PharmaSMaSH Pharmaceutical Geographies of Self Managed Sexual Health

PharmaSMaSH is the first large scale, transnational study of "self-managed health". Self-managed health takes place when people get medicines and treatments outside the formal healthcare system, usually because they can't afford medical bills or because where they live means the treatment they want is stigmatised or illegal. Self-managed health is especially prevalent on issues of sexual and reproductive health, because these issues tend to be highly stigmatised and regulated by additional laws. PharmaSMaSH will explore three relevant examples of self-managed health: people who use pills to self-manage abortion, people who use antiretrovirals to self-manage HIV/AIDS prevention, and people who use sex hormones to self-manage gender transition. Treatment communities for these products and treatments self-organise around the world, circulating medications and information on how to use them. PharmaSMaSH will provide insight into the world of clandestine self-managed health, which is rapidly growing but poorly understood in scholarship and policy. By working with people who self-manage these health issues to understand how they access treatment and whether the medication they take is safe, PharmaSMaSH will find out if and how these communities can improve the design and delivery of health services - ultimately working with stakeholders from policy, clinical care, and civil society.