Alliance of Border Collaboratives: Public Health Leader Helping to Reframe Health Equity in El Paso

Alliance of Border Collaboratives (ABC) in El Paso brings together organizations and individuals to advance the practice of public health and promote social equity, affordable housing, and community development. ABC delivers programs and services in Mexico and the United States, particularly in El Paso.

ABC’s work aligns with Achieving Together’s guiding principles of social justice and equity as well as the focus area of Collaborating, cooperating, and coordinating across systems. We recently interviewed Dr. Susana Villalobos, Interim Executive Director, to learn more about ABC, its mission, and its activities.

How does the Alliance of Border Collaboratives help prevent HIV or support people living with HIV?

The Alliance of Border Collaboratives (ABC) was established as a community based public health non-profit agency in 2009. Since then, ABC’s Executive Board and Staff has worked to ensure that marginalized populations (e.g., homeless, gay and bisexual men, sex workers, transgender people, people with substance use disorders, and others) can exercise their right to receive prevention, intervention, and treatment services for infectious diseases, substance use disorder, and mental health.

Our activities include extensive outreach with our trans community. This includes outreach to highway underpasses, abandoned buildings, and queer bars. Additional prevention activities include passing out condoms, referrals to STI/HIV testing, and encouraging  PrEP.  Grant funding also allows payment of co-pays related to medical consultations for PrEP/PEP as well as transportation to and from appointments for our trans clients.

What would you like people to know or understand about Trans-Fronterizxs?

Trans-Fronterizxs is a peer case management program for transgender individuals in the border region; due to various factors, transgender individuals in our region tend to be isolated from their communities and forced to navigate the world alone, which can lead to lack of knowledge of local resources available. Additionally, some trans folks may not follow-up with appointments due to stigma, fear, and judgment. Ignorance is also a factor that can lead to transgender folks feeling misunderstood and forces them into having to teach service providers in order to receive appropriate care. To this end, peer case management catering to trans individuals, such as Trans-Fronterizxs, can help improve the health outcomes and follow through by providing services in a safe space for transgender folks. Filling out applications, setting up appointments, and navigating the bureaucracy of the local healthcare and social services systems can be daunting for some trans-people (many of whom might not have legal documents that are in agreement with their identity). We assist individuals in these processes and help them navigate the system. For this reason, we believe in meeting the client where they are – whether they are in El Paso or in Juarez – and no matter their current situation. We hope that through our work we can create a tomorrow that is vastly improved from the difficulties and struggles of today.

Our Impact on the Trans Community:

Our trans community has received personalized case management that has helped them enjoy a better quality of life through services such as preparation of name and gender marker applications, referrals, financial assistance for hormone replacement therapy, and transportation through our partnership with Uber health. We’ve carried out this essential work; quarantine or no quarantine. We believe that words fail to capture the relief clients have felt being able to have their identity legally recognized so they can participate in society in a safer way. It opens all kinds of doors to employment and other opportunities; it’s hard to quantify the impact of living your life as a trans woman with documentation that doesn’t match your identity.

For instance, one client had lived more than 20 years openly as a trans-woman and had stopped applying to jobs because of how humiliating it feels to be called by her “dead name.” Trans-Fronterizxs has made an enormous difference; a client reports that, “we’ve changed her life forever.” Other clients have remarked how they were able to do things they never thought they would be able to do, such as getting on hormones and getting their name changed.

What aspect of your work are you most proud of?

Many of our trans clients expressed their frustration on the emphasis of research studies and awareness versus direct client services. As an agency, ABC advocates for direct services funding. Our best efforts focus on a direct response to our community’s needs, and nothing is more important than having people feel comfortable in their own skin, particularly our trans community living on the border.

What keeps you motivated to do this work?

Unfortunately, the trans population often only have each other to rely on. The world is a cruel place when there is fear and misunderstanding. ABC strives to befriend the trans community and advocate for their needs wherever they are needed. We are determined to leave a positive footprint for our trans clients, and make a path to a life well-lived, without fear and judgement.

What does success look like to you?

At the risk of sounding idealistic, I think the ultimate success would be trans organizations becoming obsolete, this would entail having all their needs met. The little victories for the present include improving health outcomes, preventing HIV, funding hormone therapy, clothing and feeding trans people, and helping trans folks update their legal identity documents. Every single trans identified person we help as an agency is a success story.

Are there any myths or misconceptions you would like to address?

Visibility does not equal public support. Often, it results in increased risk for violence. The public support is not there yet. Especially in any place that isn’t a major city.

Another myth that prevails is the notion they were born in the wrong body. Many trans folks have no desire to medically transition. It is society that drives the message that their bodies are incorrect.

Another misconception is that “they” all want “the surgery.” There are several surgeries one might undergo for medical transition. Gender reassignment surgery is increasingly not necessary to update legal identity documents.

Stigma related to sexual promiscuity is another misconception on the trans community. Higher rates of HIV in our community does not equal labeling our trans community for the cause.

Is there anything else you’d like to tell us?

I encourage folks who are interested in being allies to look up local trans folks on their Go Fund Me pages, to contribute directly. For the trans people in your lives, defend them when they are harassed, and stick up for them even when they are not in the room.

Despite the circumstance of the pandemic, our services for our trans community never faltered.  ABC in El Paso, Texas, supports our trans clients with direct financial aid, clothing and legal assistance. Our community agency collaborations help to ease the economic situation our trans people face in their day to day lives.

ABC also integrates evidence-based harm reduction strategies to address the risks associated with syringe sharing and recurrent use of a single syringe, such as HIV, HCV, and soft-tissue infections. ABC provides peer-driven education on HIV, HCV, and soft-tissue infections, in conjunction with access to syringes and injection drug use equipment. 

These initiatives resulted in ABC being recognized by peers as an underground syringe program. It has been challenging to maintain these services, but ABC has strived in the face of adversity continuing to secure and provide both Narcan and sterile syringes (as needed) during the SARS-CoV-2 pandemic implementing protective measures for staff and clients as well as continuing with street outreach throughout the ongoing pandemic.

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