HIV infection rates among Thailand’s estimated 180,000 transgenders are thought to be on the rise as prostitution, drug use and a lack of targeted health care services take their toll on one of the country’s most marginalized groups. No official figures detail HIV statistics among transgenders, who are known as “katoey” or “lady-boys.” But in the Chonburi province, local data released this year show 11 percent of transgenders there had HIV, a figure that increased to 20 percent among those age 29 and older. Chonburi is home to Pattaya, one of the centers of Thailand’s booming sex trade. During the tourist season, the city’s population of transgenders swells to 3,000. Chonburi’s data mirror the regional assessment by the UN Development Program this May, when a study estimated HIV prevalence rates among transgenders across Asia-Pacific could be as high as 49 percent. According to UNDP, many transgenders operate on the “social, economic, and legal” margins of society – pushed there by sex work, drugs, stigma, and a lack of health care. “HIV is also just one of a whole range of risks transgender people encounter every day,” said Alex Duke of PSI, the global health organization that conducted the survey on behalf of UNDP. Though Thailand has a famously permissive attitude toward sexuality, discrimination against transgenders is common, said Prempreeda Pramoj Na Ayutthaya, a transgender researcher and activist. Transgender persons often are rejected by their families and schools, resulting in social immobility that may drive them into sex work. “Many transgender people find that sex work is the only way to make a small amount of money and maintain their identity,” said Prempreeda. Advocates are calling for more resources to prevent, diagnose, and treat HIV among transgenders, and to study how the disease is impacting the community.
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