Despite condom interventions since year 2000 with the transgender (hijra) population, condom use remains low. Consequently, hijra suffer from higher rates of active syphilis, putting them under threat of HIV transmission. In an ethnographic study, 50 in-depth interviews with diverse groups of hijra along with 20 key-informants interviews with various stakeholders, and 13 focus group discussions (FGDs) were conducted with comprehensive field observations. Findings indicate that most hijra understand the importance of condoms, but none use condoms consistently. Complex underlying reasons positioned beyond the individual’s cognitive domain include: low self-confidence; economic hardships for mere survival; multiple transient partners; sexual desire, preferences, and eroticisms concerning anal sex; stigma associated with purchasing condoms; poor quality and interrupted supply of condoms and lubricants; limitation of fear-producing messages in favor of condoms; inadequate professional skills and motivational impetus of the outreach staff for condom promotion, and incompetent management with inadequate understanding about the dynamics of condom use. Imposing condoms by disregarding socio-cultural and socio-economic scripts of sexual relationships and eroticism of hijra-sexuality have challenged the effectiveness of current condom interventions. Interventions should not mechanize the process, rather they may humanize and eroticize sexual lives of the hijra. A paradigm shift is required where condoms enhance the dignity and quality of sexual lives of the hijra beyond the framework of disgrace, disease, and death.
By Sharful Islam Khan et al., 2009