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HIV prevention needs of transgender sex workers in Serbia Dr.Dragan Ilic Association Against AIDS – JAZAS Institute for Students’ Health Belgrade, Serbia. THE FACTS (from previous research) . Sex workers are “hard to reach “ group for preventive activities Reasons .
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HIV prevention needs of transgender sex workers in SerbiaDr.DraganIlic Association Against AIDS – JAZAS Institute for Students’ Health Belgrade, Serbia
THE FACTS (from previous research) • Sex workers are “hard to reach “group for preventive activities Reasons • Illegal status • High level of stigma • Discriminatory treatment in institutions • Persecution by police • Violence by police, pimps, clients, others
THE FACTS (from previous research) • 2.Transgender sex workers are a subgroup among others SW Reasons • Higher degree of isolation • More frequent drug use • Added risk (non sterile injecting equipment for hormone therapy) • Multiple form of stigma and discrimination
The reasons for selecting this group • Very little is known about transgender people in Serbia • Even less is knownabout transgender sexworkers • No specific preventive or any programs targeting them
Research goals • To learn about preventive needs of transgender SW • To provide necessary data for strategy and planning • To determine the similarities and differences of transgender SW in comparison to others. Research methodology Snow ball sample Inclusion criteria *all sw ( M, W and TG ) who sold sexual services in last 12 months *18 or older *working on the street and indoor
RESULTS -1 Overall 250SW were included • Education Tg. do not differ 40%have no education • Ethnicity Tg.are mostly of Roma ethnicity-which adds anoter level of preventive needs MULTIPLE DISCRIMINATION 155 WOMEN 55 MEN 44 TRANSGENDER
RESULTS -2 • Violence Percentage of TG persons (52,5%) who were victimsof violence –significantly higher than other SW. Fear of violence is the reason why transgender sex workers work on the streets statistically significantly less than other sex workers: exposure to violence from clients and from the police is much higher on the street • Auto-stigma,feeling of shame and quilt Among TG SW (47,5%) significantly higher than among others
RESULTS -3 • Condom usage 87% claim to have used condom during last sexual intercourse • Psyshoactive druge use and intravenous drug use. TG do not differ • Health servicess accessibility TG do not differ - 25% of TG have given up from trying to access any kind of services for fear of being exposed as SW or transgender
CONCLUSIONSwhat make trans gender SW a subgroup • Mostly Roma • Multiple discrimination • High level of violence • Very low socioeconomic and educational status • Inability to access health services • High level of auto stigma • Double HIV risk (drugs and hormones non sterile injections) • Inadequate self assessment of risk • Numerous sexual partners
RECOMMENDATIONS • Their preventive needs cannot be met through preventive programs designed for all SW. • Special programs and interventions are needed Expected results • Awareness raising about human and HIV preventive rights of TG people, SW. • Visibility and affirmation of transgender identities • Raising self efficacy and self confidence • Diminishing HIV risk