Effective peer based outreach: making the difference in HIV prevention intervention for hijra (transgender)

Published: August 1, 2008

Effective peer based outreach: making the difference in HIV prevention intervention for hijra (transgender)

Issues: Even though outreach workers in transgender program in Bangladesh are knowledgeable, skillful and hardworking, the rate of condom use is still remaining very low and the prevalence of active syphilis is 5.2% in central area (6th round sero-surveillance, 2005). This indicates a clear high risk in their sexual behavior which might requires expert review for positive changes. 

Description: In UNICEF-HAPP and other transgender intervention, outreach workers are not adequate in numbers (usually 1:60). Their acceptance in the transgender community is also poor. To increase positive impact, considering social perspective, evidence based effective outreach approach for the program need to be established. Improving the ratio between transgender and outreach worker is also crucial. 

Lessons learned: UNICEF-HAPP team organized Peer education training for master trainers in all of its program areas who will be providing center based training for all Outreach worker/Peer Educators in Hijra/transgender projects. Significant changes in approach and attitude are already seen in most of the Peer Educators. They are now working with more ownership and confidence. This seems to be more effective in future HIV program with transgender population. 

Next steps: From the lessons learnt, an effective HIV program for transgender must requires very strong OUTREACH WORK which basically contributes to the major components such as, Behavior change communication, STI management and Condom promotion in order to increase the consistent condom use.

For achieving development in the above components, an outreach worker needs to be:
• A person from the same community (preferably a Hijra/transgender) who owns the program. 
• The person should have leadership and be willing to provide support to their peers 
• The person should have strong social network by which the person gets access to their peers as well as to the community leaders. 

-Abstract can be found at link below-

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