HIV Prevention and Care of Transgender Women in an HIV and STI Clinic in the Paris Metropolitan Area A Qualitative Assessment from Medical Care to Social Integration

HIV infection burden is globally high among transgender women (TGW) and particularly in TGW migrant sex workers and TGW subpopulations with structural inequalities like racism and classism. In addition to stigma related to transphobia, migrant TGW face multiple forms of discrimination because of intersection with other experiences of stigma related to migration and working as sex workers in the host society. This study explores the experiences of TGW seeking care in an HIV and STI clinic in Paris, to evaluate medical adherence, namely, the degree to which a patient is regularly followed up in care and adequately takes the treatment, and trans individuals' social inclusion in this health institution. We examined the different forms of HIV-associated stigma among TGW. A qualitative study was conducted using semistructural in-depth interviews with TGW receiving HIV care and HIV preventive measures. A description is given of how a community-based participation policy and practice in this clinic integrate an intersectional approach among TGW. This results in a high rate of medical adherence in TGW migrants and could lead to social integration.