How to reach migrant transgender women in Paris? An example of collaborative sexual health action

Abstract

Abstract Issue In France, screening for HIV and sexually transmitted infections (STIs) is provided by free HIV and STIs screening centers called CeGIDD. Despite a complete combined prevention offer, the number of new HIV diagnosis has been stable for years. Transgender women have one of the highest HIV prevalence. Description of the problem Transgender women are a hard to reach population with multifactorial barriers in their access to healthcare including fear of stigma, leading to late HIV diagnosis and untreated STIs. The CeGIDD of a university hospital in Paris aimed to reach this public working with two associations, creating a free, complete sexual health action outside the hospital in a safe environment. Results The CeGIDD identified a Parisian association, PASTT, which accompanies transgender women, mainly migrants, in accessing healthcare and social rights. Its active file is around 1500 persons a year, mostly resorting to prostitution. Another association, AREMEDIA, pioneer in outreach interventions, was involved. The partnership allowed access to the public and to gather the funds for the intervention. It included counseling, screening, Pre Exposure Prophylaxis (PrEP), and took place once a week in PASTT facilities. Any participant could be referred to other physicians if they needed it, even if they lacked health insurance coverage. From September 2017 to November 2018, 212 persons attended the consultation and 26 received PrEP. Lessons Working together with several associative partners presents many challenges, from the definition of the objectives to operational coordination. Overcoming these difficulties lead us to reach a new public with a high risk for STIs and HIV. Key messages Community based sexual health actions dedicated to transgender women are a successful way to reach this public. The safe environment provided by the association is a great opportunity to familiarize them with the medical staff and to empower them regarding healthcare.