Although clinical experience and preliminary research suggest that som
e transgender people are at significant risk for HIV, this stigmatized
group has so far been largely ignored in HIV prevention. As part of t
he development of HIV prevention education targeting the transgender p
opulation, focus groups of selected transgender individuals assessed t
heir HIV risks and prevention needs. Data were gathered in the followi
ng four areas: (I) the impact of HIV/AIDS on transgender persons; (2)
risk factors; (3) information and services needed; and (4) recruitment
strategies. Findings indicated that HIV/AIDS compounds stigmatization
related to transgender identity, interferes with sexual experimentati
on during the transgender 'coming out' process, and may interfere with
obtaining sex reassignment. Identified transgender-specific risk fact
ors include: sexual identity conflict, shame and isolation, secrecy, s
earch for affirmation, compulsive sexual behaviour, prostitution, and
sharing needles while injecting hormones. Community involvement, peer
education and affirmation of transgender identity were stressed as int
egral components of a successful intervention. Education of health pro
fessionals about transgender identity and sexuality and support groups
for transgender people with HIV/AIDS are urgently needed.