Online Program

Lessons learned: A framework for HIV services for a transgender population in Thailand

Tuesday, November 5, 2013

Rebecca Peters, MPH, School of Public Health and Health Services, The George Washington University, Washington, DC
While HIV prevalence in Thailand has declined significantly since the 1990s, drastic disparities between sub-populations have arisen, revealing an uneven burden of disease. Notably, estimates of HIV prevalence among male-to-female transgender (TG) individuals are up to 30% higher than in the general population. Widespread discrimination in the employment market drives many TG individuals to urban areas to engage in sex work. A lack of prevention, screening and treatment services for TG sex workers has led to disproportionately high rates of HIV within this group, even as compared with female sex workers. Attempts to provide services to this marginalized community have been sparse and ineffective, as they are typically couched in the broader category of men who have sex with men. This classification is inappropriate for TG individuals, who do not view themselves as men. My research reviewed evidence on health needs and access to care among TG individuals, and found a paucity of data. While some studies describe risk behaviors among TG individuals, none endeavors to illuminate potential structural factors behind their disproportionately high risk, for example: stigma, gender-based violence, and poverty. Efforts to serve TG individuals must acknowledge the social determinants of their health status, as well as their unique and frequently misunderstood gender identity. I present a framework for providing the TG population with HIV services which appropriately address these concerns. This framework is based on international human rights standards, public health behavior models, and lessons learned from work with a Thai-based NGO that serves the TG population.

Learning Areas:

Diversity and culture
Program planning
Provision of health care to the public
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Analyze unique health needs of the male-to-female transgender population in Thailand, especially in the context of HIV prevention and treatment; Describe avenues for improved programmatic efforts to reduce HIV prevalence among the transgender population in Thailand and abroad.

Keyword(s): Gender, HIV Interventions

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: The research cited in this abstract is directly related to my Masters Thesis topic.
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.