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I’m like hey wassup hello♡ #trans #transboy #ftm #lgbt
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Causes:
It is not uncommon for trans individuals in some settingsto engage in sex work to earn money—in many cases due to the lack of other employment opportunities. A survey of trans women in Latin America found that 95% of respondents were engaged in sex work. Sex work, which by definition involves sex with multiple partners, increases the risk of HIV acquisition. A recent multi-country analysis determined that 
1) HIV prevalence was nearly twice as high among MtF trans sex workers than in trans women not engaging in sex work; and 
2) trans women engaging in sex work were six times more likely to be living with HIV than non-trans female sex workers. 
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At Risk:
By race/ethnicity, black/African American transgender women have the highest percentage of new HIV-positive test results.
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Causes:
Surveys indicate that many trans people frequently engagein sexual risk behaviors with cisgender men, especially unprotected receptive anal and/or vaginal intercourse. Much of the disproportionate HIV burden among trans people who have sex with men may be explained by the frequency of unprotected receptive anal or vaginal intercourse, which has a much higher per-act probability of transmission than other forms of sexual intercourse.
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Discriminatory practices deter trans individuals from seekingthe treatment and prevention services they need. In the U.S., 58% of trans people surveyed said it was reasonable to avoid getting tested for HIV where laws criminalize HIV exposure, transmission, or non-disclosure, with 44% saying such laws justified avoidance of HIV treatment altogether
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Causes
Untreated STDs significantly increase the risk of bothHIV acquisition and transmission. In the U.S., trans people have STD rates four times higher than the general population. Due to the lack of trans-affirming health services and often transphobic attitudes among healthcare providers, many trans people avoid seeking sexual health services until they have a symptomatic STD.
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Causes:
Behaviors and factors that contribute to high risk of HIV infection among transgender people include higher rates of drug and alcohol abuse, sex work, incarceration, homelessness, attempted suicide, unemployment, lack of familial support, violence, stigma and discrimination, limited health care access, and negative health care encounters.
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Especially in cases where trans individuals rely on the black market for the purchase of hormones, sharing injecting equipment may result in HIV transmission. Amateur injections of silicone or other materials for body contouring may pose similar issues, along with other potentially deadly threats to the individual’s health. In addition, various studies have detected high rates of drug and alcohol use, including injecting drug use, among trans populations
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Barriers:
Impediments tomeaningful healthcare access undermine the ability to reach trans people with highly effective biomedical prevention tools, including HIV treatment-as-prevention and oral pre- and postexposure (antiretroviral) prophylaxis.
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At Risk:
Approximately 90% of transgender women newly diagnosed with HIV infection in NYC were blacks/African Americans or Latinos.
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Barriers:
Surveys indicate that trans people frequently haveunsatisfactory experiences with mainstream health services. Problems faced by trans patients include providers and administrative staff using improper pronouns to address them, lack of preparedness to address their unique health needs and/or denial of health services entirely.
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Barriers:
Hostile health services and lack of access to transition relatedcare, combined with the struggles of day-to-day living, diminish health outcomes among HIV-positive trans people. 
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In 2008–2011, at least 831 trans people were murderedworldwide, with the number of reported homicides increasing each year. This growing and troubling trend continued in 2013, with a reported 238 trans people being murdered globally.In a survey of trans women in Latin America, 80% reported having experienced violence or threats of violence at the hands of government employees, with most acts of violence occurring in the context of sex work. Emerging evidence strongly links experience of gender-based violence with HIV infection.
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Barriers:
In the HIV-related policy discourse, trans people haveoften been treated as a subset of men who have sex with men. Not only is this approach fundamentally at odds with the gender identity of trans women, but this tendency has served to limit attention to the unique HIV-related needs of trans people.
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Causes:
Many trans individuals harbor low self-esteem (commonlyexacerbated by discrimination, violence, and rejection), often with concurrent body image issues. Both lower the priority many trans people place on protecting their bodies and physical health from harm, and some may even engage in self-destructive behavior as a result. 
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Police policies can conflict with public health initiatives. For example, some law enforcement officers and agencies view the presence of condoms as evidence of sex work, even though public health initiatives identify condoms as a way to prevent HIV infection.
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At Risk:
Over half (52%) of newly diagnosed transgender women in NYC were in their twenties.
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