Transgender people (male-to-female) Last update: December 2018
CONTENT Data availability and population size estimates HIV prevalence and epidemiology Risk behaviors Vulnerability and HIV knowledge National response
Data availability and population size estimates
Transgender (male-to-female) size estimates Country Estimated size Definition Males (15-49) As% of males Bangladesh(2015) 10,199 (Total) 7,925 (TGSW) Transwomen 18+ yrs; who identify themselves as belonging to a traditional hijra sub-culture and who maintain the guru-chela hijra hierarchy. They maybe sub-categorized as: Sex Worker Hijra, Badhai Hijra and Radhuni hijra 45,033,462 0.02 Cambodia(2015) 3000 TG women who are biologically male at birth and who self identify as female or third gender. This entail dressing up, expressing characteristic, attitudes and behaviour of a woman 4,036,402 0.1 Fiji(2012) 319 (TG SW) Male-to-female transgender 18+ yrs; self-identified as engaging in transactional sex work (i.e. the provision of sexual services in exchange for cash, goods or service) 237,117 India(2013) 70,000 Information not available 365,281,206 0.01 Indonesia(2016) 38,928 Biological males aged 15 years or older who identify their gender identity as females 71,618,154 Malaysia(2014) 24,000 Individuals who are biologically male but with female identity 9,109,000 0.3 Nepal(2016) 21,460 TG women are biological males who have identified themselves as Transgender. A transgender is a male who appears as, wishes to be considered as, or has undergone surgery to become a female. 6,962,000 Pakistan(2016) 52,646 Individuals 15+ yrs who identify themselves as transgender and receive money or goods in exchange for sexual services, either regularly or occasionally 50,046,000 Philippines(2015) 122,800 Born males 15+ yrs; identifies as female, who had oral or anal or vaginal sex with a male in the past 12 months. 24,435,734 0.5 Thailand(2016) 62,800 Men sexually active in last 12 months who express women characteristics e.g. long hair, wearing make-up, breast appearance, not necessarily undergo sex reassignment surgery. 17,686,000 0.4 Source: Global AIDS Monitoring reporting 2017 and 2018, Department of Economic and Social Affairs, Population Division (2017). World Population Prospects: The 2017 Revision
Key data availability for transgender people (2010-2017) Population size estimate HIV prevalence (National) (Subnational) Condom use Prevention coverage* HIV testing coverage* Treatment Spending Cambodia India Indonesia Lao PDR Malaysia Myanmar Nepal Pakistan Philippines PNG Singapore Thailand Timor-Leste Viet Nam *Survey or programme data DATA AVAILABLE DATA NOT AVAILABLE/ NOT REPORTED Source: Prepared by www.aidsdatahub.org based on HIV Sentinel Surveillance Reports, Integrated Biological and Behavioral Surveillance Reports, Behavioral Survey Reports, Global AIDS Response Progress Reporting and other country reports
HIV prevalence and epidemiology
Available data indicates higher HIV prevalence among transgender people in certain geographical areas in select countries National versus location specific HIV prevalence among transgender, countries where data is available, 2015 - 2017 * Data for Kathmandu is reported as national data for Nepal; ** 4 cities (Bangkok, Chiang Mai, Chonburi and Phuket) Source: Prepared by www.aidsdatahub.org based on HIV Sentinel Surveillance Reports, Integrated Biological and Behavioral Surveillance Reports and other serological survey reports
High HIV prevalence observed in certain cities and geographical locations HIV prevalence among transgender people, 2012-2017 Source: Prepared by www.aidsdatahub.org based on HIV Sentinel Surveillance Reports, Integrated Biological and Behavioral Surveillance Reports and other serological survey reports
High STI and hepatitis prevalence among transgender people, 2012-2017 Source: Prepared by www.aidsdatahub.org based on HIV Sentinel Surveillance Reports, Integrated Biological and Behavioral Surveillance Reports and www.aidsinfoonline.org
Risk behaviours
Proportion of transgender people who reported condom use during their most recent sexual intercourse or anal sex, 2012-2017 * Dhaka ** Combined use of condom and water-based lubricant *** Bangkok, Chonburi, Chiang Mai, Phuket Source: Prepared by www.aidsdatahub.org based on 1) Behavioural Surveillance Surveys; 2) Integrated Biological and Behavioral Survey (IBBS) reports; 3) Global AIDS Monitoring 2018
Proportion of transgender people who reported condom use at last sex with casual male partners, 2011-2017 * Dhaka; ** Kathmandu Source: Prepared by www.aidsdatahub.org based on 1) Behavioural Surveillance Surveys; 2) Integrated Biological and Behavioral Survey (IBBS) reports
Proportion of transgender people who reported consistent condom use with their sexual partners, 2012-2017 Source: Prepared by www.aidsdatahub.org based on Behavioral Surveillance Surveys and Bio-Behavioral Surveys.
Proportion of surveyed transgender people who sold sex or had sex with clients, countries where data is available, 2011 - 2016 Source: Prepared by www.aidsdatahub.org based on Behavioral Surveillance Surveys and Bio-Behavioral Surveys.
Proportion of transgender people who reported consistent condom use with male clients, 2012-2016 Source: Prepared by www.aidsdatahub.org based on Behavioral Surveillance Surveys and Bio-Behavioral Surveys.
Proportion of transgender people reported injecting drug use, countries where data is available, 2013-2017 * Dhaka ** Mixed survey sample of MSM and TG in Port Moresby Source: Prepared by www.aidsdatahub.org based on Behavioral Surveillance Surveys and Bio-Behavioral Surveys.
Mean years in the profession of selling sex and mean number of clients among transgender people, 2013-2016 Source: Prepared by www.aidsdatahub.org based on Behavioural Surveillance Surveys and Integrated Biological and Behavioral Survey (IBBS)
Vulnerability and HIV knowledge
Proportion of transgender people with comprehensive HIV knowledge, 2009-2015 Source: Prepared by www.aidsdatahub.org based on 1) Ministry of Health Republic of Indonesia. (2016). IBBS 2015 - Integrated Biological and Behavioral Survey; 2) Malaysia AIDS Council and Ministry of Health. (2010). Integrated Biological and Behavioral Survey 2009; 3) Bavinton, B., Singh, N., Naiker, D. S., et al. (2011). Secret Lives, Other Voices: A Community-Based Study Exploring Male-to-Male Sex, Gender Identity and HIV Transmission Risk in Fiji. Suva, Fiji: AIDS Task Force of Fiji; 4) icddr,b. (2015). A Survey of HIV, syphilis and risk behaviors among males having sex with males, male sex workers and hijra. Global Fund Rolling Continuation Channel Project of icddr,b; and 5) National HIV and STI Surveillance and Strategic Information Unit, National Epidemiology Center, DOH. (2014). 2013 Integrated HIV Behavioral and Serologic Surveillance (IHBSS) Report. Manila, Philippines.
National response
With current level of response, we cannot end AIDS among transgender, and we cannot end AIDS in the region HIV prevention and testing coverage among transgender women in select countries Bangladesh India Malaysia 90% 90% 90% Nepal Pakistan Philippines 90% 90% 90% Source: Prepared by www.aidsdatahub.org based on Global AIDS Monitoring (GAM) Reporting 2017 and 2018 Gap Coverage
HIV testing coverage among transgender people, 2015-2017 90% * Dhaka ** Programme data Source: Prepared by www.aidsdatahub.org based on Global AIDS Monitoring 2017 and 2018
HIV cascade performance for Sisters, an NGO serving transgender women in Pattaya, Thailand during January –March, 2015 20% tested for HIV 61% of diagnosed TG are on treatment Source: USAID and PEPFAR Linkages Project. (2015). Programme Data, Sisters and USAID LINKAGES Project- FHI 360: HIV Cascade Framework for Key Populations.
Social justice and human rights are fundamental to address the public health needs of transgender women In India… In Bangladesh… In Cambodia… In Pakistan… 1 in 5 Transgender women 1 in 3 1 in 6 experienced sexual violence in last 12 months reported being raped/beaten in last 12 months have been denied/thrown out of a housing in their life time have been denied healthcare in their life time Prepared by www.aidsdatahub.org based on Integrated Biological and Behavioural Surveys
Prevailing stigma, discrimination and violence against transgender people * Experienced in the last 12 months; Arrested – ever arrested in Cambodia and last 12 months in Pakistan Data reported for PNG is a mixed survey sample of MSM and TG Source: Prepared by www.aidsdatahub.org based on Integrated Behavioral and Surveillance Surveys
slides compiled by www.aidsdatahub.org THANK YOU slides compiled by www.aidsdatahub.org Data shown in this slide set are comprehensive to the extent they are available from country reports. Please inform us if you know of sources where more recent data can be used. Please acknowledge www.aidsdatahub.org if slides are lifted directly from this site