Unsterilized Hormone Needles, Unsafe Sex Spread HIV Through Transgender Community
HIV rates in the transgender community are "staggeringly high," and "black market" sex hormones delivered through unsterilized needles could be to blame for at least part of the problem, Salon reports. Although hormone needle sharing "has not been identified as a major risk factor for HIV transmission among transsexuals," very little research exists on how the virus has affected the transgender community. Jason Farrell, executive director of the Positive Health Project, said, "Due to the lack of tracking, there might be an epidemic out of control and we don't know about it, nor do we have the resources to address it if we need to." However, transsexuals do face several risk factors for HIV, including unsterilized needle use, a lack of outreach and education programs and unsafe sex. A study of male-to-female transsexuals conducted by Dr. Paul Simon, a medical epidemiologist with the Los Angeles County Department of Health Services, found that 22% were HIV-positive and many respondents had engaged in unprotected anal sex. Sixty-nine percent of study participants had injected hormones "at some point in their lives," and of those who had injected hormones in the past six months, 72% said they "got their needles off the streets." However, since unsafe sex and intravenous drug use were also noted among study participants, Simon determined that it is "unclear what role black market needles played" in infecting the group.
Black Market Needles
Transsexuals obtain black market sex hormone injections from a number of sources, and an "underground economy of fake doctors and self-appointed medical gurus" helps supply the shots, Salon reports. Transgender individuals often "prefer" injections to other forms of hormones, including pills, patches and liquid, because the injected hormones "supposedly take effect faster." Some of the shots are given in bar bathrooms or in the backs of vans, with "possibly hundreds" of individuals receiving injections by a single needle. A "growing number" of physicians and AIDS outreach workers feel that these shared needles "may be the cause of hundreds of [HIV] cases in the United States and abroad," and are "particularly concerned" about the high rates of HIV infection among the transgender population. Some states have started to look at needle deregulation as one possible way to reduce the risk of needle sharing. In San Francisco, for example, several health clinics provide free hormone syringes and free and low-cost hormone therapy in a "safe, medical setting," with time allotted specifically for transsexuals. On Jan. 1, New York state launched a new needle deregulation policy, under which it will make syringes available to adults without a prescription through licensed pharmacies, health care facilities and "certain health care practitioners who voluntarily register with the state" (Siegal, Salon, 3/28).