Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway.
Department of Behavioural Sciences, Muhimbili University of Health and Allied Science, Dar es Salaam, Tanzania.
Soc Sci Med. 2023 Sep;333:116147. doi: 10.1016/j.socscimed.2023.116147. Epub 2023 Aug 5.
Based on ethnographic fieldwork among men who have sex with men and transgender women in Tanzania, this article explores the various types of work that may go into enrolment into PrEP programming and using pre-exposure prophylaxis (PrEP). PrEP protects against HIV acquisition and is widely touted as an essential tool in 'ending AIDS by 2030'. While taking PrEP has often been portrayed as 'just taking a pill a day' in public health campaigns, a striking observation during fieldwork was that enrolling in PrEP programming and adhering to PrEP involved a wide range of tasks. Inspired by this fieldwork experience and the literature on sociology of work, more specifically illness work and patient work, we started to think of these tasks as work. This paper identifies the range of tasks that PrEP users in Dar es Salaam had to perform as part of their enrolment and usage of PrEP. We provide a description of these tasks, organised into three categories of work that we refer to as (a) readying work, (b) user work, and (c) social navigation work that jointly make up what we propose to call biomedical prevention work. We further suggest that this analytical framework can be applicable to other biomedical prevention methods in other contexts.
基于在坦桑尼亚男男性行为者和跨性别女性中进行的民族志实地调查，本文探讨了参与暴露前预防方案（PrEP）规划和使用暴露前预防措施（PrEP）可能涉及的各种类型的工作。PrEP 可预防艾滋病毒感染，被广泛誉为“到 2030 年终结艾滋病”的重要工具。尽管在公共卫生宣传中，服用 PrEP 常被描绘为“每天只需服用一片药”，但实地调查中一个引人注目的观察结果是，参与 PrEP 规划和坚持使用 PrEP 需要完成一系列广泛的任务。受这一实地调查经验和工作社会学，特别是疾病工作和患者工作文献的启发，我们开始将这些任务视为工作。本文确定了达累斯萨拉姆的 PrEP 用户在参与和使用 PrEP 过程中必须完成的一系列任务。我们对这些任务进行了描述，将其组织成我们称之为（a）准备工作、（b）用户工作和（c）社会导航工作的三个类别，共同构成我们提议的生物医学预防工作。我们进一步建议，这一分析框架可适用于其他背景下的其他生物医学预防方法。
