D.I.Y. Pharma
Pharmaceutical Geographies of Self-managed Sexual Health
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Pharmaceutical Geographies of Self-Managed Sexual Health (PharmaSMaSH) is a major new research project hosted in the School of Geography and funded by UK Research and Innovation from 2024-2029.
PharmaSMaSH is a research project that investigates of transnational self-managed sexual and reproductive health interventions.
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People choose to self-manage sexual and reproductive health treatments when the medical products and treatments that they need are unavailable in the healthcare system or their health needs are stigmatised by local providers. Meanwhile, the expanding global market in pharmaceutical products, and digital health technologies is opening up possibilities for new forms of self-managed care, many of them clandestine and unregulated.
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PharmaSMaSH examines three treatment communities who engage in self-managed sexual and reproductive health interventions, together with the pharmaceutical products they use: sex hormones for trans healthcare, antiretrovirals for HIV/AIDS prevention and treatment, and medication abortion pills for termination of pregnancy.
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Abortion Pills
Abortion Pills
People self-manage abortion pills for termination of pregnancy in places where abortion is illegal, highly restricted, or very expensive. The pills they use are called mifepristone and misoprostol. Sometimes they are availble to buy on the 'black' market or online.
HIV PrEP
HIV PrEP
Pre-exposure Prophylaxis (PrEP) is a highly effective way to prevent the transmission of HIV. People use it informally in countries where it is very expensive, unapproved by regulators, or stigmatized by providers.
Hormones
Hormones
Trans people sometimes self-manage with gender-affirming hormones, in what's known as Do-It-Yourself Hormone Replacement Therapy (DIY HRT). This is especially prevalent where trans health is legally restricted, stigmatized, or practically unavailable.
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The study of these products is siloed, meaning the current scholarship fails to examine the parallels between them which extend to their pharmaceutical origins, their transport, the communities that facilitate self-management of the products, and the users’ experiences of self-managed sexual health.
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PharmaSMaSH has three key research objectives:
Objective 1: To transform the study of self-managed health and treatment communities by examining connections between groups that are organised around particular treatments and products in the sexual and reproductive health field.
Objective 2: To understand the transnational flow of pharmaceutical products that straddle the boundaries between licit/ illicit and legal/ illegal.
Objective 3: To facilitate knowledge exchange between informal treatment communities and stakeholders in medical and policy areas.
For its first phase focused on qualitative research with therapeutic communities, PharmaSMaSH team consists of three members:
💊 Dr Sydney Calkin (leading on abortion pills)
💊 Dr Alvaro Martinez Lacabe (leading on HIV PreP)
💊 Dr Tate Morgan (leading on gender affirming hormones)
Image credits (left to right): "File:Cytotec photo.jpg" by Guineapigmom is licensed under CC BY 2.0.; "File:Truvada.JPG" by Jeffrey Beall is licensed under CC BY-SA 3.0; "all in a day's work" by Dawn Huczek is licensed under CC BY 2.0.
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