Article
Autonomy and care in context: the paradox of sex workers’ acceptability of hiv self‑tests in São Paulo, Brazil
Registro en:
MURRAY, Laura Rebecca et al. Autonomy and care in context: the paradox of sex workers’ acceptability of hiv self‑tests in São Paulo, Brazil. Archives of Sexual Behavior, [s. l.], n. 51, p.1-10, 2021.
0004-0002
10.1007/s10508-021-02129-y
Autor
Murray, Laura Rebecca
Ferraz, Dulce Aurélia de Souza
Zucchi, Eliana Miura
Sorrentino, Isa da Silva
Grangeiro, Alexandre
Resumen
Cisgender female sex workers (CFSW) continue to face structural barriers to HIV prevention. We analyzed the acceptability
of the oral HIV self-test (HIV-ST) among CFSW as part of a pragmatic trial on HIV prevention in Brazil. Data from in-depth
interviews conducted with 12 women from diverse sex worker contexts and participant observation were analyzed using thematic
analysis. CFSW valued autonomy in their workplaces and saw the HIV-ST as a possibility for self-care. Some feared
clients’ reactions, manager reprimands, and a positive result. HIV and sex work stigma largely drove self-care practices and
perceived acceptability of the self-test. We argue that the autonomy offered by the self-test presents a paradox: increasing
autonomy on the one hand while risking sidestepping structural dimensions of HIV vulnerability on the other. These nuances
must be considered in interventions promoting the HIV-ST by considering the specificities of sex worker contexts, addressing
stigma, and effectively involving CFSW and their organizations in intervention development.