Transgender people

Transgender women are around 49 times more likely to be living with HIV than other adults of reproductive age with an estimated worldwide HIV prevalence of 19%; in some countries the HIV prevalence rate in transgender women is 80 times that of the general adult population. Little data is available for transgender men or other transgender populations.

Transgender people have low rates of access to health and HIV services due a range of issues including violence, legal barriers, stigma and discrimination.

WHO works with international and country partners to address the varied health needs of transgender people, including HIV prevention, diagnosis and treatment while also supporting partners to address structural barriers which impact on service access by transgender people.

Violence against transgender people is common (including police abuse, abuse perpetrated by clients of sex workers and intimate partner violence). Further, transgender people may experience family rejection, violation of their rights to education, employment and social protections and as such experience higher rates of unemployment, poverty, housing insecurity and marginalisation.

A lack of legal recognition of transgender in most countries contributes to their exclusion and marginalisation. While a few countries in South Asia now recognise a “third gender” in other settings transgender people are required to undergo genital surgery before legal recognition of their gender.

A comprehensive package of services is recommended to address HIV in transgender people including:

Health interventions

- Condom programming
- Harm reduction interventions for those that inject drugs
- Behavioural interventions
- HIV testing and counselling
- HIV treatment and care + PrEP
- Prevention and management of viral Hep, TB and mental health conditions
- Sexual and reproductive health interventions

Structural interventions

- Supportive legislation, policy and funding
- Addressing stigma and discrimination
- Community empowerment
- Addressing violence