Scientists: Excluding transgender individuals from HIV research hurts everyone
In an urgent commentary published in the journal Lancet HIV, University of Michigan researchers joined fellow researchers from Emory and Yale universities to urge the scientific community and the public to resist the "erasure" of trans people from HIV research.
The commentary comes in response to the U.S. government's ongoing moves to cease funding and programs that involve trans individuals. It includes a table laying out examples of acquiescence in response to federal actions, which include stop-work orders or grant terminations of HIV research, removal of data from HIV epidemiological surveillance, deleting reports from public websites, and plans to ban and restrict gender-affirming health care, including HIV services.
"The HIV epidemic cannot be brought to an end without prioritizing health equity for all communities, and specifically trans individuals," the authors wrote. "In this crucial moment, institutions and researchers must resist all forms of trans erasure, elevate trans leadership and prioritize equity—not as rhetorical gestures but as foundational principles of HIV science and ethical practice."
They warn that the changes have the potential to harm millions of Americans and threaten public health in general.
The authors include: Kristi Gamarel, associate chair and associate professor of Health Behavior & Health Equity, and Sari Reisner, associate professor of Epidemiology, both at the University of Michigan School of Public Health; Arjee Restar of the Department of Social and Behavioral Science at Yale University's School of Public Health; and Don Operario of the Department of Behavioral, Social, and Health Education Sciences at Emory University's Rollins School of Public Health.
The trans community in the U.S. is estimated to be about 1% of the population, or about 3.3 million people, a number that is likely undercounted, the authors say.
Trans communities, and specifically trans women, were a priority population in the U.S. Ending the HIV Epidemic Initiative and the 2022-2025 National HIV/AIDS Strategy. HIV research involving the trans community, the authors say, is critical to the science that has led to treatments, prevention and groundbreaking progress in combating the HIV epidemic.
"Decades of evidence demonstrates that inclusion of trans populations is not merely beneficial—it is indispensable for achieving equitable and effective HIV science," the authors wrote. "The systematic erasure of trans communities, fueled by strong nonscientific forces, represents a direct assault on the integrity of scientific research and public health.
"Despite this established evidence base, our field is witnessing a rapid regression in trans inclusion. This rollback in HIV science and programming mirrors the broader erasure of trans people's social, health care and legal rights. These occurrences are not haphazard. Instead, they reflect targeted and coordinated efforts by multifaceted and politicized forces that will compromise the effectiveness and integrity of HIV science if the field does not counteract and resist.
"Allowing these regressive forces to shape our evidence base compromises not only the scientific integrity but also the relevance, reliability and ethics of HIV science ... This moment demands renewed commitment, anchored in ethical integrity, to ensure HIV science fosters inclusivity and is grounded in intersectional epistemic justice. Only then can HIV science advance the promise of health equity and justice for all."