“They are Not ‘Hidden’, ‘Unseen’ or ‘Hard-To-Reach’”: Reflections on Recruiting Women who Have Sex with Women to Tailored Public Health Research in Tanzania

Available literature suggests that women who have sex with women (WSW) are ‘hidden’, ‘unseen’, or ‘hard-to-reach’ because they operate underground, their size is unknown, and their daily lived-experiences remain a mystery to outsiders including (public) health researchers. As a result, WSW are claimed unwilling to participate in medical/clinical or public health research. In this paper we present our experience recruiting WSW to tailored public health research in Tanzania: the planned nationwide integrated behavior and biological surveillance survey. We conducted a cross-sectional descriptive and retrospective qualitative formative study in Dar-es-Salaam Region, Tanzania, between January and February, 2021. Study population included community leaders; and WSW aged 18 years and above, who had lived in Dar-es-Salaam for six (6) months or more; had engaged in same-sex sex in the past year or were in same-sex relationship(s); had knowledge of WSW’s lived experiences, and willing to participate in the study. Findings indicate that WSW in the study area are not ‘hidden’, ‘unseen’ or ‘hard-to-reach’ as researchers and other professionals claim. Similarly, we demonstrate that WSW’s recruitment to participate in (public health) research is not as tedious and tricky as previously presented. We validate that WSW exist in Tanzania and are willing to participate and support research with direct relevance to their livelihoods and their community’s wellbeing. They require WSW-friendly and sensitive approaches, as well as working with or through their trusted individuals, institutions, or organizations.

The authors declare no conflict of interest.

Not applicable

The datasets used in this study are openly available at [repository link] and the source code is available on GitHub at [GitHub link].

This work did not receive any external funding.