What can PrEP do for female sex workers? Unpacking the "effectosphere" of biomedical HIV prevention in Dar es Salaam
Bibliographic Data
| ID | 4589622 |
|---|---|
| Authors | Hanne Ochieng Lichtwarck (0000-0003-4495-7480, University of Oslo), Emmanuel Peter Massawe (Muhimbili University of Health and Allied Sciences), Elia John Mmbaga (0000-0003-3768-0225, University of Oslo), Kåre Moen (0000-0002-4537-9654, University of Oslo) |
| Year | 2024 |
| Volume | 358 |
| Pages | 117245 |
| Publication date | 2024-10-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Social Science & Medicine (JOURNAL) |
| Journal identifiers | ISSN: 0277-9536 • E-ISSN: 1873-5347 |
| Publisher | Elsevier BV (PUBLISHER) |
| DOI | 10.1016/j.socscimed.2024.117245 |
| PMID | 39197277 |
| OpenAlex | W4401662593 |
| Language | EN |
| Citations received | 1 |
| References cited | 31 |
Pre-exposure prophylaxis (PrEP) is a drug with the power to prevent HIV transmission. This study delved into the broader implications of PrEP use among female sex workers in Dar es Salaam, Tanzania, a group disproportionately affected by HIV and socio-structural challenges. Through 46 in-depth interviews with 40 women who were either former or current PrEP users or intended to start PrEP between January 2021 and February 2022, we sought to explore the nuanced effects of PrEP. Inspired by Whyte et al. and "Social Life of Medicines", we asked what PrEP could do in the lives of female sex workers and analyzed the data using reflexive thematic analysis and an interpretative phenomenological approach. We found that PrEP had multiple and diverse effects in many domains of women's lives and refer to these collectively as the "effectosphere" of PrEP. The study identifies four key themes that jointly describe this effectosphere: (1) PrEP could promote human flourishing and empowerment by facilitating a feeling of freedom and confidence which could promote health, social relations, and economic and work opportunities, (2) PrEP could inflict harm (and fears of such harms), partially reflecting medical mistrust rooted in an understanding that sex workers were undesired in society, (3) PrEP could expose sensitive information about its users that could lead to stigma, arguments and needs for elaborate explanations, and (4) PrEP could medicalize daily life, evidenced through daily pill taking, clinical appointments, side-effects, becoming reliant on the medication, and the challenges of integrating PrEP use with other life priorities. We argue that investigating the full effectosphere of any medicine in particular geographic and sociocultural contexts can lead to a better understanding of its use and non-use, highlighting that engaging with medication extends beyond just "taking a pill
Empowerment · Family medicine · Human immunodeficiency virus (HIV · Men who have sex with men · Political science · Pre-exposure prophylaxis · Qualitative research · Sex work · Sociology · Thematic analysis · Gender Studies · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Psychology · Sex work and related issues
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Reducing HIV-Related Stigma
Towards a More Inclusive and Dynamic Understanding of Medical Mistrust Informed by Science
“Whatever is in the ARVs, is Also in the PrEP” Challenges Associated With Oral Pre-exposure Prophylaxis Use Among Female Sex Workers in South Africa
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Awareness, Willingness and Use of HIV Pre-Exposure Prophylaxis Among Female Sex Workers Living in Dar-es-Salaam, Tanzania
Beyond exploitation
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Terms of empowerment/exemplars of prevention
Between Individual Agency and Structure in HIV Prevention
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| Unique citing works | 1 |
|---|---|
| Citations per year | 1 |
| Citation span | 2026 - 2026 (1) |
| Citation velocity | current |
| Highly cited | No |
| Citation types | Neutral: 1 |