Pushed to the Margins: Post-diagnosis Experiences of Hijra (Transgender) Sex Workers Living with HIV Infection

Sexual health rights of hijra (transgender) sex workers are not usually given due attention by the conventional frameworks of AIDS intervention in Pakistan. This study examines the perceptions and experiences of HIV infected HSWs regarding their post-diagnosis identity, sexual conduct with clients, religious life, and social support system. In-depth interviews were conducted with the HSWs residing in Lahore city, Pakistan. Purposive sampling technique was used to select the study participants. Data was analyzed using thematic analysis technique. The study found that the diagnosis of HIV infection adds to the social stigmatization of HSWs and further declines their social standing. Hijras usually carry on with paid sex after being diagnosed with HIV infection. There is less sensitivity among HSWs about the use of condom and other precautionary measures, while having sex. Many clients continue to have sex with HSWs despite knowing about their illness. In the post-diagnosis phase, hijras are likely to experience humiliating behavior of their fellow hijras. As a result, these hijras tend to avoid interaction within their community setting and face isolation after being diagnosed with HIV. The study recommends that collaborated efforts and concentrated actions are needed from the governmental bodies and law making authorities to ensure human rights for hijras. Also, there is a dire need to raise community awareness among hijras regarding HIV/AIDS through awareness campaigns and AIDS control programs.