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Background: Sexual harassment is associated with negative sexual and mental health outcomes. There is a lack of clarity on its conceptualization in many settings, especially in low-income countries. Context-specific conceptualizations of sexual harassment is vital to develop effective measurement tools, estimate its magnitude and to develop interventions to address it. We explored how different population groups in Tanzania understood, conceptualized, and experienced sexual harassment. Methods: This study employed a qualitative research design involving 74 in-depth interviews and 13 focus group discussions with participants from educational, workplace and public settings in Mwanza, Tanzania. Participants were adolescent girls (n=28) and boys (n=26) in and out of school; adult women (n=10) and men (n=10) in workplace and public spaces. We explored individual level perceptions and experiences of sexual harassment, and community norms and perceptions around sexual harassment. We used thematic analysis to analyse the transcripts. Results: Participants' perceptions of sexual harassment emphasized the critical role of consent, the expression of male power and social norms with regards to sexual harassment. Sexual harassment was understood to be a result of men being in positions of power and in charge of material resources, school grades or employment opportunities. These in turn enabled them to take advantage of girls and women. The place and person involved in the act of harassment were important in defining the practice. The types of sexual harassment varied from blurred/unclear acts of unwanted/displeasing behaviours to clear sexual abuse and exploitation practices such as rape, forced sex or violence. Social norms around male and female interactions, courtship and seduction, expressions of sexual interest were crucial in delineating what was and what was not considered sexual harassment. Conclusion: Sexual harassment is a fluid concept. Consent and power in relationships underpin the conceptualization of sexual harassment and is a fundamental feature in the definition and measurement of sexual harassment in Tanzania. Consent is largely determined by sexual norms around male and female interactions and gendered power. There is a need for consensus in schools, workplaces, and communities about what constitutes sexual harassment in order to measure and address it appropriately. [ABSTRACT FROM AUTHOR]

Background: Despite being at an increased risk of violence and HIV infection, young women who sell sex, may not easily access HIV services. The objective of the study is to explore views of health providers and young female sex workers (YFSWs) themselves on barriers and enablers to accessing HIV services in Tanzania and to offer insights to enhance access. Methods: This study utilized an ethnographic research design involving six SRH programme implementers and photovoice with 10 Young Female Sex Workers (YFSWs) aged 18-24 years. Thematic analysis was conducted with the aid of NVIVO qualitative analysis software. Results: Health providers reported common SRH services available in their communities as HIV testing and treatment, contraception, and STIs treatment. Barriers to accessing HIV services among YFSWs were stigma as a result of the young age of the women as well as their engagement in sex work; lack of differentiated type of services for adolescents and YFSWs in the communities; limited preferred contraception options. Enabling factors were reported as: Service providers supporting girls to access SRH services through peer groups; respect and trust built between health providers and YFSWs; prompt service provision to YFSWs when they come to facilities; localization of services to where YFSWs operate and making these services available for 24 hours. Conclusions: There is a need to address health provider-related barriers to YFSWs accessing HIV services while emphasizing the promotion of the factors that promoted uptake such as localization of services and 24-hour access. [ABSTRACT FROM AUTHOR]