1. Transgender people (male-to-female)
Last update: December 2016

2. CONTENT Data availability and population size estimates
HIV prevalence and epidemiology
Risk behaviors
Vulnerability and HIV knowledge
National response

3. Data availability and population size estimates

4. Transgender (male-to-female) size estimates
Country
Estimated size
Definition
Afghanistan(2015)
28,000
Information not available
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
Cambodia(2013)
3000
Transgender women 18+yrs; biological male at birth who identify as female or third gender.
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)
India( )
62,137
Indonesia(2012)
37,998
Male-to-female transgender 18+ yrs; men who dress like women
Malaysia(2014)
24,000 (TG SW)
Individual who transformed from male to female and has been reporting having sex at least once in previous 3 months.
Nepal(2010)
9,474
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. Transgender belong to a distinct socio-religious and cultural group, a “third gender” (apart from male and female). They usually dress in feminine attire (cross-dressing).
Pakistan(2011)
50,598
Transsexual 15 + yrs; who undertakes sexual activity with a man in return for money or benefits
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.
Thailand(2015)
50,000
Source: GARPR online reporting 2016

5. Inclusion of transgender in sentinel and bio-behavioural surveys
Country
Sentinel and/or Bio-behavioural surveys
Behavioural surveys
Comment 1
Bangladesh
2015
2013*
*Midline survey among MSM, MSW, and TG in Dhaka 2
Cambodia
IBBS 3
Fiji
IBBS 2012
Transgender sex workers in Suva, Nadi, Lautoka, Labasa 4
India
HSS
IBBA
Hijra sex workers (IBBA) 5
Indonesia
IBBS 2015
Waria 6
Lao PDR
Vientiane Capital and Savannakhet 7
Malaysia
IBBS 2014 - 8
Pakistan
SGS 2011
Hijra sex workers 9
Papua New Guinea
IBBS 2010
Transgender sex workers,
Port Moresby 10
Philippines
IHBSS 2015 11
Thailand
Bangkok, Chonburi, Chiang Mai, Chonburi and Phuket
Source: Prepared by based on HIV Sentinel Surveys and Bio-Behavioural Surveys.

6. HIV prevalence and epidemiology

7. * 2011 data; ** Hijra sex workers
Available data indicate high HIV prevalence among transgender people - both at national and sub-national level in select countries
* 2011 data; ** Hijra sex workers
Source: Prepared by based on 1) Ministry of Health Republic of Indonesia. Integrated Biological and Behavioral Survey 2011 and 2015; 2) National AIDS Control Organisation, India. (2012). HIV Sentinel Surveillance : A Technical Brief; 3) National AIDS Control Program, Pakistan. (2011). HIV Second Generation Surveillance in Pakistan - National Report Round IV 2011; and 4) Suleiman, A. (2015). Mesyuarat Persediaan ‘National Strategic Plan for Ending AIDS (NSPEA) ’ Presentation made during 8-11 June Le Grandeur Palm Resort Senai

8. Higher HIV prevalence observed in some cities and geographical locations
Source: Prepared by based on 1) HIV Sentinel Surveys 2) Integrated Biological and Behavioural Surveys; 3) Suleiman, A. (2015). Mesyuarat Persediaan ‘ Malaysia National Strategic Plan for Ending AIDS (NSPEA) ’ Presentation made during 8-11 June Le Grandeur Palm Resort Senai; and 4) National AIDS Committee. (2015). Thailand Ending AIDS. Thailand AIDS Response Progress Report Reporting Period: Fiscal Year of 2014.

9. High STI and hepatitis prevalence among transgender people, 2010-2015
* TG sex workers; ** 2012 data for Hepatitis B and C; *** Vientiane and Savannakhet
Source: Prepared by based on HIV Sentinel Surveillance Reports, Integrated Biological and Behavioral Surveillance Reports and

10. Risk behaviours

11. * Sold sex to new clients; ** Sold sex to regular clients
Proportion of transgender people who sold sex or had sex with clients, countries where data is available,
* Sold sex to new clients; ** Sold sex to regular clients
Source: Prepared by based on 1) Ministry of Health Republic of Indonesia. (2011). IBBS Integrated Biological and Behavioral Survey; 2) Malaysia AIDS Council and Ministry of Health. (2010). Integrated Biological and Behavioral Survey 2009; 3) National Center for HIV/AIDS Dermatology and STD Cambodia. (2013). Behavioral Sentinel Surveillance (BSS 2013): Presented by Mun Phalkun on 16 December 2013; 4) Indian Council of Medical Research, & FHI. (2011). National Summary Report - Integrated Behavioural and Biological Assessment. Round 2 ( ); 5) Presentation by Tac-an I.A (2014). HIV and Syphilis Prevalence among Transgender People in the Philippines. Cebu City Health Department Philippines; 6) 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 7) Malaysia Global AIDS Response Progress Reporting (Country narrative report)

12. Mean years in the profession of selling sex and mean number of clients among transgender people,
Source: Prepared by based on 1) National AIDS Control Program, Pakistan. (2011). HIV Second Generation Surveillance in Pakistan - National Report Round IV 2011; 2) National AIDS/STD Programme Bangladesh. (2008). Behavioral Surveillance Survey : Technical Report.; 3) Liu, K.-L., & Chhorvann, C. (2010). Behavioral Risks On-site Serosurvey among At-risk Urban Men in Cambodia; 4) Ministry of Health Republic of Indonesia. (2011). IBBS Integrated Biological and Behavioral Survey; 5. National HIV and STI Surveillance and Strategic Information Unit, National Epidemiology Center, DOH. (2014) Integrated HIV Behavioral and Serologic Surveillance (IHBSS) Report. Manila, Philippines; and 6. 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.

13. Proportion of transgender people who reported condom use at last sex with male clients, 2009-2014
* Dhaka
** Combined use of condom and water-based lubricant
*** Bangkok, Chonburi, Chiang Mai, Ratchaburi and Phuket
Source: Prepared by based on 1) Behavioural Surveillance Surveys; 2) Integrated Biological and Behavioral Survey (IBBS) reports; 3) Malaysia Global AIDS Response Progress Reporting (Country narrative report); and 4) National AIDS Committee. (2015). Thailand Ending AIDS. Thailand AIDS Response Progress Report Reporting Period: Fiscal Year of 2014.

14. Proportion of transgender people who reported condom use at last sex with casual male partners,
* Dhaka
Source: Prepared by based on 1) 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.; 2) Malaysia AIDS Council and Ministry of Health. (2010). Integrated Biological and Behavioral Survey 2009; 3) Indian Council of Medical Research, & FHI. (2011). National Summary Report - Integrated Behavioural and Biological Assessment. Round 2 ( ); 4) CHAS, USAID, The Global Fund, and PSI. (2012). Results of Second Round HIV/STI Prevalence and Behavioral Tracking Survey among Male-to-Female Transgender in Vientiane Capital and Savannakhet, Lao PDR, Consensus Meeting; 5) Ministry of Health Republic of Indonesia. (2011). IBBS Integrated Biological and Behavioral Survey; and 6) National Center for HIV/AIDS Dermatology and STD Cambodia. (2013). Behavioral Sentinel Surveillance (BSS 2013): Presented by Mun Phalkun on 16 December 2013.

15. Proportion of transgender people who reported consistent condom use with male clients, 2009-2014
Source: Prepared by based on Behavioral Surveillance Surveys and Bio-Behavioral Surveys.

16. Proportion of transgender people who reported consistent condom use with their sexual partners,
Source: Prepared by based on Behavioral Surveillance Surveys and Bio-Behavioral Surveys.

17. Proportion of key populations who reported condom use at last sex with transgender people ( )
* with commercial TG partner
** with regular TG partner
Source: Prepared by based on 1) 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. ; 2) CHAS, USAID, The Global Fund, and PSI. (2012). Results of Second Round HIV/STI Prevalence and Behavioral Tracking Survey among Male-to-Female Transgender in Vientiane Capital and Savannakhet, Lao PDR, Consensus Meeting; 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 Fijii; 4) Indian Council of Medical Research, & FHI. (2011). National Summary Report - Integrated Behavioural and Biological Assessment. Round 2 ( ); and 5) National AIDS Control Program, Pakistan. (2011). HIV Second Generation Surveillance in Pakistan - National Report Round IV 2011.

18. Proportion of transgender reported injecting drug use, countries where data is available, 2011-2016
Source: Prepared by based on 1) 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.; 2) Ministry of Health Republic of Indonesia. (2011). IBBS Integrated Biological and Behavioral Survey; 3) Malaysia Global AIDS Response Progress Reporting (Country narrative report); 4) National AIDS Control Program, Pakistan. (2011). HIV Second Generation Surveillance in Pakistan - National Report Round IV 2011; 5) IBBS Integrated Biological and Behavioral Survey; and 6) Ministry of Health Cambodia. (2016). Integrated Biological and Behavioural Survey among Transgender Women in Cambodia 2016

19. Vulnerability and HIV knowledge

20. Proportion of transgender people with comprehensive HIV knowledge, 2009-2014
Source: Prepared by based on 1) Ministry of Health Republic of Indonesia. (2011). IBBS 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) Integrated HIV Behavioral and Serologic Surveillance (IHBSS) Report. Manila, Philippines.

21. National response

22. Proportion of transgender reached with outreach or prevention programmes in the last year, 2009-2014
* Prevention programmes in 5 provinces: Bangkok, Chonburi, Chiang Mai, Ratchaburi and Phuket
Source: Prepared by based on 1) 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;; 2) 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; 3) Indian Council of Medical Research, & FHI. (2011). National Summary Report - Integrated Behavioural and Biological Assessment. Round 2 ( ); 4) National HIV and STI Surveillance and Strategic Information Unit, National Epidemiology Center, DOH. (2014) Integrated HIV Behavioral and Serologic Surveillance (IHBSS) Report. Manila, Philippines; 5) Malaysia Global AIDS Response Progress Reporting (Country narrative report), 6) National AIDS Committee. (2015). Thailand Ending AIDS. Thailand AIDS Response Progress Report Reporting Period: Fiscal Year of 2014; and 6)

23. HIV testing coverage among transgender people, 2009-2016
* TG/Hijra sex workers; ** 5 Provinces: Bangkok, Chonburi, Chiang Mai, Ratchaburi and Phuket
Source: Prepared by based on 1) Behavioural Surveillance Surveys and Bio-Behavioural Surveys; 2) Malaysia Global AIDS Response Progress Reporting (Country narrative report), 3) National AIDS Committee. (2015). Thailand Ending AIDS. Thailand AIDS Response Progress Report Reporting Period: Fiscal Year of 2014; and 4) GARPR 2016 reporting

24. 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.

25. Prevailing stigma, discrimination and violence against transgender people
Source: Prepared by based on Integrated Behavioral and Surveillance Surveys

26. slides compiled by www.aidsdatahub.org
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slides compiled by
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 if slides are lifted directly from this site