Exploring HIV stigma and transphobia among health care providers in Mumbai, India: Preliminary findings from project shakti

The prevalence of HIV/STIs are disproportionately higher among hijras, a sociology-culturally distinct sub-group of transgender women, than any other high-risk group in India, a country with third largest HIV infected population in the world. As a result, India's National AIDS Control Organization (NACO) identified HIV prevention among hijras to be one of the key priorities. Stigma among health care provider limits HIV testing, treatment and care and creates a barrier to HIV protective behavior. However, data on the nature and extent of stigmatization, and the factors that contribute to stigmatization of hijras by health care providers is limited. Such an evidence base is necessary in order to inform an effective, culturally sensitive stigma reduction intervention to promote HIV prevention among hijras. As a formative part of a larger study that intends to develop and pilot a hijra-specific stigma reduction intervention among health care providers in Mumbai called, “Project SHAKTI (Stigma reduction, Health care providers Awareness & Knowledge enhance on Transgender Issues, India)”and jointly funded by National Institutes of Sciences (NIH) and Indian Council of Medical research (ICMR), the current presentation describes preliminary findings on the myriad forms of stigma and discrimination experienced by hijras in health care sectors in Mumbai (e.g., denial and/or delay in providing treatment, sexual stigma, discrimination due to gender-nonconformity) based on four focus group discussions and five key informant interviews with hijra community members across Mumbai. The presentation highlights the implications of experienced and perceived stigma by health care providers on HIV/STI risk behavior among hijras.