In Search of ‘Success’: The Politics of Care and Responsibility in a PrEP Demonstration Project

ABSTRACT

We illustrate the lively existence of the notion of success in the unfolding of a PrEP project led by a sex worker organization in India. In what we call the “search for success,” particular attention is placed on the role that care plays among sex workers guiding the project. Drawing on our ethnographic work, we highlight how the search for success underlines particular affective dispositions that are underscored by overlapping temporal registers: in the early stages of fostering adherence; when project fatigue sets in; and as the project draws to a close, in the anticipation of what comes next for the organization.

KEYWORDS:

• India
• community-led
• demonstration projects
• HIV
• PrEP
• sex work

Acknowledgments

Our deepest and heartfelt thanks to everyone at Ashodaya who devoted their time to this work, as both a researcher and a participant. The first author obtained ethics approval as part of her doctoral research through the University of Manitoba Health Research Ethics Board. Local ethics approval was obtained from Durbar Mahila Samanwaya Committee (DMSC).

Additional information

Funding

This research was supported through a Canadian Institute of Health Research Doctoral Research Award, a University of Manitoba Tri-Council Top Up, a University of Manitoba David G. Fish Memorial Award, a Michael Smith Foreign Study Supplement, and a Social Sciences and Humanities Research Council of Canada Insight Grant studentship [grant number IG/435-2014-1310].

Notes on contributors

Lisa Lazarus

Lisa Lazarus is a Research Associate in the Institute for Global Public Health, University of Manitoba, where she recently completed a PhD in Community Health Sciences. She is a community-based researcher, with her work centering on community-led HIV prevention and treatment interventions. She has been collaborating on research projects with Ashodaya Samithi for over ten years. Address correspondence to Lisa Lazarus, PhD, at the Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, R070 Med Rehab Bldg, 771 McDermot Ave. Winnipeg, Manitoba, R3E 0T6, Canada. Email: [email protected];

Sushena Reza-Paul

Sushena Reza-Paul is an Assistant Professor in the Department of Community Health Sciences at the University of Manitoba and is also a Mentor to Ashodaya Samithi. She has been working over the last two decades with marginalized communities in various countries in South/Southeast Asia and Africa. Her work primarily focuses on community-led HIV and STI prevention and treatment and sexual and reproductive health research.

Syed Hafeez Ur Rahman

Syed Hafeez Ur Rahman is a Masters in Social Work (MSW). He has been working with Ashodaya Samithi, a sex workers’ organization, for the last 15 years. His work predominantly centers around community-to-community capacity building and community-led research in the organization. Syed is responsible for the learning and research unit of Ashodaya Academy which collaborates with various universities.

Robert Lorway

Robert Lorway is Associate Professor of Medical Anthropology in the Institute for Global Public Health, University of Manitoba, where he holds the Canada Research Chair in Global Intervention Politics and Social Transformation. His research analyzes how forms of intervention life unfurl around transnationally-mediated attempts to alleviate the suffering of stigmatized people. He has written two books on the subject, Namibia’s Rainbow Project: Gay Rights in an African Nation, and AIDS Activism, Science and Community across Three Continents.