Publications

Previous systematic reviews have identified a high prevalence of HIV infection in transgender women in the USA and in those who sell sex (compared with both female and male sex workers). However, little is known about the burden of HIV infection in transgender women worldwide. We aimed to better assess the relative HIV burden in all transgender women worldwide. Our fi ndings suggest that transgender women are a very high burden population for HIV and are in urgent need of prevention, treatment, and care services. The meta-analysis showed remarkable consistency and severity of the HIV disease burden among transgender women.  

The annual HIV Sentinel Sero‐surveillance survey, the systematic and regular collection of information on the occurrence, distribution and trends of HIV infection and factors associated with the infection, has been carried out since 1992. The survey has been conducted among 8 targeted sentinel groups:

• Pregnant Women attending the antenatal clinics (ANC)
• New Military Recruits
• Blood Donors
• Newly diagnosed TB patients
• People Who Inject Drugs (PWID)
• Men who have Sex with Men (MSM)
• Female Sex Workers (FSW)
• Male patients attending sexually transmitted infection (STI) clinic

The baseline study for CAHR project was implemented in a selection of sites across the five countries (China, Kenya, India, Indonesia and Malaysia) in order to obtain baseline data on a number of indicators that relate to drug injecting practices, risky injecting and sexual behaviour, interactions with the legal system, knowledge about HIV and safe injecting, access to and satisfaction with services, and quality of life of people who inject drugs (PWID). The study also attempted to determine certain associations between access to HIV-prevention services and risky injecting practices, as well as to identify contextual factors that might influence behaviours that put people at risk of HIV infection and quality of life of PWID.

The present report focuses on certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment. It identifies the policies that promote these practices and existing protection gaps. By illustrating some of these abusive practices in health-care settings, the report sheds light on often undetected forms of abusive practices that occur under the auspices of health-care policies, and emphasizes how certain treatments run afoul of the prohibition on torture and ill-treatment. It identifies the scope of State's obligations to regulate, control and supervise health-care practices with a view to preventing mistreatment under any pretext.

This report summarizes the findings of 2011 Bangladesh Demographic and Health Surveys (BDHS) conducted under the authority of the National Institute of Population Research and Training (NIPORT) of the Ministry of Health and Family Welfare and implemented by Mitra and Associates of Dhaka. ICF International provided financial and technical assistance for the survey through USAID/Bangladesh. The BDHS is part of the worldwide Demographic and Health Surveys program, which is designed to collect data on fertility, family planning, and maternal and child health. The preliminary results of the 2011 BDHS, with its key indicators, were released through a dissemination seminar in April 2012. This final report brings more comprehensive analysis of the survey results. Along with the key results, detailed findings and possible interpretations are presented. 

The findings of the Afghanistan: Multiple Indicator Cluster Survey (AMICS) reveal the story of a country in transition, where many significant improvements have occurred in the last decade, as Afghanistan emerged from decades of war, poor governance, and widespread human rights abuses. Many Afghans have improved access to drinking water, school attendance is up for both boys and girls, and child mortality is relatively down, if still unacceptably high when compared with global estimates. Yet, progress has come more slowly in many areas, such as women s literacy, and Afghanistan faces new threats on the horizon, such as HIV/AIDS.

Trends between 2002 and 2010 provide an indication of donor priorities and important shifts. For instance, the U.S. remained the largest donor to health in each year over the period and provided the greatest share of its ODA for health. Additionally, the donor mix has shifted over time, in part due to the entrance of new donors, particularly the Global Fund, which was created in 2002 and has been the second largest donor since 2006. The U.S. and the Global Fund combined accounted for more than half of total donor funding for health in 2010.

This Regional Legal Reference Resource - Protective Laws related to HIV, MSM and Transgender People in South Asia (Reference Resource) is an output of the South Asian Roundtable on Legal and Policy Barriers to HIV held in Kathmandu in November 2011 (South Asian Roundtable). This Reference Resource documents key protective laws focused on HIV, men who have sex with men (MSM) and transgender people in five countries in South Asia. The two primary objectives of the Reference Resource are to: 1. build the capacity of legal professionals to analyze protective laws (focusing on people living with HIV, MSM and transgender people); and 2. develop a resource to support legislative drafting, law reform and advocacy initiatives.

In the Asia region, an increasing number of HIV infections occur among men who have sex with men (MSM) and transgender people. Unless effective HIV prevention strategies are implemented, the Commission on AIDS in Asia's regional projections predict that about half (46%) of all new HIV infections in Asia will soon be among MSM, an increase of 13% from 2008. While inadequate HIV data exists on transgender women due to their limited inclusion in national HIV surveillance systems, studies that do exist show transgender women are at disproportionate risk for HIV infection. Young MSM and transgender people in Asia Pacific are at high risk for HIV. Like their older peers who are MSM and/or transgender, these young people face additional barriers to services due to the criminalization of male-to-male sex in 19 out of 38 countries in the Asia-Pacific region, and the intense stigma experienced from family, employers, service-providers and the state (among others).

Hijras and other transgender (TG) people in India face a variety of issues. So far, Hijra/TG communities have been excluded from effectively participating in social and cultural life; economy; and politics and decision-making processes. A primary reason (and consequence) of the exclusion is the lack of (or ambiguity in) legal recognition of the gender status of hijras and other transgender people. It is a key barrier that often prevents them in exercising their civil rights in their desired gender. So far, there is no single comprehensive source on the basis of which an evidence-based advocacy action plan can be prepared by transgender activists or possible legal solutions can be arrived at by policymakers. This background document, hopefully will lead to further consultations with trans communities and other stakeholders, could be an essential first step towards achieving the legal rights of hijras/transgender people in India. The overall purpose of the assignment was to build an evidence-base for improving universal access to HIV prevention services, rights and social protection services for hijras/transgender people.