Not in our Name Emily Jay Nicholls; Jade Vu Henry; Fay Dennis
Nordic journal of science and technology studies,
04/2021, Letnik:
9, Številka:
1
Journal Article
Odprti dostop
In this paper, we draw on our collaborative work running a salon for thinking about care in STS research, which quickly became more about fostering an ethico-politics for thinking with care as a mode ...of academic intervention. Not dissimilar to the origins of the salon in nineteenth-century France, the salon provided a provocative and disruptive space for early career researchers (ECRs) to think together. As attention and critique increasingly point towards the unequal distribution of harms arising from marketization and the vulnerability of ECRs in the ‘neoliberal university,’ we have witnessed a surge in activities that promise a supportive space, such as pre-conference conferences, seminar series, discussion forums and self-care workshops. In this paper, we ask not only what these modes of care might make possible, but also what exclusionary practices and patterns they mask or render more palatable (Ahmed, 2004; Duclos & Criado, 2020; Martin et al., 2015; Murphy, 2015). Reflecting on our experiences of organizing and participating in the salon, with the stated purpose to explore ‘ecologies of care’ as an embodied socio-material practice (Puig de la Bellacasa, 2017), we move from care ‘out there’ in STS research to care ‘in here’. We follow threads spun by and out from the group to rethink our own academic care practices and how to do the academy otherwise.
The potential of HIV self-testing (HIVST) to cause harm is a concern hindering widespread implementation. The aim of this paper is to understand the relationship between HIVST and harm in SELPHI (An ...HIV
f-testing
ublic
ealth
ntervention), the largest randomised trial of HIVST in a high-income country to date.
10 111 cis and trans men who have sex with men (MSM) recruited online (geolocation social/sexual networking apps, social media), aged 16+, reporting previous anal intercourse and resident in England or Wales were first randomised 60/40 to baseline HIVST (baseline testing, BT) or not (no baseline testing, nBT) (randomisation A). BT participants reporting negative baseline test, sexual risk at 3 months and interest in further HIVST were randomised to three-monthly HIVST (repeat testing, RT) or not (no repeat testing, nRT) (randomisation B). All received an exit survey collecting data on harms (to relationships, well-being, false results or being pressured/persuaded to test). Nine participants reporting harm were interviewed in-depth about their experiences in an exploratory substudy; qualitative data were analysed narratively.
Baseline: predominantly cis MSM, 90% white, 88% gay, 47% university educated and 7% current/former pre-exposure prophylaxis (PrEP) users. Final survey response rate was: nBT=26% (1056/4062), BT=45% (1674/3741), nRT=41% (471/1147), RT=50% (581/1161).Harms were rare and reported by 4% (n=138/3691) in exit surveys, with an additional two false positive results captured in other study surveys. 1% reported harm to relationships and to well-being in BT, nRT and RT combined. In all arms combined, being pressured or persuaded to test was reported by 1% (n=54/3678) and false positive results in 0.7% (n=34/4665).Qualitative analysis revealed harms arose from the kit itself (technological harms), the intervention (intervention harms) or from the social context of the participant (socially emergent harms). Intervention and socially emergent harms did not reduce HIVST acceptability, whereas technological harms did.
HIVST harms were rare but strategies to link individuals experiencing harms with psychosocial support should be considered for HIVST scale-up.
ISRCTN20312003.
Objectives
This qualitative sub‐study aimed to explore how cisgender gay, bisexual, and other men who have sex with men (cis‐GBMSM) and transgender people who reported non‐consensual sex (NCS) ...accessed health care services, what barriers they faced, and how this experience influenced subsequent HIV testing.
Methods
SELPHI is an online randomized controlled trial evaluating both acceptability and efficiency of HIV‐self testing among cis‐GBMSM and transgender people. Semi‐structured interviews were conducted, audio‐recorded, transcribed, and analysed through a framework analysis, as a qualitative sub‐study. We identified narratives of NCS from interviews and investigated experiences of cis‐GBMSM and transgender people accessing health care services following sexual assault.
Results
Of 95 participants, 15 (16%) spontaneously reported NCS. Participants reported a broad range of NCS, including partner's coercive behaviours, non‐consensual removal of condoms, and rapes. All feared HIV transmission, leading them to test for HIV, underlining a marked lack of awareness of post‐exposure prophylaxis (PEP). Most had negative experiences in communicating with reception staff in sexual health clinics following these incidents. A lack of confidentiality and empathy was described in these situations of psychological distress. Clinic visits were primarily focused on testing for HIV and sexually transmitted infection, and generally no specific psychological support was offered. Getting a negative HIV result was a key step in regaining control for people who experienced NCS.
Conclusions
Sexual health care providers should take care to more fully address the issue of NCS with cis‐GBMSM and transgender people when it arises. Recognizing and managing the emotional impact of NCS on affected patients would prevent negative experiences and increase confidence in care.
We use the concept of the ‘monster’ in this article as an analytical tool to grasp a variety of persons who – understood to be criminals in their countries of residence, and living with or thought to ...be particularly vulnerable to HIV – are perceived as threats from across the European region. Building on the field of monster studies, we focus here on strategies undertaken to shift the ‘monstrous’ towards the ‘human’ along what we describe as monster–human continuums. Relying on ethnographic fieldwork from Germany, Poland and Greece, four case studies examine processes of (re-)humanisation in the fields of migration, prisons, drug use and sex work that emerge at the intersections of humanitarianism, public health, human rights and citizenship. In particular, we propose that these strategies can entail the production of dissimilar forms of political subjectivity, the redistribution of responsibility or vulnerability and a reshuffling of blame within the moral economy of innocence and guilt – strategies that produce particular norms and forms of the human. These strategies, moreover, involve the normalisation or suppression of ‘abnormal’, ‘irrational’ or ‘guilty’ dimensions of criminalised subjects, thereby taming their capacity to confuse or confront societies’ worldviews, and ultimately foreclosing the possibility to imagine a being-in-the-world otherwise. We thus conclude by asking how embracing the monstrous might facilitate the navigation of cultural, social and moral anxieties that leave room for complex and conflicting practices and subjectivities.
Most cervical cancer can be prevented through routine screening. Disparities in uptake of routine screening therefore translate into disparities in cervical cancer incidence and outcomes. ...Transmasculine people including transgender men experience multiple barriers to cervical screening and their uptake of screening is low compared with cisgender women. Comprehensive evidence-based guidelines are needed to improve cervical screening for this group.
We searched for and synthesised clinical and programmatic guidelines for the provision of cervical screening for transmasculine patients.
The guidelines offer recommendations addressing: (1) reception, check-in and clinic facilities; (2) patient data and invitation to screening; (3) improving inclusion in screening programmes; and (4) sexual history taking, language and identity. Guidelines offer strategies for alleviating physical and psychological discomfort during cervical screening and recommendations on what to do if the screening procedure cannot be completed. Most of the guidelines were from and for high-income countries.
The evidence base is limited, but existing guidelines provide recommendations to ensure life-saving screening services are available to all who need them. We were only able to identify one set of guidelines for a middle-income country, and none for low-income countries. We encourage the involvement of transmasculine people in the development of future guidelines.
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