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KEBAYAKeluarga Besar Waria Yogyakarta

assisting transvestites

living with HIV

starting antiretroviral

treatment

in Yogyakarta, Indonesia

Vinolia Wakijo, Priyadi Prihaswan, Ken Murray

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Presentation Structure

• KEBAYA • HIV and AIDS situations in Yogyakarta• Lessons learned• Future roles

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KEBAYA

• Stands for Keluarga Besar Waria Yogyakarta

• Means Yogyakarta’s Big Transvestite Family

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Waria

•Wanita (woman)• Pria (man)

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KEBAYA

• Peer based organisation• Established in December 2006 • A group of dedicated waria/transvestites• Runs safe accommodation for waria living

with HIV to commence treatments• Acts as a site for VCT for HIV testing mobile

clinics • Relies on donations

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Kebaya Safe Accommodation

• Two bedroom house• Members/volunteers assist clients with

food, support in managing ART adherence, side effects and doctors’ appointments

• Self referred and referred from the local HIV hospital clinics

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Context

• Waria are marginalised • Estranged from their family• Approximately 75% of the 500 waria

reached by KEBAYA outreach program are sex workers

• Waria is an important population to target in treatment as prevention program

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Yogyakarta, Indonesia

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Access to ARV in Indonesia

• Available with subsidy in 2006• Limited ARV combination options• High level of adherence is required to

prevent resistance• Stigma and discrimination

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Overview

• 59 waria (10% of all people with HIV accessing treatment in Yogyakarta) have utilised the service

• 18 have passed away• 7 are lost to follow up• 34 are confirmed continuing ARV• Currently 2 people are staying at KEBAYA• Kartu Jaminan Kesehatan Sosial

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Group discussion • With 12 waria

and MSM with HIV

• Current and past clients

• 28 – 54 years old• Interview with an

HIV consultant

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Lessons Learned

• Trust

“….in here I know that I will be well cared for….” (Waria, 32 yrs)

• Emotional support

“….it feels like living with a family. Vinolia is just like my mother…..” (Waria, 28 yrs)

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• Managing side effect

“…I still cannot go home because I still have rash on my hands. I am not out to my family…” (MSM, 47yrs)

• Managing adherence

“I was always reminded to take my medications” (Waria, 53 yrs)

• Doctors’ appointment

“…they look after you very well and would take you to the doctor’s appointment...” (Waria, 44 yrs)

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Challenges

• Medical complexity• Working relationship with local Ministry of

Social Welfare• Moving out• Life after KEBAYA • Sustainable income for organisation

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The future

• To continue current work • To support Strategic Use of Antiretrovirals

to help end the HIV epidemic (WHO)

“KEBAYA has become the meeting point for Waria and MSM. It will play an important role to reach priority populations for HIV testing, educate them about treatments

and monitor adherence” (HIV consultant)

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Acknowledgement

• Group discussion participants• Ken Murray• Dr Yanri Subronto• KEBAYA’s supporters

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Terima kasih - Thank you