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Structural, Personal and Socioenvironmental Determinants of HIV Transmission among Transgender Women in Indonesia

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  • Nelsensius Klau Fauk

    (College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia
    Institute of Resource Governance and Social Change, Jl. R. W. Monginsidi II, No. 2, Kupang, Nusa Tenggara, Timur 85221, Indonesia)

  • Maria Silvia Merry

    (Medicine Faculty, Duta Wacana Christian University, Jl. Dr. Wahidin Sudirohusodo, No. 5-25, Kotabaru, Yogyakarta 55224, Indonesia)

  • Theodorus Asa Siri

    (Saint Peter Pastoral Institute of the Diocese of Atambua, Kefamenanu, Nusa Tenggara, Timur 85613, Indonesia)

  • Lillian Mwanri

    (College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia)

  • Paul Russell Ward

    (College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia)

Abstract

Transgender populations are considered as a highly vulnerable group to HIV infection. This study aimed to understand structural, personal and socioenvironmental factors and the mechanisms through which these factors facilitate HIV transmission among transgender women ( waria ) in Yogyakarta, Indonesia. A qualitative inquiry using one-on-one in-depth interviews was employed to collect data from participants ( n = 29). Thematic analysis was used to guide data analysis. Findings showed that poverty in families, a sense of responsibility to support family necessities, limited employment options and low education attainment were the structural factors driving participants’ engagement in sex work practices and unprotected anal intercourse, which facilitated HIV transmission among them. Personal need fulfilment and the desire for savings were personal factors driving their engagement in these high-risk practices that supported HIV transmission. Social relationships, social influence and the participants’ living environment were socioenvironmental factors that also supported sex work practices and HIV transmission among the participants. The findings indicate the need for capacity building in terms of knowledge and skills for waria populations to prepare and enable them to gain meaningful employment to prevent the vicious cycle of HIV transmission among them. As structural factors seemed to be the main drivers predisposing w aria to HIV acquisition, further studies to explore effective HIV/AIDS interventions that address economic aspects of waria in Yogyakarta and other similar settings in Indonesia are recommended.

Suggested Citation

  • Nelsensius Klau Fauk & Maria Silvia Merry & Theodorus Asa Siri & Lillian Mwanri & Paul Russell Ward, 2021. "Structural, Personal and Socioenvironmental Determinants of HIV Transmission among Transgender Women in Indonesia," IJERPH, MDPI, vol. 18(11), pages 1-12, May.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:11:p:5814-:d:564416
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    References listed on IDEAS

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    1. Edwards, J.W. & Fisher, D.G. & Reynolds, G.L., 2007. "Male-to-female transgender and transsexual clients of HIV service programs in Los Angeles County, California," American Journal of Public Health, American Public Health Association, vol. 97(6), pages 1030-1033.
    2. Pande Putu Januraga & Julie Mooney-Somers & Hailay Abrha Gesesew & Paul R Ward, 2020. "The Logic of Condom Use in Female Sex Workers in Bali, Indonesia," IJERPH, MDPI, vol. 17(5), pages 1-12, March.
    3. Nemoto, T. & Operario, D. & Keatley, J. & Han, L. & Soma, T., 2004. "HIV risk behaviors among male-to-female transgender persons of color in San Francisco," American Journal of Public Health, American Public Health Association, vol. 94(7), pages 1193-1199.
    4. Nelsensius Fauk & Rik Crutzen & Maria Silvia Merry & Sukma Putra & Mitra Andhini Sigilipoe & Lillian Mwanri, 2017. "Exploring Determinants of Unprotected Sexual Behaviours Favouring HIV Transmission among Men who Have Sex with Men in Yogyakarta, Indonesia," Global Journal of Health Science, Canadian Center of Science and Education, vol. 9(8), pages 1-47, August.
    5. Clements-Nolle, K. & Marx, R. & Guzman, R. & Katz, M., 2001. "HIV prevalence, risk behaviors, health care use, and mental health status of transgender persons: Implications for public health intervention," American Journal of Public Health, American Public Health Association, vol. 91(6), pages 915-921.
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    Cited by:

    1. Roberta Tassinari & Francesca Maranghi, 2021. "Rodent Model of Gender-Affirming Hormone Therapies as Specific Tool for Identifying Susceptibility and Vulnerability of Transgender People and Future Applications for Risk Assessment," IJERPH, MDPI, vol. 18(23), pages 1-14, November.

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