1. Transgender people (male-to-female)
Last update: December 2018

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
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

5. 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 based on HIV Sentinel Surveillance Reports, Integrated Biological and Behavioral Surveillance Reports, Behavioral Survey Reports, Global AIDS Response Progress Reporting and other country reports

6. HIV prevalence and epidemiology

7. 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,
* Data for Kathmandu is reported as national data for Nepal; ** 4 cities (Bangkok, Chiang Mai, Chonburi and Phuket)
Source: Prepared by based on HIV Sentinel Surveillance Reports, Integrated Biological and Behavioral Surveillance Reports and other serological survey reports

8. High HIV prevalence observed in certain cities and geographical locations
HIV prevalence among transgender people,
Source: Prepared by based on HIV Sentinel Surveillance Reports, Integrated Biological and Behavioral Surveillance Reports and other serological survey reports

9. High STI and hepatitis prevalence among transgender people, 2012-2017
Source: Prepared by based on HIV Sentinel Surveillance Reports, Integrated Biological and Behavioral Surveillance Reports and

10. Risk behaviours

11. Proportion of transgender people who reported condom use during their most recent sexual intercourse or anal sex,
* Dhaka
** Combined use of condom and water-based lubricant
*** Bangkok, Chonburi, Chiang Mai, Phuket
Source: Prepared by based on 1) Behavioural Surveillance Surveys; 2) Integrated Biological and Behavioral Survey (IBBS) reports; 3) Global AIDS Monitoring 2018

12. Proportion of transgender people who reported condom use at last sex with casual male partners,
* Dhaka; ** Kathmandu
Source: Prepared by based on 1) Behavioural Surveillance Surveys; 2) Integrated Biological and Behavioral Survey (IBBS) reports

13. 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.

14. Proportion of surveyed transgender people who sold sex or had sex with clients, countries where data is available,
Source: Prepared by based on Behavioral Surveillance Surveys and Bio-Behavioral Surveys.

15. Proportion of transgender people who reported consistent condom use with male clients, 2012-2016
Source: Prepared by based on Behavioral Surveillance Surveys and Bio-Behavioral Surveys.

16. Proportion of transgender people reported injecting drug use, countries where data is available,
* Dhaka
** Mixed survey sample of MSM and TG in Port Moresby
Source: Prepared by based on Behavioral Surveillance Surveys and Bio-Behavioral Surveys.

17. Mean years in the profession of selling sex and mean number of clients among transgender people,
Source: Prepared by based on Behavioural Surveillance Surveys and Integrated Biological and Behavioral Survey (IBBS)

18. Vulnerability and HIV knowledge

19. Proportion of transgender people with comprehensive HIV knowledge, 2009-2015
Source: Prepared by based on 1) Ministry of Health Republic of Indonesia. (2016). 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.

20. National response

21. 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 based on Global AIDS Monitoring (GAM) Reporting 2017 and 2018
Gap
Coverage

22. HIV testing coverage among transgender people, 2015-2017
90%
* Dhaka
** Programme data
Source: Prepared by based on Global AIDS Monitoring 2017 and 2018

23. 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.

24. 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 based on Integrated Biological and Behavioural Surveys

25. 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 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