College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
Institute of Resource Governance and Social Change, Jl. R. W. Monginsidi II, No. 2, Kupang, Nusa Tenggara, Timur 85221, Indonesia.
Int J Environ Res Public Health. 2021 May 28;18(11):5814. doi: 10.3390/ijerph18115814.
Transgender populations are considered as a highly vulnerable group to HIV infection. This study aimed to understand structural, personal and socioenvironmental factors and the mechanisms through which these factors facilitate HIV transmission among transgender women () in Yogyakarta, Indonesia. A qualitative inquiry using one-on-one in-depth interviews was employed to collect data from participants ( = 29). Thematic analysis was used to guide data analysis. Findings showed that poverty in families, a sense of responsibility to support family necessities, limited employment options and low education attainment were the structural factors driving participants' engagement in sex work practices and unprotected anal intercourse, which facilitated HIV transmission among them. Personal need fulfilment and the desire for savings were personal factors driving their engagement in these high-risk practices that supported HIV transmission. Social relationships, social influence and the participants' living environment were socioenvironmental factors that also supported sex work practices and HIV transmission among the participants. The findings indicate the need for capacity building in terms of knowledge and skills for populations to prepare and enable them to gain meaningful employment to prevent the vicious cycle of HIV transmission among them. As structural factors seemed to be the main drivers predisposing to HIV acquisition, further studies to explore effective HIV/AIDS interventions that address economic aspects of in Yogyakarta and other similar settings in Indonesia are recommended.
跨性别群体被认为是感染 HIV 的高风险群体。本研究旨在了解印度尼西亚日惹地区跨性别女性（）中促进 HIV 传播的结构、个人和社会环境因素以及这些因素发挥作用的机制。采用一对一深入访谈的定性研究方法从参与者（= 29）处收集数据。使用主题分析来指导数据分析。研究结果表明，家庭贫困、对家庭生计的责任感、有限的就业选择和低教育程度是促使参与者从事性工作和无保护肛交行为的结构性因素，从而促进了 HIV 在他们之间的传播。个人需求的满足和储蓄的愿望是促使他们从事这些高风险行为的个人因素，这些行为支持了 HIV 的传播。社会关系、社会影响和参与者的生活环境是社会环境因素，也支持参与者从事性工作和 HIV 传播。研究结果表明，需要在知识和技能方面为 群体进行能力建设，以准备和使他们能够获得有意义的就业机会，从而防止 HIV 在他们之间的恶性循环传播。由于结构性因素似乎是导致 感染 HIV 的主要驱动因素，因此建议在日惹和印度尼西亚其他类似环境中开展进一步研究，以探索针对跨性别女性的有效 HIV/AIDS 干预措施，解决经济方面的问题。
