142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

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Role of Gender Transition Services in HIV prevention among male- to- femaleTransgenders in India: Preliminary findings

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Swagata Banik, PhD , Center for Health Disparities Research & Education, Baldwin Wallace University, Berea, OH
Vivek Anand, CEO , Humsafar Trust, Mumbai, India
Ankur Srivastava, M.Phil , Humsafar Trust, Mumbai, India
Shruta Mengle, M.Sc. , Humsafar Trust, Mumbai
Alpana Dange, M.Phil , Humsafar Trust, Mumbai, India
Leslie Fisher, PhD , Psychology, Cleveland State University, Cleveland, OH
Hemangi Jerajani, MD , Dermatelogy, MGM Hospital and Medical School, Mumbai, India

Background: HIV and other infectious diseases disproportionately impact transwomen around the globe. Male-to-female (MtF) transgenders in India, popularly known as Hijra, are recognized as a high risk group for HIV/STI in India by National AIDS Control Organisation (NACO) with HIV prevalence of 8.2% in India and 18.8% in Metropolitan areas (Sentinel Surveillance, 2010-2011). However, the majority of previous HIV/STI research and prevention efforts have ignored unique issues specific to MtF transgenders/hijras.  As a part of a larger study funded by NIH and ICMR, we conducted a needs assessment in terms of HIV-related care among  hijra community in Mumbai, India. 

Methods: We conducted 10 key-informant interviews and 8 focus group discussions with Hijras to identify and document nature and extent of  HIV care needs for the community. 

Results: Hijras report transition-related health care and services are primary needs of the community. Lack of free sex reassignment surgery (SRS) and hormone therapy in public hospitals and the prohibitive cost of SRS in private hospitals compel some hijras/transwomen  to engage in HIV risk behavior including commercial sex work, self-adminstered hormone, needles sharing and  non-clinical methods of castration and/or removal of genitalia. Stigma, discrimination and lack of gender-transition, and socio-cultural knowledge about hijra community needs among health care providers are significant barriers to accessing care and associated with mental health outcomes.  

Conclusion:  Free or affordable gender transition services in public hospitals with a national guidelines on gender transition, and development of a workforce of   technically- and culturally-competent gender transition service providers may be important  approaches to HIV prevention.

Learning Areas:

Advocacy for health and health education
Basic medical science applied in public health
Program planning
Public health biology
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the role of gender transition services in HIV Prevention among male-to- female transgenders in the context of developing countries. Identify health care needs of male-to-female transgenders that may prevent HIV risk behavior. Identify barriers to and facilitators for gender transition services for male-to-female transgender in international setting

Keyword(s): HIV/AIDS, Lesbian, Gay, Bisexual and Transgender (LGBT)

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Principle Investigator of the project. I have been involved in HIV prevention research for over a decade.
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.