decided to treat transgender people as a subgroup of MSM, rather than establish
stand-alone HIV-prevention programs for them.258
The research for this report illuminates that the community of female presenting sex
workers is very complex and includes MSM, transgender people and transsexuals.
Their vulnerabilities to HIV and their varied health needs must be carefully assessed,
strategically targeted and addressed. As China is the process of drafting a new HIV/
AIDS action plan for 2016-2020, now is a good opportunity to develop a specific
strategy on HIV prevention and care for the transgender community.
At the global level, the health and rights of the transgender community are drawing
increasing attention and concern. At the 20th International AIDS Conference in
Melbourne, Australia in 2014, concrete epidemiological statistics were used to
show the high risk of HIV infection faced by the transgender community. At that
conference, the World Health Organization launched new “Consolidated guidelines on
HIV prevention, diagnosis, treatment and care for key populations,” which included
recommendations for interventions targeting five groups, including transgender people.
WHO noted the five groups were people who were “most at risk of HIV infection yet are
least likely to have access to HIV prevention, testing and treatment services. In many
countries they are left out of national HIV plans, and discriminatory laws and policies
are major barriers to access.”259
The Global Fund to Fight AIDS, Tuberculosis and Malaria is the world’s largest health
financing organization for the each of the three diseases on which it focuses. In
consideration of the increased vulnerability of sexual minorities caused by social
expectations regarding gender, and the consequent effect on the health of these
minorities, the Global Fund formulated a “Global Gender Equality Strategy” and a
“Global Fund Sexual Orientation and Sexual Identities Strategy.” These strategies
provide concrete guidance on how Global Fund projects concern themselves with
problems of sexual orientation and gender identity.260
At the same time, more states have been acknowledging transgender communities
in their laws. In April 2014, the Supreme Court of India issued a ruling recognizing
“third gender,” allowing the choice of a third gender beside male or female, and the
258 Chengdu Tongle Health Counseling Service Center. “Assessment analysis report on the scale and sexual health needs and behavior of the MSM
subgroup in Chengdu.” [成都市MSM亚群体规模及性健康需求和行为评估分析报告]. June 2011.
259 World Health Organization. “WHO: People most at risk of HIV are not getting the health services they need.” July 11, 2014. http://www.who.int/
mediacentre/news/releases/2014/key-populations-to-hiv/en/ (accessed November 15, 2014).
260 The Global Fund to Fight AIDS, Tuberculosis and Malaria. “The Global Fund Strategy in Relation to Sexual Orientation and Gender Identity.” http://
www.theglobalfund.org/documents/core/strategies/Core_SexualOrientationAndGenderIdentities_Strategy_en/ (accessed November 15, 2014).
62