1. www.aids2014.org KEBAYA Keluarga Besar Waria Yogyakarta assisting transvestites living with HIV starting antiretroviral treatment in Yogyakarta, Indonesia Vinolia Wakijo, Priyadi Prihaswan, Ken Murray

2. www.aids2014.org Presentation Structure KEBAYA HIV and AIDS situations in Yogyakarta Lessons learned Future roles

3. www.aids2014.org KEBAYA Stands for Keluarga Besar Waria Yogyakarta Means Yogyakarta’s Big Transvestite Family

4. www.aids2014.org Waria Wanita (woman) Pria (man)

5. www.aids2014.org KEBAYA Peer based organisation Established in December 2006 A group of dedicated waria/transvestites Runs safe accommodation for waria living with HIV to commence treatments Acts as a site for VCT for HIV testing mobile clinics Relies on donations

6. www.aids2014.org Kebaya Safe Accommodation Two bedroom house Members/volunteers assist clients with food, support in managing ART adherence, side effects and doctors’ appointments Self referred and referred from the local HIV hospital clinics

7. www.aids2014.org Context Waria are marginalised Estranged from their family Approximately 75% of the 500 waria reached by KEBAYA outreach program are sex workers Waria is an important population to target in treatment as prevention program

8. www.aids2014.org Yogyakarta, Indonesia

9. www.aids2014.org Access to ARV in Indonesia Available with subsidy in 2006 Limited ARV combination options High level of adherence is required to prevent resistance Stigma and discrimination

10. www.aids2014.org Overview 59 waria (10% of all people with HIV accessing treatment in Yogyakarta) have utilised the service 18 have passed away 7 are lost to follow up 34 are confirmed continuing ARV Currently 2 people are staying at KEBAYA Kartu Jaminan Kesehatan Sosial

11. www.aids2014.org Group discussion With 12 waria and MSM with HIV Current and past clients 28 – 54 years old Interview with an HIV consultant

12. www.aids2014.org Lessons Learned Trust “….in here I know that I will be well cared for….” (Waria, 32 yrs) Emotional support “….it feels like living with a family. Vinolia is just like my mother…..” (Waria, 28 yrs)

13. www.aids2014.org Managing side effect “…I still cannot go home because I still have rash on my hands. I am not out to my family…” (MSM, 47yrs) Managing adherence “I was always reminded to take my medications” (Waria, 53 yrs) Doctors’ appointment “…they look after you very well and would take you to the doctor’s appointment...” (Waria, 44 yrs)

14. www.aids2014.org Challenges Medical complexity Working relationship with local Ministry of Social Welfare Moving out Life after KEBAYA Sustainable income for organisation

15. www.aids2014.org The future To continue current work To support Strategic Use of Antiretrovirals to help end the HIV epidemic (WHO) “KEBAYA has become the meeting point for Waria and MSM. It will play an important role to reach priority populations for HIV testing, educate them about treatments and monitor adherence” (HIV consultant)

16. www.aids2014.org Acknowledgement Group discussion participants Ken Murray Dr Yanri Subronto KEBAYA’s supporters

17. www.aids2014.org Terima kasih - Thank you