A comprehensive package of HIV interventions for transgender people in the post-soviet region

BACKGROUND: Transgender people belong to one of the five key populations recognized by UNAIDS as particularly vulnerable to HIV, HIV prevalence among transgender women can be up to 49 times higher than the prevalence in the general population. However, in the post-Soviet region, with the exception of Kyrgyzstan, transgender people are not identified as a key group, and their specific needs are not taken into account when developing HIV prevention and treatment programs.Medical professionals involved in prevention programs rarely understand how trans-specific and trans-competent services should be built.
The proposed comprehensive package of activities aims to fill these gaps.
METHODS: The data collection method is a desk analysis. The first project of a comprehensive package of services created was piloted in five countries of the region: Armenia, Georgia, Kyrgyzstan, Russia, Ukraine, reaching 50 transgender people through a facilitated focus group discussion, where transgender people gave their feedback. Feedback was taken into account when finalizing the comprehensive package of services.
RESULTS: The set of activities as a whole corresponds to the international recommendations and expertise. Among the differences, the following can be noted: (a) the classification of activities is based on the Health Impact Pyramid; (b) a wider range of gender transition activities are included, which are seen as preventive strategies and motivational activities; (c) the social and legal specifics of the countries of the post-Soviet region are taken into account.
The package presented below contains the most complete set of activities and in this sense is the "ideal" option to strive for.
CONCLUSIONS: The created package of comprehensive services is not only designed to fill the gap associated with HIV activities for trans* people in the post-Soviet region, but also provides for the specifics of the region for subsequent implementation. The package provides recommendations for creating an environment free of discrimination and violence, provides for long-term preventive measures, which include activities that are carried out one-time or infrequently and have a long-term effect on preventing HIV infection. The package details clinical regulatory activities, the Implementation chapter with practical recommendations, and M&E chapter.

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