become more responsive if we are to impact decisively on combatting HIV and AIDS.”

Helen Savva, CDC SA’s Key Populations Lead emphasized the significance of this study if public health messages and interventions in reducing HIV and AIDS are to be effective, “Significant resources are invested globally in fighting HIV and AIDS.  However, the effectiveness of public health programmes will be determined by their relevance to key populations.  It is for this reason that the CDC South Africa is very proud to have initiated this important study with transgender women.  I am confident that the results of this study will influence our understanding and therefore, our responses, to the public health needs of transgender women in South Africa and globally.”

Representing S.H.E, Leigh Ann van der Merwe said, “The transgender community is very pleased to be part of, and support, this study because we know it gives us a voice.  For too long our reality as transgender women has been invisible to society and we are thrilled that we will now be seen, and heard, through the work of the HSRC funded by the CDC South Africa.”

Steve Letsike,  SANAC co-chair and Founding Director of Access Chapter 2 (AC2) said, “South Africa is one of very few countries in the world with a particular HIV plan to support its LGBTIQ (Lesbian, Gay, Bisexual, Transgender, Intersex and Questioning).  This study is part of South Africa’s commitment to looking at the real issues which impact on the community.  The community has many challenges with which to deal, including socio-economic and politics realities, least of which is the daily marginalisation and stigma we face.  This survey builds on the knowledge and evidence that will result in programming and serving everyone regardless of their gender identity and expression or even sexual orientation, it is about putting people first. BotshelobaTrans means trans women’s dignity will be realised and documented and this brings us closer to the time of lived realityand will enable people to participate equally in society, that is what the National Strategic Plan 2017-2022 seeks of us.”

The study goes towards South Africa’s commitment to the UNAIDS global target to ensure that by 2020, 90% of all people living with HIV will know their HIV status, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy and 90% of all people receiving antiretroviral therapy will have viral suppression.

South Africa has committed itself to reducing new infections of HIV by 60% from 270,000 in 2016 to less than 100,000 by 2022.

Join the conversation at #OkToBeMe #BotsheloBaTrans

Notes to the Editor

About the study
This study will be conducted in the Cape Town metropolitan area, in the Western Cape; the Johannesburg metropolitan area in Gauteng; and the Buffalo City Metro in the Eastern Cape.  These sites have been selected because of the existence of civil society organisations working with transgender women.  These include,  Social, Health, Empowerment (S.H.E.) Feminist Collective in East London, Sex Workers’ Advocacy and Education Taskforce (SWEAT), Gender Dynamix and Access Chapter 2 (AC2).  The University of California, San Francisco will provide technical assistance. 

The study aims to survey 300 transgender women in each of the three study sites with a total sample of 900 respondents. In addition, respondents will also have access to HIV antibody testing (to test for HIV prevalence), antiretroviral testing, HIV viral load testing (to test the level of HIV in the body), screening for TB and testing for sexually transmitted infections  (STIs).

This study will be conducted in three parts:
•    A rapid ethnography will be implemented in order to explore the specific HIV vulnerabilities of transgender women.
•    Secondly pre-surveillance formative research will be conducted in order to inform the implementation of the proposed survey.
•    Finally a behavioural survey and biomarker testing will be conducted to assess HIV risk taking behaviours and HIV prevalence among transgender women.

Through this methodology, this study will aim to:
1.    Identify the social, structural, economic and cultural factors that are related to HIV infection in transgender women
2.    Understand risk  behaviours and practices related to HIV infection and onward transmission in transgender women
3.    Determine the percentage of transgender women who are HIV positive in the three study sites
4.    Conduct a population size estimation of transgender women in the Cape Town and Johannesburg Metropolitan areas and Buffalo City Metro Municipality based on “Wisdom of the Crowds” (WoTC) methodology; unique object identifier; unique event and service data multiplier methods.
The study will be conducted from January to September 2018.

About the Human Sciences Research Council (HSRC)
The HSRC was established in 1968 as South Africa’s statutory research agency and has grown to become the largest dedicated research institute in the social sciences and humanities on the African continent, doing cutting-edge public research in areas that are crucial to development.

Our mandate is to inform the effective formulation and monitoring of government policy; to evaluate policy implementation; to stimulate public debate through the effective dissemination of research-based data and fact-based research results; to foster research collaboration; and to help build research capacity and infrastructure for the human sciences.

The Council conducts large-scale, policy-relevant, social-scientific research for public sector users, non-governmental organisations and international development agencies. Research activities and structures are closely aligned with South Africa’s national development priorities.

About the Centres for Disease Control and Prevention (CDC)
The CDC works 24/7 to protect America from health, safety and security threats, both foreign and in the U.S. Whether diseases start at home or abroad, are chronic or acute, curable or preventable, human error or deliberate attack, CDC fights disease and supports communities and citizens to do the same.

CDC increases the health security of America. As the nation’s health protection agency, CDC saves lives and protects people from health threats. To accomplish our mission, CDC conducts critical science and provides health information that protects our nation against expensive and dangerous health threats, and responds when these arise.

CDC started work in South Africa in 1989, helping partners address HIV. In 1994, CDC began to collaborate with the government to conduct epidemiology training, develop national health goals and objectives, develop national HIV clinical, ethical, and research guidelines, and support HIV and TB programs.

About S.H.E
S.H.E was born from a need to give voice and visibility to the issues affecting transgender women in South Africa. It is the only organisation working to advance the health and human of exclusively transgender women. S.H.E implements service provision, advocacy and capacity building programs at the provincial, national and regional level.

About Access Chapter 2
Established in 2013, and registered in 2014. Initiated to promoting the human rights and empowerment of women and LGBTI people, and the participation of civil society organisation in governance and policy processes at local, national, regional and international level by creating space and coordinating platforms for engagement on governance, policy and accountability processes and by developing innovative and active empowerment for transformation knowledge on community systems strengthening and build solidarity within civil society and other various sectors.
Join the conversation at:

 www.hsrc.ac.za   
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For more information or to set up interviews, please contact:
Manusha Pillai
Mobile:  082 389 3587
Email: MPillai@hsrc.ac.za