HIV-related needs for safety among male-to-female transsexuals (mak nyah) in Malaysia

Abstract

This research, commissioned by the Malaysian AIDS Council in 2007, is qualitative and descriptive in nature. In depth face-to-face interviews were carried out with 15 mak nyah respondents from five major towns. The interviews were guided by an interview schedule that had seven main topics: brief background; hormone-taking behaviour; safe sex; health care; substance abuse; harassment from authorities; and HIV prevention. The HIV problem among the mak nyah, mak nyah sex workers and their clients is critical. Many do not have in-depth HIV/AIDS knowledge and do not practise safe sex. The problem gets worse when most mak nyah do not consider HIV/AIDS as a primary concern because of other pressing problems like employment and discrimination. There are also no HIV prevention activities in many parts of Malaysia. Mak nyah also face constant harassment from enforcement authorities for prostitution. This hampers HIV prevention work.Keywords: Transsexuals, transgender, sex workers, HIV prevention. RésuméCette étude, commandée par le Conseil du SIDA de Malaisie en 2007, est par nature qualitative et descriptive. Des entretiens approfondis en tête à tête ont été organisés avec 15 personnes mak nyah interrogées de cinq grandes villes. Les entretiens étaient guidés par un programme d' entretien qui présentait sept thèmes principaux: contexte rapide; comportement vis-à-vis de la prise d'hormones; rapports sexuels protégés; soins médicaux; abus de substances; harcèlement des autorités; et prévention du VIH. Le problème du VIH parmi les mak nyah, les travailleurs du sexe mak nyah, et leurs clients est critique. Nombre d' entre eux n' ont pas de connaissances approfondies sur le VIH/SIDA et ne pratiquent pas de rapports sexuels protégés. Le problème s'aggrave lorsque la majorité des mak nyah ne juge pas que le VIH/SIDA constitue une préoccupation première du fait d'autres problèmes pressants tels que l' emploi et la discrimination. Il n' existe pas non plus d'activités de prévention du VIH dans de nombreuses régions de Malaisie.Les mak nyah sont confrontés à des harcèlements constants de la part des autorités chargées du respect de la loi pour cause de prostitution. Cela gêne le travail de prévention du VIH.

Acceptability of a microfinance‐based empowerment intervention for transgender and cisgender women sex workers in Greater Kuala Lumpur, Malaysia

“…These groups have been marginalized through a process of stigmatization, discrimination, and criminalization [ 7 – 10 ]. As in most countries, sex work is criminalized in Malaysia [ 11 ], leaving CWSWs and TWSWs vulnerable to physical and sexual abuse from legal authorities. Structural conditions also leave TWSWs and CWSWs vulnerable to economic instability [ 12 – 14 ], with research highlighting that transgender women often experience difficulties entering stable forms of employment due to lack of qualifications and discrimination.…”

“…Structural conditions also leave TWSWs and CWSWs vulnerable to economic instability [ 12 – 14 ], with research highlighting that transgender women often experience difficulties entering stable forms of employment due to lack of qualifications and discrimination. Poverty inhibits sex workers’ use of condoms with clients [ 11 , 15 – 17 ]; evidence has shown that many sex workers acquiese to requests from clients to not use condoms in exchange for higher payments [ 18 , 19 ].…”

Gender identity, healthcare access, and risk reduction among Malaysia'smak nyahcommunity

“…Though the total number of TGW in Malaysia is unknown, an estimated 21,000 TGW engage in sex work, with 37.5% of them residing in greater Kuala Lumpur (Lim, Ang, & Teh, 2010); HIV prevalence among all TGW is estimated at 10% (Ministry of Health Malaysia, 2013). While some literature has highlighted the need for HIV prevention and advocacy services for mak nyah (Teh, 2008a) , there is otherwise limited recent research available, particularly surrounding how their identity influences access to and engagement in healthcare generally and specifically for HIV prevention and treatment services.…”

The Phenomena Of Transsexualism In Malaysia – A Socio-Legal Perspective

“…They encounter immense hardship to secure gainful employment and in order to survive, some of them resorted to involve in sex work. As a result, they are exposed to the high risk of HIV infection (Teh, 2008) and other sexually transmitted diseases. According to the Human Rights Watch's report in 2017, legal criminalisation and public discrimination have caused transsexuals to avoid public health facilities and as a result, HIV prevalence among the transsexual individuals is estimated at 5.6% as compared to 0.4% among the general population.…”