| Language and Cultural Barriers to Medical Engagement |
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1
I think having to go speak to a physician or doctor just to get [PrEP] who probably, in most cases, are White – I think that scares them… I’ve met a lot of trans Latina women who, yeah, their English isn’t completely on point, and I feel like that embarrassment gets to them in regards to not wanting to go to a facility to get prescribed something. I think there’s a lot of underlining fears that go behind that: not being able to read the application form, not being able to understand the full question, walking into a facility and having a lot of medical professionals judge you based off your appearance… It might be deportation or [a fear of being] treated horribly or to be assaulted. (Latina, age 21, 44 months on PrEP)
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2
I just believe that people are a little fearful from past experiences of being used. Black people, at one point, were used as experiment projects like Tuskegee… Black people are afraid and still a lot of Black communities see AIDS and HIV as a gay man’s disease, because it was gay men that we know, initially, in America and here in Los Angeles that had contracted the virus. So people are always still kind of seeing it as a White person’s problem. (Black, age 48, 2.5 months on PrEP)
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| Lack of Transgender Competent Medical Care |
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3
Doctors need to be more educated on not only PrEP, but trans people, period. I was so pleased with my doctor being so aware of me and my body, and being able to tell me what I needed to do and what tests I needed to take for my body – my trans body – and not giving me some rigmarole about a man. And that helped me in my experience. Does every trans person get that type of knowledge in their medical appointments? I don’t know… I think so many of them in their transitions aren’t in a space of comfort where they are able to be in situations and deal with what they might receive at the doctor’s office from the security, to the front desk clerk, to the people in the waiting room. (Black, age 48, 6 months on PrEP)
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4
I feel like a lot of the providers that are prescribing hormones should be more of an advocate about PrEP… Because as their provider, you should have the comfort to talk about their sexual history. As long as you know they’re sexually active with [someone] assigned male at birth, that should already be on your radar and maybe just bring it up just in case they might want to get on it. (Latina, age 27, 2 months on PrEP)
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| Prioritization of Hormones over PrEP |
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5
I found that some Latina trans women are Latina trans women without that medication. And they’re like, ‘I don’t need the hormones, but I need my PrEP.’ And I’ve also met other Latina trans women, especially in the modeling industry, where they’re like, ‘I don’t need PrEP. I just need my hormones and I’m fine.’ So it goes both ways; it just depends on what you value more. (Latina, age 21, 44 months on PrEP)
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6
The Black trannies that I know are just all over the place. They have no priorities or focus. I don’t even think they go see a doctor for their pills. They buy it off the streets. I don’t know why they don’t go to see a doctor since it’s free. So all this street shit… It’s not a priority for them. It’s more like, ‘I want a bigger ass and I want a thigh gap.’ But none of them are concerned about internal health – it’s more outer. (Black, age 31, 2 months on PrEP)
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