Recent judicial rulings and policy changes create a more enabling legal environment for the fight against HIV and AIDS

The policy changes in Bangladesh and the judicial decisions in Nepal, Pakistan, and India which legally recognize a third gender will aid the fight against HIV and AIDS in Asia and the Pacific.

Transgender people and hijras have been historically disadvantaged by punitive laws, social marginalization, and extreme stigma. This stigma manifests in social rejection, abandonment by parents, violence, and inability to find employment. As a result, transgender people and hijras often resort to sex work, increasing their risk of HIV transmission.[1] Fearing discrimination and harassment by medical professionals, they often do not seek medical services.[2] In some countries, transgender people are up to seven times more likely than other groups to become infected with HIV.[3]

The Ministry of Social Welfare of Bangladesh and the Supreme Courts of Nepal, Pakistan, and India have chosen to address these issues by clearly communicating that all people—including transgender persons and hijras—are entitled to the fundamental rights guaranteed to them by international agreements and domestic constitutions. Legal recognition of a third gender and transgender people helps reduce stigma and discrimination, making it easier to access government and medical services, and to receive the state’s protection. This is a critical step towards halting HIV in the region and represents steps to implement commitments made on universal access to HIV prevention, treatment, care and support in ESCAP resolutions 66/10 and 67/9, as well as the Political Declaration on HIV and AIDS: Intensifying Our Efforts to Eliminate HIV and AIDS, adopted by the United Nations General Assembly in 2011.

Key facts[4]

  • Although estimates are difficult to come by, UNDP has estimated that there are approximately 9 to 9.5 million transgender people living in Asia-Pacific.
  • HIV prevalence for transgender individuals has been reported to be up to 49 per cent in certain parts of Asia and the Pacific.
  • The Commission on AIDS in Asia has predicted that by 2020 transgender people and MSM will together constitute the majority of new HIV infections in Asia.
  • Stigma leads to marginalization. Marginalization leads to risky behaviours which lead to HIV transmission. Risky behaviours can include sex work, which carries its own stigma, creating a double impact for transgender sex workers.