The virtual Conference on Retroviruses and Opportunistic Infections (CROI 2020) this week has included research assessing HIV prevalence, risk, access and adherence to medication in transgender women and men in the United States, Kenya and Zimbabwe. Transgender women continue to have high rates of HIV infection globally, with an estimated prevalence of around 19%. Although transgender men are often overlooked by researchers as not being at a high risk for HIV infection, some estimates suggest prevalence is as high as 8%. Moderating the session at CROI, Dr Sari Reisner of Harvard University emphasised that it is crucial to make a clear distinction between gender identity and sexual orientation. While gender identity pertains to an internal, felt sense of self as either male, female, transgender or another type of gender (such as nonbinary), sexual orientation is how a person identifies their physical, romantic and emotional attraction to others (such as heterosexual or bisexual). Transgender people can be of any sexual orientation.