Transgender Women and Men
Transgender women and men are at significant risk for HIV as a result of greater risk of violence and discrimination in health services. No evaluated interventions were found that provided services for transgender women and transgender men. Very little information has been published on HIV and transgender women and men in developing countries. No data was found concerning what percent of transgender women and men work as sex workers. [See also Female Sex Workers] Most of the literature does not specify whether those included in the study are transgender men or transgender women, despite the differing needs of each group. Transgender men, who are biologically women, need sexual and reproductive health services such as screening for cervical cancer. Yet accessing needed health and HIV services, which usually operate on strict male/female gender identities, may be extremely difficult.
Transgender women and men in many societies face marginalization and social exclusion (Ehrhardt et al., 2009). Some organizations such as Genderdynamix (www.genderdynamix.org.za) and the Triangle Project (www.triangle.org.za) in South Africa advocate and provide services for transgender people.
While not enough studies were found to include as "what works," some studies were found showing programs with positive impacts for transgender women and men. Non-formal education and livelihood programs for transgender people may improve safer sex practices. SAATHI, a capacity-building NGO in India, provided non-formal education and livelihood programs together with existing HIV prevention interventions to members of Santi Seva, a community based organization of transgender people (Sarkar et al., 2008b).
Transgender women and men are often overlooked in HIV prevention planning and treatment programs and little evidence is therefore available on what works for transgender women and men. In 2011, WHO issued recommendations and guidelines for a public health approach to HIV prevention, care and treatment for transgender people and men who have sex with men (WHO et al., 2011c).