Economic marginalization as a result of institutionalized discrimination, stigma, and low levels of education contribute to a severe lack of opportunities for many transgender. In the Asia-Pacifc Region, a considerable percentage of transgender women are engaged in sex work.12 Available statistics indicate the following percentages of transgender persons involved in the sex industry in the following countries: Indonesia, 81% (2011); Malaysia, 84% (2009); Cambodia, 36% (2009); India, 90% (2009- 2010).13 There is no comparable data available for China.

An increasing amount of evidence shows that transgender women14 and transgender female sex workers are among the populations most heavily afected by HIV.15 Transgender women are 49 times more likely to acquire HIV than all adults of reproductive age.16 In global terms, the rate of HIV infection among transgender women engaged in sex work is 27.3%, and the rate of infection among transgender persons overall is 14.7%.