PharmaSMaSH Pharmaceutical Geographies of Self Managed Sexual Health

PharmaSMaSH是第一个大规模的“自我管理健康”的跨国研究。自我管理健康发生在人们在正规卫生保健系统之外获得药物和治疗时，通常是因为他们负担不起医疗费用，或者因为他们居住的地方意味着他们想要的治疗是耻辱或非法的。在性健康和生殖健康问题上，自我管理的健康尤其普遍，因为这些问题往往受到高度歧视，并受到其他法律的管制。PharmaSMaSH将探讨自我管理健康的三个相关例子：使用药物自我管理堕胎的人，使用抗逆转录病毒药物自我管理艾滋病毒/艾滋病预防的人，以及使用性激素自我管理性别转变的人。这些产品和治疗方法的治疗社区在世界各地自我组织，传播药物和如何使用它们的信息。PharmaSMaSH将提供对秘密自我管理健康世界的洞察，这一领域正在迅速发展，但在学术和政策方面却知之甚少。通过与自我管理这些健康问题的人合作，了解他们如何获得治疗以及他们服用的药物是否安全，PharmaSMaSH将发现这些社区是否以及如何改进卫生服务的设计和提供——最终与政策、临床护理和民间社会的利益相关者合作。

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.