1. Transgender in Tamil Nadu are still highly vulnerable to HIV and STIs; findings from bio-behavioral surveys
L. Ramakrishnan1, P. Goswami1, T. Subramaniam2, S. Mathew1, S. Ramanathan1, B. George1, R. Adhikary3, M.K. Mainkar4, R.S. Paranjape4
1FHI 360, India, New Delhi, India
2National Institute of Epidemiology (NIE),ICMR, Chennai, India
3FHI 360, Washington, Washington DC, United States
4National AIDS Research Institute-ICMR, Pune, India

2. Background
A prevention program for Transgender (TG) (Hijra or Aravani) was implemented in parallel to the program for MSM populations, across 14 districts of Tamil Nadu, India since 2004
Program focus was on peer education, condom promotion, STI clinical services, community mobilization and advocacy for rights against marginalization
Current analysis examines outcomes among Aravani after program implementation, based on two rounds of cross-sectional bio-behavioral survey data (IBBA) collected in (Round 1) and 2009 (Round 2)
Probability based sampling approach was used to recruit respondents from street and home based locations
A total of 404 respondents in Round 1 and 403 in Round 2 were sampled across five districts: Chennai, Coimbatore, Dharmapuri, Madurai, Salem
Madurai
Salem
Coimbatore
Chennai
Dharmapuri

3. Key Results

4. Summary
Condom use (at last sex) declined between IBBA rounds with all partners; consistent condom use increased with regular and casual partners, but statistically not significant
Peer contacts increased over the two rounds however STI clinic visits declined
Prevalence of HIV remained unchanged between rounds; Syphilis prevalence declined significantly
Additional behavior change communication strategies and structural interventions are needed to reduce risk of HIV and STIs among Transgender in Tamil Nadu

5. Acknowledgement
The collection and analysis of data presented hereby were conducted as part of the Avahan evaluation strategy and were supported by the Bill & Melinda Gates Foundation

6. Thank You