Data on transgender people and HIV in Asia and the Pacific are scarce, but country estimations suggest there are substantial numbers of these people in the region.
Transgender people are frequently arrested or harassed under laws relating
2011 Political declaration on hiv/aids PrioritiZes action on Gender
In June 2011, in their Political Declaration on HIV/AIDS endorsed at the High Level Meeting on AIDS, the UN General Assembly reiterated earlier pledges to “eliminate gender inequalities and gender-based abuse and violence,”
and to ensure “that national responses to HIV and AIDS meet the specific needs of women and girls … for the promotion and protection of women’s full enjoyment of all human rights and the reduction of their vulnerability to HIV through the elimination of all forms of discrimination.”
Gender
to sex work, loitering or vagrancy. Several studies have reported significant health risks due to their socially marginalized status and lack of access to public health services, which often forces transgender people to use informal health services or to self‑medicate.
Sabin, an 18‑year‑old Nepalese transgender person, has become increasingly involved in peer HIV‑prevention activities. She recounts some of the incidents and issues that have shaped her life.
“Since I was 8 or 9, I would borrow my sisters’ make‑up, use their lipsticks, and help them cooking and cleaning,” Sabin recalls. “When I was about 14, I realized I was attracted to boys. I had sex for the first time when I was 16, without condoms.”
“Transgender people are highly stigmatized in Nepal,” she says, “so I have only shared my true identity to my sex partners and a few friends—not with my family. If there was more protection for people like me, I would open up and live as a transgender woman.”
“The first time I decided to go to the transgender group, an outreach educator inspired me to go for voluntary counselling and testing. There were no restrictions for age at all and because the organization was run by transgender people, I felt very comfortable,” she says. “In other medical centres and hospitals, parents collect the reports, so I couldn’t go to them.”
“I went for a check‑up and after the session with the pre‑counsellor, I found out after 15 minutes that I was not [HIV] positive. This was good news, and the counselling really helped me to understand HIV and the preventive measures I needed to take.”
“I only knew a few bits of information about HIV, through general books and ads, but I didn’t have correct knowledge about condom use. After the counselling and the interactions with the NGO, I knew more about correct and consistent use of condoms and lubricants, and this really helps for transgender people,” she says.
“Now I am able to teach this to my peers, to inspire them to get counselling and to motivate others.”
“At one point in my life, sex was a way to get food and pay for my studies.
I would have sex for less than a dollar. But then I realized I should not do these things without knowing. Now, I want to speak out to and for young, 18 and under transgender people who don’t usually have a voice.” ■
HIV IN ASIA AND THE PACIFIC : GETTING TO ZERO 86
taKinG Gender seriously in national resPonses to hiv
If programmes are to address the needs of all people affected by HIV, national AIDS strategies need to tackle issues of gender and sexual identity. Some countries in Asia and the Pacific are showing how this can be done.
In 2010, Viet Nam organized a gender analysis of its national AIDS response to inform a new national AIDS strategy. The analysis revealed that greater focus was needed on gender dynamics of the epidemic and especially its effect on women. The concerns of men and norms of masculinity also had to be addressed. More robust data were needed, as were sex-disaggregated indicators for monitoring and evaluation, and stronger capacity to undertake gender analysis, programming and monitoring.
A multi-partner gender assessment of Myanmar’s national AIDS plan ensured wide ownership of the process and greater commitment to adopt the findings.
In Cambodia, a gender caucus that included civil society and UN representation helped make the new National Strategic Plan on HIV/AIDS 2011 more gender inclusive in its approach to programming, monitoring and budgeting.
“Such initiatives are very encouraging,” says Nazneen Damji, Programme Manager on Gender Equality and HIV/AIDS from UNWOMEN, who was part of the UNAIDS delegation that supported Viet Nam in its 2011 gender analysis initiative. “It shows that gains in gender [awareness] can be made when multiple actors come together—and it proves that gender must be on everyone’s agenda.”
the art of deMystification
In the attempt to help demystify the complex issues of gender and HIV and make them easier to understand, new methods are being initiated—including the use of art and cartoon.
In one example, Australian cartoonist Judy Horacek has teamed up with UNAIDS Regional Support Team for Asia and the Pacific to develop a series of cartoon-based messages aiming to underline the complexities of the gender and HIV debate. The cartoons will be used for advocacy and training to help better define and explain key aspects of gender and HIV.
Gender