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

Nelsensius Klau Fauk, Maria Silvia Merry, Theodorus Asa Siri, Lillian Mwanri and Paul Russell Ward
Additional contact information
Nelsensius Klau Fauk: College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia
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

IJERPH, 2021, vol. 18, issue 11, 1-12

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.

Keywords: HIV infection; structural personal and socioenvironmental factors; transgender women; waria; Indonesia (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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