In February 2016, the Centers for Disease Control and Prevention (CDC) released a report where they projected that one in two black men who have sex with men (MSM) and one in four Latino MSM would be diagnosed with HIV in their lifetime. In Philadelphia, estimates suggest that 32 percent of black and 19 percent of Latino MSM have HIV. This is not far from the CDC estimate. Additionally, a CDC Issue Brief in September 2016 stated that transgender people, particularly transgender women, are vulnerable to HIV infection. Available evidence suggests that, in relation to their population size, transgender women are among the most heavily affected populations in the United States. So how do we approach prevention in a new way that can change the path of the CDC’s projections?