[health menu] XI International Conference on AIDS
July 7-12, 1996

Serre A., Maugat S., De Vincenzi, I.
European Centre for the Epidemiological Monitoring of AIDS
Saint-Maurice, France

Lansun, Eva, Cabral C.,
Castelletti S., Ourkia S.
PASTT, Paris, France


Preventive Actions Against HIV Infection Among Tranvestite and Transformist Sex Workers (CSW) in Paris


First year of activity of a community-based preventive action among street-based transvestite/transformist CSW.


In September 1994 a mobile drop-in centre (bus) was set up with the objectives of developing HIV/STD prevention and facilitating access to health and social services among sex workers. Field work (inside or around the bus) has been coordinated by three (former) sex workers working in collaboration with health/social workers in two areas of Paris. Strategies include providing information and prevention materials (condoms, lubricant) on a one-to-one basis and help in accessing health and social services. Exhaustive data were collected on the number and characteristics of transvestites/transformists visiting the bus.


Between 1 September 1994 and 31 August 1995, during 88 sessions in the bus (46 in the park "Bois de Boulogne" and 42 on the ring roads), 39500 condoms were distributed (18/person/visit). Since no specific prevention leaflets were available for this population, an illustrated leaflet was designed with the participation of transvestites/transformists themselves. During the same period, 374 transvestites/transformists, 79% of whom were migrants, came to the bus with a total of 2192 visits. In both districts, more than 54% lived precariously (hotel or no fixed address) and 83% had no health insurance. The team encountered difficulties in trying to improve individual circumstances. For example, it is hard to find emergency accommodation for transvestites/transformists, since they are not easily accepted by women or by men. It is also difficult for migrants to have access to health insurance, and thus to health services. During the one-year period, 6 transvestites/transformists died of AIDS representing a mortality rate of nearly 2%/60 times higher than the AIDS mortality rate among 25-44 year-old men in France. As a consequence of the need to support transvestites/transformists with AIDS, a housing project for people with AIDS is being set up.

Lessons learned

The situation of this population is extremely precarious. Working at improving the health and social living conditions of the population is the only means to get the HIV preventive action message across. However, the task is difficult, and requires an intensive partnership between the team and existing health and social services. Besides primary HIV infection prevention, secondary prevention (support of HIV-infected persons) is essential.

E. Lansun
PASTT, c/o AIDES-Federation
23 rue du chateau Landon
75010 Paris, France
Tel: (33) 1 53 26 26 92; Fax: (33) 1 53 26 27 88

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Created: August 3, 1996
Last modified: August 4, 1996

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