1. THE 6 TH NATIONAL SCIENTIFIC CONFERENCE ON HIV/AIDS Study on Transgender Women’s Health and Well-being in Ho Chi Minh City, Vietnam (TransVN Study) Le Quoc Bao, Trang Van Toan, Ngu Thanh Huy

2. The 6 th National Scientific Conference on HIV/AIDS Outline 1.Background 2.Objectives 3.Methods 4.Results & Discussions 5.Conclusions 6.Recommendations

3. The 6 th National Scientific Conference on HIV/AIDS BACKGROUND Transgender women (TW) are highly vulnerable to HIV infection & face several social exclusion including to services. The marginalization of TW contributes to negative health outcomes, including suicide attempts, substance use, sex work, or violence victimization. In Vietnam, very limited data on TW available, often as a small subgroup within the larger population of MSM. HCMC has an estimated population of between 2,000- 3,000 TW (based on discussions with TW group leaders and community stakeholders).

4. The 6 th National Scientific Conference on HIV/AIDS STUDY OBJECTIVE Main purpose: better understand the health risks and needs for health services for transgender women. inform the development of interventions to promote health services for transgender people. Study objectives: Measure barriers and facilitators to social/health care services experienced by TW in HCMC Measure HIV testing uptake, prevalence and risk behaviors among TW population in HCMC

5. The 6 th National Scientific Conference on HIV/AIDS STUDY SUBJECT Total 205 transgender women (TG) who met the following criteria, participated in the study : 18 years of age or older Vietnamese citizen Self-report as male sex assigned at birth and self- identified as expressing female gender; Residing in HCMC at time of enrollment Agrees to participate in the study.

6. The 6 th National Scientific Conference on HIV/AIDS STUDY SUBJECT

7. The 6 th National Scientific Conference on HIV/AIDS STUDY METHOD Cross-sectional survey Participants assisted through a structured questionnaire with support of trained research staff. Snowball sampling method for subject recruitment.

8. The 6 th National Scientific Conference on HIV/AIDS STUDY METHOD Phase 1: Establish the TW Community Advisory Board (CAB) and maintain regular consultation with CAB throughout the study. Phase 2: CAB meetings with CARMAH research team, recruitment of study participants, data collection process including screening, informed consent, interviews and free testing of HIV test and syphilis. Phase 3: sharing of study findings with TW representatives in HCMC, local government agencies, NGOs and others in Vietnam and through publications internationally.

9. The 6 th National Scientific Conference on HIV/AIDS Study results (1)

10. The 6 th National Scientific Conference on HIV/AIDS Study results (2)

11. The 6 th National Scientific Conference on HIV/AIDS Reason s for not going for HIV testing n% Don’t think that I have any risks of HIV infection 3843,2% Don’t know any HIV testing services 1112,5% Test is too expensive 11,1% I am afraid of knowing HIV test result 1213,6% Do not trust confidentiality from HIV testing sites 22,3% I am afraid that people who know me can see me when I go to testing services 910,2% Don’t care 1517,0%

12. The 6 th National Scientific Conference on HIV/AIDS HIV and Syphilis test results

13. The 6 th National Scientific Conference on HIV/AIDS Factors associated with HIV infection Factor HIV neg N = 168 (%) HIV pos N= 37 (%) P-valueOR Paid male for sexNo150 (84.3%)28 (15.7%) Yes16 (64%)9 (36%)0.0084.04 Alcohol in last 1 month No51 (89.5%)6 (10.5%) Yes113 (79%)30 (21%)0.0822.39 ATS use in last 1 month No139 (85.8%)23 (14.2%) Yes29 (67.4%)14 (32.6%)0.0102.93 Childhood sexual abuse No52 (89.7%)6 (10.3%) Yes114 (78.6%)31 (21.4%)0.0622.60 Method: Multivariate Logistic Regression

14. The 6 th National Scientific Conference on HIV/AIDS Knowledge and experience about PEP

15. The 6 th National Scientific Conference on HIV/AIDS Knowledge and experience about PrEP

16. The 6 th National Scientific Conference on HIV/AIDS How interested are you in taking daily oral PrEP if it were available in Vietnam?

17. The 6 th National Scientific Conference on HIV/AIDS Conclusions Confirmed higher rate of TG working as entertainment employees About half have ever used hormones Still more than 40 % never HIV tested. Main reasons for not HIV tested in order of priority include: (1) don’t think that I have risk; (2) don’t care; (3) afraid of knowing HIV result and (4) don’t know any service. Rate of HIV and syphilis: high (18% & 17.8%), higher than the reported prevalence rate among MSM. Tỷ lệ nhiễm HIV và giang mai khá cao (18% & 17.8%). Cao hơn tỷ lệ nhiễm trung bình của nhóm MSM.

18. The 6 th National Scientific Conference on HIV/AIDS Conclusions Knowledge about PEP (29.8% have heard of PEP & 9.3% know a place in HCMC to get PEP) and use (0%): very low Kowledge about PrEP (11.7% ever heard of PrEP) and use (0%): very low High interest in using PrEP if available: 61.3 %

19. The 6 th National Scientific Conference on HIV/AIDS Recommendation Need interventions, HIV services tailored to the transgender women community. Current HIV prevention education, counseling and testing services should reach more to this group of population. Considerations to include transgender women in new HIV prevention interventions, including PrEP.