20th International AIDS Conference - Melbourne, Australia


WEPDC0104 - Poster Discussion Abstract

Mapping and size estimation of male-to-female transgender community in 17 states of India: first level findings at the country level

Presented by Thilakavathi Subramanian (India).

T. Subramanian1, S. Mehendale1, N. Dhingra2, V. Chakrapani3, V. Selvaraj1, E. Noronha4, A. Narang4

1National Institute of Epidemiology, Chennai, India, 2Goverment of India, Department of AIDS Control, Targetted Interventions, New Delhi, India, 3Centre for Sexuality and Health Research and Policy (C-SHaRP), Chennai, India, 4United Nations Development Programme, HIV and Development Unit, New Delhi, India

Background: Male-to-Female transgender (TG) people have been recognized by the Department of AIDS Control, India, as a core population among which HIV interventions need to be scaled up. For effective planning, implementation and evaluation of HIV interventions among TG people, it is crucial to have information on mapping and size estimation. Hence, a large-scale study was executed in 17 States, where some baseline data on TG people were available.
Methods: The study was conducted between December 2012 and September 2013 in17States. Detailed listing of the sites up to the district level was done with the help of stakeholders, especially NGOs/CBOs working with sexual minorities. Participatory approaches using key community informants (with Delphi consensus) for site identification and nomination methods for size estimates were followed by site-visits for verification. Ten percent of the districts from each state and a sub-sample of the mapped sites were randomly selected for validation, and an independent team visited those sites.
Results: In the 17 study States, initially 7185 TG sites were identified, and subsequent validation found 1364 sites to be defunct. Point estimate of the TG population from the remaining 5,821 sites was 62,137 (53,280 to 74,297). Majority (71%) of TG people were in urban locations and 47% were part of ''gharanas'' (living in groups under ''Guru'' or Master). Among the estimated TG population in sex work (62%), 72% were gharana based. Estimated number of TG people to engage in: begging=28%, get paid for blessings=31%, and dancing=18%. In 9/17 states, more than 60% of TG people were estimated to be in sex work. Twenty-nine districts out of 466 districts in 17 states had more than 400 TGs. Original estimates and estimation by validation team were similar.
Conclusions: In a phased manner, exclusive TG Targeted HIV interventions can be planned and implemented in sites with high number and concentration of TG people. In 11 states, 15 sites have been identified for tracking HIV and risk behaviors of TG people through National Integrated Biological and Behavioural Surveillance of Dept. of AIDS Control, starting from 2013/14.

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