Title:	Autonomy and care in context: the paradox of sex workers’ acceptability of hiv self‑tests in São Paulo, Brazil
Authors:	Murray, Laura Rebecca Ferraz, Dulce Zucchi, Eliana Miura Sorrentino, Isa da Silva Grangeiro, Alexandre
Affilliation:	Universidade Federal do Rio de Janeiro. Núcleo de Estudos de Políticas Públicas em Direitos Humanos. Rio de Janeiro, RJ, Brasil. Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil. Universidade Católica de Santos. Programa de Pós-Graduação Profissional em Psicologia e Políticas Públicas. Santos, SP, Brasil / Universidade Católica de Santos. Programa de Pós-Graduação em Saúde Coletiva. Santos, SP, Brasil Universidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Preventiva. São Paulo, SP, Brasil. Universidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Preventiva. São Paulo, SP, Brasil.
Abstract:	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.
Keywords:	Sex work Brazil HIV self-test Autonomy Stigma
DeCS:	Autoteste Teste de HIV Profissionais do Sexo Autonomia Profissional
Issue Date:	2021
Publisher:	Springer Nature
Citation:	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.
DOI:	10.1007/s10508-021-02129-y
ISSN:	0004-0002
Copyright:	open access
Appears in Collections:	BSB - Artigos de Periódicos

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