211471 Substance Use and HIV Risk Behaviors among Transgender Female (Kathoey) Sex Workers in Bangkok, Thailand

Tuesday, November 10, 2009: 12:30 PM

Tooru Nemoto, PhD , Public Health Institute, Oakland, CA
Mariko Iwamoto, MA , Public Health Institute, Oakland, CA
Birte Boedeker, MSc , Public Health Institute, Oakland, CA
Perngparn Usaneya, MA , Institute of Health Research, Chulalongkorn University, Bangkok, Thailand
Chitlada Areesantichai , Institute of Health Research, Chulaongkorn University, Bangkok, Thailand
Background: A number of kathoey engage in sex work at entertainment businesses in Bangkok. The study aims to describe substance use and HIV risk behaviors among kathoey sex workers.

Methods: After conducting ethnographic mapping, kathoey sex workers were recruited from bars/clubs (n=80) and street (n=32) for a survey. Demographics are: average age=25 years old; 88% single; 38% not completed high school.

Results: Street sex workers had a higher number of customers than those working at bars/clubs. 27% reported inconsistent condom use with customers for anal sex and almost all have engaged in sex under the influence of alcohol. More bar/club kathoey reported willingness to engage in unprotected sex with customers for extra money. Substance use was reported (36% ecstasy, 32% marijuana, 20% ketamine, and 10% amphetamine). More than 60% injected hormone, but only one person reported having seen health care providers in the past year. 19% identified themselves as girl in early age (between 5 to 12 years old), 42% reported abuse from father, brother, and other family members, and 45% reported current difficulties in living as kathoey.

Conclusions: Although the majority of Kathoey have used condoms with customers, many engaged in risk behaviors, such as sex under the influence of alcohol and drugs. In spite of a notion that transgender people are accepted in Thai society, study participants reported abuse from family members and difficulties in current lives. Early intervention and comprehensive health care and promotion are needed to meet the specific needs among kathoey sex workers.

Learning Objectives:
At the end of the session, the audience will be able to: 1. Understand the prevalence of depression and violence among transgender women in relation to transphobia and social support. 2. Understand racial and ethnic differences in psychological vulnerability and health risk. 3. Learn implications for developing future programs targeting transgender women in order to promote their health and well-being.

Keywords: Asian and Pacific Islander, Sex Workers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been conducting substance abuse and HIV prevention studies for hard-to-reach and stigmatized populations for the past 20 years as a psychologist and behavioral scientist.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.