Here, we present reports on the first generation of transgender HIV prevention, research, and care initiatives. We thank the editors of the International Journal of Transgenderism, Friedemann Pfaefflin and Eli Coleman, for giving us this opportunity, and acknowledge the assistance of Brunhild Kring. We dedicate this special issue to the memory of Lou Sullivan, founder of the community organization now known as FTM International, who died of AIDS in 1991. The first article by Inciardi, Surrat, Telles, and Pok illustrates how marginalization impacts the effectiveness of HIV prevention programming for transvestite sex workers in Rio de Janeiro, Brazil. The study assessed HIV prevalence, drug use, and sexual behavior of 100 travestis, and shows how their identities intersect with HIV risk.
Prevention needs to take participants' unique self-views and sexual roles into account.
Even though introduction of the female condom appeared promising, safer sex instructions seem insufficient to address the complexity of travestis' HIV risk. Medical anthropologists Kammerer, Mason, and Connors contend that neglected health and social service needs of transgenders affect their HIV risk. Through ethnographic research in Boston, Massachusetts, the authors identified misperceptions of providers that interfere with care. They recommend HIV prevention strategies that contribute to diminishing the social stigma that shape both transgenders' HIV risk and their difficulties in obtaining appropriate services. Reback and Lombardi report on the experience of serving transgenders in a community-based harm reduction program in Hollywood, California.