Abstract
Song-making is a powerful tool with the potential to harness cultural knowledge to reduce stigma and support community-led advocacy. HIV prevalence (8.1%) among sex professionals in Congo is double the national average, yet stigma and discrimination deter sex professionals from accessing needed healthcare. Limited research has focused on developing music videos for reducing sex work-related stigma. In the Congolese context, music and song-making are deeply embedded cultural practices for storytelling and solidarity, making them especially resonant vehicles for community-led stigma reduction efforts. This manuscript describes the process of creating Esengo (“Joy”), a song and music video, to reduce stigma and promote the health and rights of sex professionals in Pointe-Noire, Congo. Esengo applies a strengths-based approach to address stigma by incorporating song lyrics, rhythms and melodies created and performed by sex professionals, first identifying ‘problems’ in sites of stigma followed by descriptions of ‘solutions’ that reflect improved community and healthcare scenarios, including animation of sex professional’s visual drawings. Lyrics, melodies, and drawings originate from a participatory mapping intervention that we developed and piloted with sex professionals in Pointe-Noire. We piloted Esengo with sex professionals and healthcare workers, who provided qualitative feedback on their emotional responses and perceptions of stigma, indicating its potential as a health promotion resource and stigma reduction tool. The process underscored how joy can be mobilized for social change, community slogans through songs can strengthen social movements, and community-based co-creation can itself facilitate knowledge translation. This community-based approach to song making may be adapted for other contexts, populations, and health issues to support sex professional-related and other stigma reduction, health promotion, training, and community empowerment.
Keywords
Introduction
Congolese music’s melodies and rhythms offer both entertainment and a political act of resilience (Mbembe, 2005). Congolese rumba specifically, a popular form of music worldwide, stems from Afro-Cuban music—as a form of cultural resilience and identity reconstruction—and originates from the era of the African slave trade and colonialist regimes (White, 2002). The importance of Congolese rumba to Congolese identity – described as “serenity in the face of tragedy” (Mbembe, 2005, p. 72) – is reflected by its inclusion on the United Nations Educational, Scientific and Cultural Organisation’s (UNESCO) Representative List of Intangible Cultural Heritage (UNESCO - Congolese Rumba, n.d.). Congolese music draws on an oral culture to communicate a range of emotions and topics (Mbembe, 2005), as well as regional social and cultural values (UNESCO - Congolese Rumba, n.d.). Historically, rumba has also enabled communities to confront social exclusion and challenge stigma through collective expression (Wheeler, 2005).
Song-making draws on knowledge embedded in culture (Gwerevende & Mthombeni, 2023), language (Khupe, 2017; Nel, 2008), and emotions (Bratianu, 2015), and holds the potential for reinforcing joy, creative expression, and collective strengths in the face of challenges. Beat-making and community music have been shown to contribute to wellbeing; for example, by enabling self-downregulating stress responses (Baltazar & Saarikallio, 2019), cultivating resilience (Werner & Johnson, 2004), and facilitating social cohesion (van der Merwe & Morelli, 2022). Further, songs created through qualitative research methods can be used in knowledge mobilization for community education (Publicover et al., 2017). Short, animated films have been used to shift public perceptions and inspire empathy for mental health issues with refugee populations (Boydell & Croguennec, 2022). Music-making and participatory visual methodologies have also been used to reduce HIV stigma and promote empowerment among sex workers. In South Africa, digital storytelling workshops supported sex workers in co-creating short films as tools for empowerment and self-representation (Kannengießer, 2014). In rural Uganda, live musical performances were utilized to decrease HIV-related stigma and increase access to testing, demonstrating the efficacy of music events in public health interventions (Adams et al., 2019).
It is particularly important to develop innovative approaches to reduce stigma towards sex workers. Sex workers’ vulnerability to HIV is shaped by multi-level stigma, including: structural stigma reflected in criminalization of sex work and other punitive laws and policies targeting sex workers; institutional level mistreatment, bias, and discrimination in health care settings; community-level stigma that includes stigmatizing norms and values that can be manifested in social exclusion and violence; and individual-level stigma that includes internalized stigma, acceptance of shame and blame rooted in social devaluation of sex work (Shannon et al., 2014; Stangl et al., 2019). Sex work stigma is key to understand and address in Congo Republic, where sex workers are criminalized and have an HIV prevalence of 8.1% – double the national average (UNAIDS, 2018). Yet stigma and discrimination deter sex workers in Congo from accessing HIV and other healthcare services (UNAIDS, 2018).
Research has shown that song-making has been used in participatory research to foster inclusion, reflection, and equity, particularly in health and migration contexts (Garry et al., 2023; Phelan et al., 2025). While music has been used to mobilize knowledge (Walker & Boyer, 2018) and generate empathy (Golden et al., 2025), little attention has been given to songs and music videos as tools for reducing sex work-related stigma. Participatory mapping has also served as a powerful visual methodology for diagnosing community health assets, challenges, and social determinants (Douglas et al., 2020), driving community empowerment and agency (Panek, 2015), and promoting equity and amplifying voices of structurally marginalized communities (Lung-Amam & Dawkins, 2020). Yet, there is a dearth of studies that have combined song-making and participatory mapping as complementary qualitative methods, and we identified none focused on reducing sex work stigma.
Given the popularity of Congolese music, documented stigma toward sex workers in the Congo, and growing evidence that music can support stigma reduction (Adams et al., 2019), we used song-making as a method of community-engaged knowledge production and dissemination to reduce stigma towards sex workers (locally referred terminology is ‘sex professionals’) in Pointe-Noire, Republic of the Congo. We contribute to this emerging literature by detailing the methodological process used to create the song and music video “Esengo (Joy)” within a community-based research study in Pointe-Noire, Congo. Our approach integrated song-making into participatory mapping workshops and culminated in developing an animated music video that combined the song with visual outputs generated through participatory mapping activities. This pairing of a structured song-making protocol with participatory mapping is novel, as is the focus of the lyrics and video on the ‘dream’ world that sex professionals envision for themselves. By synthesizing affective, arts-based community knowledge into a multi-media output, this approach extends arts-based qualitative research and demonstrates the potential of song making for knowledge translation and public engagement. This paper thus aims to address how song-making can be a) integrated into participatory mapping methods and b) developed into an animated music video as a knowledge translation tool for sex work-related stigma reduction.
Study Context
The Esengo (“Joy”) song and animated music video, the focus of this paper, was co-developed with sex professionals and a community-based organization (Union pour l’Assistance aux Femmes Prostituées d’Afrique [UAFPA]) in Pointe-Noire, Congo. The song was developed using a song-making research method called ‘Dream Studio’, an arts-based approach we developed and conducted with a local Research Assistant (RA) and four peer navigators affiliated with UAFPA. After developing this song, we then used this song and song-making research method as part of a two-day participatory mapping workshop in a larger study in Pointe-Noire focused on increasing sex professionals’ HIV and sexually transmitted infections (STI) testing uptake and reducing sex work-related stigma. The broader study employed a community-based research framework, and was a collaboration between UAFPA, an academic institution, and a local polyclinic. The song and music video were also shared in knowledge mobilization activities, including community screenings, social media campaigns, and healthcare trainings. Pointe-Noire was selected as the study site due to its high HIV prevalence among sex professionals (UNAIDS, 2018) and the presence of established partnerships with local organizations and health providers. This paper details the aims and methodology for making the Esengo song and music video, the dissemination plan, and offers recommendations for using such creative knowledge translation products to train healthcare professionals and advocate for policy and social change in communities in Congo and beyond. This study received ethics approval from the University of Toronto Research Ethics Board (Protocol Number: 41845) and the Comité d´Éthique pour la Recherche en Santé (CERS) de la Fondation Marie Madeleine GOMBES (Research Ethics Committee in Health of the Marie Madeleine Gombes Foundation) in Pointe Noire, Congo. All participants provided informed consent prior to participation.
Positionality shapes all facets of the research process, and most of our team are outsider academic researchers working alongside community insiders. This insider-outsider balance, facilitated by a Research Assistant and peer navigators with insider knowledge of sex professionals in Pointe Noire, shaped the co-production process and ensured cultural grounding. The co-authors’ collective positionalities include diverse lived experience and networks, bringing experience in global health equity with sex professionals, HIV care and research, medical practice, arts-based approaches, song and video making, public health, and social work. Our team includes cisgender men and women, sexually diverse and heterosexual persons, persons with lived experience as a sex professional, Congolese persons living and working in Congo and Congolese persons living and working in Canada, individuals living in Canada and South Africa, Black and other racialized persons. Our team includes members with diverse educational backgrounds, including students, clinicians, community activists, and academic faculty. Across our various backgrounds, our team shares a commitment to ethical, justice-oriented, community-based research that responds to community priorities—in this case, sex professionals—and advances health equity and social justice. Communities are equal partners in this research and ensured that the data collected and methods developed (such as this song and video) are meaningful, useful, and prioritized by community partners. We practice shared data ownership, where all team members—including community and clinic-based collaborators—can use the findings to inform their programs, funding applications, and other forms of knowledge mobilization (including peer-reviewed approaches as well as other forms of community knowledge sharing, including this song and video).
Methods
Developing the Esengo Song
In this paper we discuss developing a song-making methodology that we then implemented in participatory mapping workshops. The song-making methodology was developed with an all-women team during a participatory mapping workshop facilitator training; this training was facilitated by a professor and post-doctoral research fellow and included four sex professional peer navigators, a medical laboratory technician, a Research Coordinator, and a community organizer with sex professionals who was the study Research Assistant (RA). In this participatory mapping workshop facilitator training, five facilitators (four peer navigators and the RA) formed two smaller groups, and each of these groups were supported to produce a different song. The four peer navigators, all women with lived experience as a sex professional (ages ranging from 20s to 50s) were selected for their existing relationships with local networks of sex professionals. (No further demographic details of the peer navigators and RA are described to maintain confidentiality). One group, self-titled ‘UAFPA Musica’, mostly sang their lyrics; while a second group, self-titled ‘Les Quatros’, mostly rapped their lyrics, and both used finger snapping.
The songs resulting from this training articulated aspirations for how sex professionals wanted to be treated in community, healthcare, and police settings, and were then used to produce a music video as a stigma reduction knowledge translation tool. Knowledge translation refers to the process of transforming community-generated cultural expressions into accessible outputs for practice, policy, and training (Boyko et al., 2018). This music video was planned to be used: 1) in subsequent research phases, including in the participatory mapping workshop methods with sex professionals; and 2) as a stigma-reduction training tool for healthcare professionals and community members. In collaboration with a Congolese music producer with prior experience composing and producing a song as research knowledge translation (Van Borek, n.d.), we first developed these materials into a broadcast-quality song.
This song-making approach was adapted from a South African study that applied the concept of ‘dream clinics’ for youth living with HIV to design their desired change to clinics’ health and social services (Hodes et al., 2018). Our approach was also informed by strengths-based approaches to intersectional stigma reduction that leverage community resilience, solidarity, and creativity (Collective, 1981; Poteat & Logie, 2022). In this study, stigma reduction is conceptualized as addressing social and structural devaluation and reduced access to power, resources and opportunities, in line with a structural determinants framework (Shannon et al., 2014). Situating this within an intersectional stigma framework (Logie et al., 2022; Poteat & Logie, 2022; Sievwright et al., 2022; Turan et al., 2019), the ‘Dream Studio’ explicitly sought to surface converging stigmas related to social categories such as gender, sexuality, and sex work, while also highlighting resilience and resistance strategies. A minority of intersectional stigma studies center strengths-based and empowerment outcomes (Logie et al., 2022), but a deficits-perspective can overlook the knowledge, priorities, collective resources, and existing resiliencies within communities (Poteat & Logie, 2022). By framing song-making as creative expression and resistance, the method positioned participants as knowledge production agents rather than subjects of deficit-based narratives. The ‘Dream Studio’ activity included a few basic prompts to ensure content aligned with research aims for stigma reduction and minimal parameters in terms of musical elements. This aimed to maximize participant self-expression, including sharing knowledge and lived experiences embedded in language (Nel, 2008), culture (Gwerevende & Mthombeni, 2023) and emotions (Bratianu, 2015).
Demographic Details of Sex Professional Participatory Mapping Workshop Participants in Pointe Noire, Congo (n=99)
aSD: standard deviation; *n=missing participants.
In small groups of 5, participants were invited to translate recommendations for changes they would like to see in their communities and healthcare settings, as shared in a recommendations focused activity, into songs. Groups were encouraged to prepare songs in their choice of language, musical genre, and cultural style, with an understanding that song delivery was acoustic and acapella. This used only voices and bodies to make sounds and involved sung, spoken and/or rapped verse. Songs aimed to be solutions-oriented by articulating participants’ dreams for reducing sex work stigma in their communities, healthcare settings, and with police. Groups were given a pen and printed handout of a song-making template, designed by a post-doctoral researcher (author Van Borek) with experience performing and teaching traditional African music.
The template, shared in French for the workshop, included a suggested structure of three song verses grouped thematically and each based on a location: 1) clinic; 2) police; and 3) community (a setting of the group’s choosing, e.g., church, market, neighbourhood, etc.). These locations were first identified by peer navigators during a role-playing activity within their facilitators’ training. Each of the three verses on the template followed the same structure: 1) I went to the clinic/police/(community setting) ____; 2) I was received ____ (complete the sentence); 3) (Describe the interaction) _______; 4) I felt ____ (complete the sentence).
Group facilitators were advised that it was optional to follow the template, as part of composing songs. Groups could also write their lyrics, or simply prepare them orally, to accommodate various literacy levels. Groups had time to create and rehearse their songs, following which each group performed their song to the larger group. During performances, songs were recorded by the community-based Research Assistant and academic researcher using smartphones.
The process of transforming the field recordings of songs into the professional song involved several steps: 1) basic song analysis; 2) restructuring song lyrics; 3) composing and producing (supporting instrumentals and a professional quality song, including editing the original audio files).
Song Analysis
First, we translated the lyrics into English and conducted thematic analysis using a framework approach (Braun & Clarke, 2006, 2023; Gale et al., 2013) across the two songs to draw out similarities and differences in the content. Based on this initial analysis, we decided to combine key aspects of the two songs into one, thereby simultaneously combining the aesthetics of singing and rap; and French and Lingala languages to produce a song that could represent key issues (e.g., stigmatization; sexual and gender-based violence; challenges accessing health services) and key community settings (e.g., neighbourhood; church; clinic; police station). The final decision to merge key aspects of the two songs into one was co-informed by the research team that facilitated the analytic synthesis and the sex professionals who shaped which verses and themes best represented their experiences.
Restructuring Song Lyrics
Next, author Van Borek restructured the song lyrics into a narrative based on the study’s ‘mapping’ approach so that the protagonist, a sex professional, moves from one place in the community to the next. Where certain places (for example, the clinic) were repeated across the two songs and sometimes at different points within the same song, these were edited together and trimmed back, at times, to avoid repetition. Lyrics revealing the sex professional’s experience of reporting a rape to the police was intentionally placed toward the end of the song. This allowed the earlier sections to build a joyful mood by highlighting situations where she is treated with dignity and respect. Following the typical methodology of a music producer, we emphasized those sections of songs where the performances were particularly impactful (Deacon et al., 2023), for example, the sections of rap with a clear rhythm or rhyme. In this way, the song production process was a balance between sharing content and aesthetics. The chorus that was originally sung directly addressed stigma reduction, so was left intact and repeated at several points in the new song structure. The chorus lyrics are detailed below: Chorus: Joy, eh, joy (x4) Friends come, we will dance. As of today, we are in peace. Joy, eh, joy (x2) Our rights are respected. We are considered to be like the rest of the population.
All participants who contributed to the song-making workshops received financial compensation as well as food and transport reimbursements. The Congolese music producer was contracted and paid at professional rates for composition, recording, and production. These ethical considerations were central to ensuring that both artistic and lived experience contributions were valued.
Song Composition and Production
The restructured song lyrics were shared with the music producer to edit the audio files of the songs based on the new structure, and to compose, record, and produce an instrumental accompaniment based on the Congolese rumba style from the first (sung) song (UAFPA Musica) that could tie sections together and elicit the sense of joy referred to in the lyrics. Specific instructions to the music producer included that: “It should make people want to dance.” The song-making process continued to finalize the choice and placement of words, particularly because the placement also needed to work musically. For example, the transition from singing the chorus to rapping about visiting the church (0:49 minutes into the song) was initially too abrupt because of a slower tempo in the rap section, thus the music producer added a distinct bridge with an instrumental stepping down of the tempo. Following this rapped verse, the instrumentals take a dramatic pause as the voices echo before the instrumentals move into the faster tempo again around 1:13 minutes. This song-making process also engaged the larger team, including the Research Assistant based at UAFPA. The Esengo song which appears in the final Esengo animated music video was edited further during the making of the music video, to balance the narrative flow and introduction of visuals.
Decision Making Process
It is important to clarify the level of participant involvement and decision-making power during the transition from raw community-generated material to polished knowledge translation (KT) products. Both the song and the music video were produced as stigma-reduction KT tools. The idea for these KT methods emerged from observing the cultural and communicative strengths of the audiovisual materials generated through the study’s participatory processes. The professional song was produced before conducting the five participatory mapping workshops and was meaningfully incorporated into those workshops, while the music video was produced after all participatory mapping workshops had been completed. The music video thus was able to integrate artwork and drawings produced across the participatory mapping workshops. Translating raw, community-generated content into a polished, professional product was an approach we adopted to meaningfully extend sex professionals’ creative expressions beyond the participatory data collection phase, expanding the potential audience and impact of these expressions.
The academic researcher, Van Borek, who had engaged with community collaborators in the field to generate the original source songs (from the training-of-trainers) collaborated with the professional music producer to initially organize the professional song. The researcher restructured the lyrics based on the aim of developing a narrative that could impactfully communicate key issues and community settings identified through the thematic analysis of the source songs, while the music producer influenced this structure based on what was musically impactful and feasible, given the pre-determined structural possibilities and limitations of the field recordings. Draft versions of the song were shared by the academic researcher with the community Research Assistant, who then shared these drafts with sex professional peer navigators and collaborators and reported their feedback. This feedback, combined with feedback from other research team members, contributed to adjustments before the song was finalized.
A similar process guided the music video creation. The academic researcher (Van Borek) who had supported the drawing of images during the participatory mapping workshops reviewed digital scans of visual data to identify imagery that could visually support the song’s narrative (e.g., clinics, churches, neighbourhoods, police vehicles). The draft storyboard and subsequent edited versions were shared with the community RA, who consulted sex professional peer navigators and collaborators and relayed their feedback. Input was also generated from other research team members, and this collective input contributed to revisions prior to finalization of the music video.
Developing the Esengo Animated Music Video
The aim of the Esengo music video was to build a compelling visual narrative that could enhance the meaning and impact of the song, while meaningfully including creative expressions of sex professionals in Pointe-Noire. Producing the video involved four key steps: 1) storyboarding; 2) designing backgrounds; 3) designing characters; and 4) animating characters. Each of these steps is detailed below.
Storyboarding
Storyboard Examples From the Esengo (“Joy”) Music Video Developed With Sex Professionals in Pointe Noire, Congo
Designing Backgrounds
To design the backgrounds, we reviewed the participatory mapping workshop data which included drawings by sex professionals, largely from participatory mapping and dream clinic drawings, to identify visual elements that related to the settings Figure 1. Participant drawing in the participatory mapping workshop in Pointe Noire, Congo
For example, we identified a police car for the police station, ambulances and examination room furniture for the clinic, umbrellas and food for the market, waves for the beach, and various buildings (e.g., church, homes) for the neighbourhood. The five differently shaped buildings that appear in the background for the police station, for example, each represent a police station drawn by sex professionals on a map from the participatory mapping workshops, while the four different ambulances in the clinic scene each represent an ambulance drawn by sex professionals on a dream clinic drawing. Additional aesthetic details, such as trees and flowers, were chosen to help build out the visual composition of backgrounds. Screenshots were then taken of these various elements and organized into folders categorized by setting. We then used Photoshop software to collage these elements together into visual compositions that reflected each desired setting. The original collages appeared quite rough because of different colours and thicknesses of ink used to draw the different elements. Using an iPad, Apple pencil, and Procreate software, we retraced the lines of these drawings in (digital) black ink to ensure each background composition was a consistent, clear aesthetic. We then added colour to these backgrounds to make them more visually engaging and to support the strengths-based approach to emphasizing joy. With the aim to draw on local colours and textures, we searched through photo documentation of the participatory mapping workshop process and observed the traditional clothing worn by many sex professionals. The colours and designs from these local fabrics were edited these into the backgrounds using Photoshop. We then added a solid grey to fill the pavement, and purple to fill the sky. Figure 2, Figure 3, and Figure 4 below illustrate the transformation between: i) initial collage; ii) black and white background; iii) full colour background. Initial collage of visual elements for the Esengo (“Joy”) music video developed with sex professionals in Pointe Noire, Congo Digital black lines retraced over visual elements for the Esengo (“Joy”) music video developed with sex professionals in Pointe Noire, Congo Full colour final background for the Esengo (“Joy”) music video developed with sex professionals in Pointe Noire, Congo
Designing Characters
To design the characters, we also looked for drawings by sex professionals of characters when reviewing data of maps and dream clinics. One drawing featured a sex professional drawn by a sex professional which became the basis for our music video’s protagonist. This was the only character illustration in the visual data generated by sex professionals. To address this gap, additional characters were illustrated digitally by Van Borek using Procreate software based on photographs from Pointe-Noire that were sourced from the internet and shared with the Research Assistant at UAFPA. The protagonist’s wardrobe design was an important consideration. While the short skirt and high heels, drawn by a sex professional during the participatory mapping workshop, informed the appearance, we acknowledged the risk of reinforcing stereotypes. We discussed this wardrobe with the Research Assistant at UAFPA who shared it with a group of sex professionals, who confirmed that it was appropriate for this character to wear this outfit throughout the video, and that alternative clothing styles could be included. We created seven versions of the main character, where six involved only slight modifications to the colour of dress and the colour and style of purse and jewellery (see Figure 5 below). A traditional outfit was deemed appropriate for the scene where the sex professional visits the church (0:51-1:30 minutes). To support viewer engagement, we introduced multiple, similar, characters at the market with different outfits (e.g., three women selling fish) and at the beach (e.g., four youth playing ball). These additional characters were created by duplicating the original designs and making slight modifications to wardrobe colour/style and/or hair colour/style to the additional characters. These decisions were informed by feedback from sex professionals and the Research Assistant, who emphasized the need for diverse and contextually accurate representations that reflected the community. Six versions of the main character’s wardrobe for the Esengo (“Joy”) music video developed with sex professionals in Pointe Noire, Congo
Animating Characters
Before animating the characters, we edited together an animation test of the music video with still images of characters and backgrounds, arranged according to the storyboard. This was shared with the larger team and community collaborators for approval before moving into the animation process. Character animation was conducted using Adobe After Effects (AE), where two-dimensional (2D) images of characters (.png) were imported and animated using the ‘Puppet Tool’ through a method known as ‘character rigging’. Character rigging, often used in games, movies, cartoons, and video clips, involves creating a digital “skeleton” for a model and creating the conditions for skeletal character movement (Arshad & Manaf, 2019). The AE Puppet Tool allows users to determine where motion pins are added (see Figure 6 below), which determine the kinds of movements that are possible for the character. Once adding the pins, holding down a certain keyboard command allows for recording, in real-time, movements of the computer mouse by the animator, which translates as visible character movements on screen over time. In this way, the animator engages in a kind of digital puppeteering of the dance moves in real-time. This method was cost-effective and less time-intensive than other methods of animation such as traditional frame by frame manipulation. Dance movements were modeled after YouTube videos of Congolese rumba styles and shared with the Esengo music producer and research team. Once the full body movements were recorded, the characters were exported as a video file with a transparent background and composited to the background scenes using Adobe Premiere Pro video editing software. Further animation was then conducted using basic motion effects in Premiere Pro to determine the placement of the characters within each scene over time, and to cut between wide/medium/close-ups to keep the pacing of the video engaging. These animations were shared back with the community research partners for input, ensuring that the movements captured the celebratory, participatory spirit of rumba. By centering dance as a joyful, embodied expression, the animation process itself transformed community cultural forms into accessible visual storytelling. Digital ‘skeleton’ of main character to animate using character rigging for the Esengo (“Joy”) music video developed with sex professionals in Pointe Noire, Congo
Community Dialogues Screening the Esengo Song
Following the completion of the participatory mapping workshops, and prior to the production of the Esengo music video, two community dialogues were held in Pointe-Noire: 1) one with approximately 30 sex professionals; and 2) one with approximately 30 health professionals. As part of the research activities, the Esengo song was shared as a catalyst for dialogue. Dialogue participants were asked to respond to two questions about the song: 1) What did you feel when you listened to the song? and 2) What problems struck you when listening to the song? All discussions were audio recorded, transcribed in French, and translated into English by bilingual team members. Quotes presented in this manuscript were selected by the Research Assistant and peer navigators to represent central themes and diverse viewpoints. All discussions were audio-recorded, transcribed in French, and translated into English by bilingual team members. For clarity and readability, some quotations were condensed without altering meaning.
Sex Professionals’ Perspectives
Positive Emotions and Empowerment
Sex professionals largely discussed positive emotions and feelings of empowerment after listening to the song. A sex professional described satisfying feelings after hearing the Esengo song lyrics, particularly those that reflected positive treatment by police, “It was pleasant listening to those songs because they say we the prostitutes have found a place, when we go to the police, they welcome us and find a solution.” (Sex professional). Another sex professional’s response to the song suggested feelings of empowerment: “if people see us on the streets or in our living areas, they must respect us.” (Sex professional). Others described noting how the song aimed to reduce sex work stigma: “This song speaks about the fact that a married woman and a prostitute are just alike…So, the married women need not to point fingers at us because we are all the same.” (Sex professional).
Importance of Stigma Reduction
Multiple sex professionals brought up the need to reduce community-level stigma after listening to the song. For instance, one described experiencing stigma within the community: “You worked all night long and… people point fingers at you saying: ‘look at this whore returning home early in the morning after frolicking all night long’, it is unpleasant!” (Sex professional). Relatedly, another sex professional described the importance of reducing community-level sex work stigma through humanizing sex professionals and reinforcing sex work as legitimate work: “We are people, not animals, prostitution is our way of making a living, so nobody [should] be pointing fingers on us…We just have a different job, so we need to live our lives without the stigma of the neighbors.” (Sex professional).
Others described the need to stop stigma within sex professional communities, including based on dress and outward appearance, including in community centers tailored for sex professionals as well as towards other sex professionals: “We make it our duty to explain to the center’s workers… so that they would do a better job dealing with our needs. We should also be supportive of one another instead of mean, because today when you are well dressed you are given consideration, but when you have a bad outfit, nobody would even bother to check the background before throwing harsh judgement.” (Sex professional).
Legal Recognition and Healthcare Dignity
Some sex professionals described after listening to the Esengo song their wishes for legal protection for sex professionals: “The state [government] must make new laws that make it important when the prostitutes [sex professionals] go to the police station, they must be well received and their problems be taken care of right away, that’s what is on my mind.” (Sex professional).
Additional sex professional narratives responded to the health clinic portrayal in the song, which reflected welcoming treatment of sex professionals that differed from their current experiences accessing health care: “When it comes to the hospitals, what we want is that they ought to receive us well, because sometimes you have the money but they won’t welcome you because of the clothes you’re wearing. they should see us just as normal people.” (Sex professional).
This led several sex professionals to discuss how they wanted their own sex work-specific clinics. For instance, one sex professional explained: “I want them to build a hospital only for us, [where] they would welcome us, take good care of us and, the treatment is free of charges. When we go to other hospitals, they neglect us quite a lot, they disrespect us and insult us, so if we have our own hospital, it will be peace.” (Sex professional).
Health Professionals’ Perspectives
Healthcare Reform
Health professionals’ reactions to the song also reflected considerations of the themes regarding sex professionals wish for respectful and tailored healthcare, and the importance of legal protection. This included sharing perspectives on the importance of health provider education and reducing stigma in the health system: “What I would like is to raise awareness among health professionals because … many among us stigmatize people, we must try to educate them as much as possible on the fact that they have to treat SP [sex professionals] as normal people.” (Health worker). Another health worker described that they would be supportive of the concept of sex work-specific clinics as it reflected community priorities: “If they [sex professionals] dream of having their own clinic, we ought to train the doctors who would be working with them in accordance with the situation in order to avoid stigmatization.” (Health worker). In another example, a health worker explained that they understood this wish for a specialized clinic due to pervasive mistreatment of sex professionals in healthcare: “In our country the health system does not work… these ladies have felt so discriminated that they don’t even want to mix with the general population, this is terrible because from the studies we’ve seen they are a population with a high mortality rate…They don’t want to go to the hospital because the stigmatization is excruciating… insults rain down on them, or they are neglected, other people are received but they are passed over as if they were invisible; so, it is a huge problem. It is not therefore a problem if a dedicated clinic is created for them, but the system must work, it is why we have to organize things in the country so that we would make things happen and really be of help to them.” (Health worker).
There were differing perspectives regarding the need for a sex professional-specific clinic among health workers, but overall participants agreed on the need for appropriate and improved services for sex professionals. A health worker described that what was wanted in a dream clinic described in the Esengo song was in fact similar to what should be offered in standard clinical practice: “For the dream clinics the characteristics are almost the same, they want to have all the services that are needed in a good clinic.” (Health worker). Another health worker described that there may not be a need for a sex worker-specific clinic if they could access adequate and accessible services: “These ladies really want to do their job well… the dream clinic shows how they want to be screened for STDs, they need medicines, they need a doctor for consultation, they also insist on having good nutrition; so, these four points are at the core of their particular needs. So, we might not build a special clinic for them, but we can manage to have them attend an existing hospital with all the services they need.” (Health worker).
Legal Reform
The songs also inspired some solutions raised by health workers related to the local socio-political and legal context regarding sex work: “The first solution is political because that [sex work] profession needs to be legalized”; and “we must have the political will to do so, and the job [sex work] must be legalized.” Another health worker reinforced the need to prioritize legalization of sex work: “On the short term we propose that the government and the public must sit together to find a way to legalize the sex profession, as long as it is not legalized it will be difficult, it is why there must be first a struggle in order to attain legalization.” (Health worker).
The importance of engaging other actors in creating a supportive legal and health environment was also underscored. For instance, one health worker raised the need to engage politicians in order to create positive social change for sex professionals: “I think it is a social problem… as long as the politicians would not support the project nothing will be done and, it is up to them too to give it a legal framework and the necessary means to have the hospitals provide them the health care, otherwise it is impossible.” (Health worker).
Another idea raised was to support rights-based advocacy movements to include sex professional issues, as well as to support sex professional led advocacy: “There are many associations in the country that work to improve the conditions of the most vulnerable group of people in society, [they] must unify their strength to plead to the ministries [and] international institutions for the protection of these vulnerable groups, to help recognize officially the sex profession.... the problem comes from lack of legal ground, so everything concerning this profession is illegal and is done informally. The ladies must themselves regroup into a group that will advocate for their own rights, because if the effort does not come from them how would the civilians get a better understanding of their problems.” (Health worker).
World AIDS Day Esengo Music Video Launch
The Esengo music video was launched on World AIDS Day, December 1, 2024 to raise awareness about the need for stigma-reduction towards sex professionals. The 4 minute 45 second video was uploaded to a YouTube channel (https://youtu.be/cSI4t3CzLOA?si=7k4SnXqEKE6RkulR) and shared on multiple social media platforms (X, Instagram, Facebook, LinkedIn). UAFPA held a music video launch with an in-person screening in Pointe-Noire. While some attendees expressed the desire to see a live action music video instead of an animated one, the song and music video were overall well-received. Animation was intentionally chosen over live-action to ensure participant safety and anonymity in a criminalized and stigmatized context, as live-action footage risked exposing sex professionals to harm. Animation also allowed us to incorporate participant-generated drawings directly into the video and create a cohesive, joyful aesthetic that would not have been possible with filmed footage. The collaborating academic institution (University of Toronto, Canada) also developed media coverage for the launch.
Discussion
This manuscript detailed the process of developing a song and music video with sex professionals in Pointe, Noire, Congo that focused on the world sex professionals dream of living in, with the goal to promote stigma reduction and solidarity among sex professionals as well as healthcare providers. Three key lessons emerged from developing Esengo: 1) centering joy in messaging for social change; 2) amplifying community slogans to support social movements; and 3) engaging sex professionals in participatory knowledge translation and stigma reduction.
First, the Esengo song and video embody joy through its chorus—Esengo, meaning “joy”—which repeats throughout, as well as through its melodies, rhythms, tempo, and mood. Creating a song that elicits joy requires the creators themselves to feel joy (Cespedes-Guevara & Dibben, 2022). In our song-making workshop, sex professionals envisioned the world they want to live in and how they wish to be treated. The resulting song imagines a desired future. We call this affirmative affect—an empowering expression of self-determination where participants articulate the change they want, through culturally grounded tools, while embodying the feelings associated with that envisioned future. The researchers observed that the process evoked joy, seen in spontaneous dancing, ululating, and cheering. This aligns with findings from Indigenous communities in Australia, where song supports resilience and redefines collective identity (Palmer, 2018). Similarly, in Latin American movements, music has long been a vehicle for expressing resistance and imagining liberation, even in highly repressive contexts (Aldama et al., 2012). Such affective approaches can help counteract the shame and silencing often imposed by stigma. Here, joy served as resistance to internalized stigma by affirming dignity and rejecting societal devaluation.
The use of song and animation in Esengo also reads as a decolonial methodological practice that amplifies sex professionals’ own visions for the future. In contrast to postcolonial contexts that privilege Eurocentric epistemologies (Chilisa, 2012), Esengo locates knowledge in Congolese music and visual vocabularies—reclaiming rumba and song-making as valid ways of theorizing and meaning-making (Lee, 2023; Walker, 2022). Further, the emphasis on imagination and dreaming aligns with decolonial calls for anti-systemic liberation (Grosfoguel, 2011) that transform epistemic and affective hierarchies of the colonial world. Through co-creating lyrics and imagery, sex professionals were not ‘research subjects’ but storytellers and knowledge holders, offering Esengo as both a decolonial research method and an amplification of community-authored futures grounded in joy and hope.
Second, songs can amplify existing slogans to strengthen social movements. Both music and social movements use chanting to unify people, communicate goals, and call for change (Kunreuther, 2018). In music, chanting emphasizes emotion and message (Parada-Cabaleiro et al., 2024). Esengo ends with the chant: “Viva sex professionals!”—a counter to stigma that rehumanizes and celebrates sex professionals. We suggest this chant can bolster the global sex worker movement. This aligns with calls from international sex worker rights organizations to reclaim language and visibility as tools for dignity and political resistance (Global Network of Sex Work Projects, 2013). When slogans are embedded in creative expressions like song, they become emotionally resonant and easier to disseminate across contexts. Such collective affirmations help to disrupt anticipated stigma by challenging expectations of rejection and replacing them with expectations of solidarity and recognition (Adams et al., 2019; Golden et al., 2025).
Third, song and video-making offer a way to meaningfully engage sex professionals in knowledge translation and stigma reduction. While sex professional community involvement in research has grown (Benoit et al., 2017; Lobo et al., 2020), opportunities for meaningful participation in knowledge translation—especially for stigma reduction—remain limited. Community-engaged elements in the music video included: 1) lyrics, melodies, and rhythms by peer navigator sex professionals; 2) animations of places and objects drawn by participants; 3) colors and textures from traditional clothing; and 4) lyrics in Lingala. Community engagement in knowledge translation empowers individuals to share lived experience and influence change, while enhancing representation (Boyko et al., 2018; Dembele et al., 2024). Moreover, involving community members as co-creators of cultural products helps bridge the gap between academic knowledge and local realities (Boyko et al., 2018; Dembele et al., 2024). This model not only increases the relevance of interventions but also fosters long-term ownership and sustainability.
The song-making process in this project created space for participants to reflect on a stigma-free world. To generate aspirations for how they wanted to be treated in such a world, participants raised multiple forms of stigma they faced, including: enacted stigma (e.g., mistreatment by healthcare professionals, neighbours, and police officers); perceived/felt-normative stigma (e.g., awareness of being devalued in society, whereby song lyrics refer to societal views of sex professionals as ‘garbage’ and ‘enemies’); and internalized stigma (e.g. a lack of self-worth and value which is challenged in the song through lyrics affirming they are ‘human beings’). These lyrics reflect the complex types of stigma detailed in the Health Stigma and Discrimination Framework that span institutional (e.g. legal, healthcare), community (e.g. social norms), and interpersonal (e.g. neighbour interactions) levels that are both experienced by a marginalized group (in this case, sex professionals) and enacted by multiple actors (Stangl et al., 2019). Song making as an arts-based method can thus foster critical reflection and help marginalized groups to reimagine identities and futures within stigmatized contexts (Leavy, 2015). The process of creating songs, including group-based work, as well as the song itself, could be integrated into internalized stigma reduction strategies with sex professionals that address internalized negative beliefs, self-acceptance, critical consciousness raising, solidarity building, and reframing identity and agency (Benoit et al., 2017; Stangl et al., 2019, 2023). Songs such as Esengo could also be used as part of stigma reduction approaches with healthcare and other social service providers to address actionable drivers of stigma such as a lack of understanding of how stigma is experienced within health/social/legal services and its harmful consequences on sex professionals (Logie & Nyblade, 2024).
Healthcare providers shared perspectives after the music video screening that signalled openness and receptivity to listening to, and considering the importance of, sex professionals' calls for stigma reduction in healthcare and the decriminalization of sex work. This reinforces findings from other arts-based modalities about the role of arts-based products in reducing healthcare provider stigma, for instance using methods such as participatory comics (Logie et al., 2023), animated storytelling videos (Klapow et al., 2025), and digital stories (Linz et al., 2022). Live music has also been used to generate empathy and reduce mental health stigma (Golden et al., 2025), and music videos could be further explored as a sex work stigma reduction method. By positioning sex professionals as knowledge producers and experts, this project also directly counters enacted stigma, which often manifests through exclusion from healthcare and research decision-making (Shannon et al., 2014).
Esengo also methodologically advances arts-based qualitative research. By embedding song-making within participatory mapping workshops, the project extends mapping beyond spatial and visual representation to include rhythmic and cultural dimensions of community knowledge. In particular, the Dream Studio allowed participants to articulate desired changes across the same settings (health clinics, police stations, community spaces). Additionally, by incorporating participants’ hand-drawn participatory mapping outputs into the animated music video, our project demonstrates how visual illustrations can be both a data source and a visual element for multi-media (i.e., song, video) knowledge translation. In doing so, Esengo demonstrates how participatory mapping can function not only as a diagnostic tool (Douglas et al., 2020; Panek, 2015), but also a creative knowledge mobilization tool where music becomes a mode of theorizing and collective sense-making (Lee, 2023).
Although participants articulated powerful visions for sex worker-specific clinics and the legalization of sex work, translating dreams into policy or practice requires careful consideration and structural-level changes. Community-based health research frequently elicits recommendations that reflect both lived realities of exclusion and desires for safety, dignity, and structural change (Cargo & Mercer, 2008). At the same time, implementing changes such as dedicated services for marginalized groups can raise concerns regarding: resource constraints within healthcare systems; the potential for segregation and further marginalization of a clinic and its clients; the differing needs and preferences among a community, whereby some may prefer mainstream and others differentiated services; and the need to embed stigma-reduction and equity within mainstream legal and health systems (Cargo & Mercer, 2008; Logie & Nyblade, 2024). These recommendations document how creative methods enable sex professionals to imagine and articulate broader socio-environmental conditions where they can experience dignity, safety, and respect. Future research should engage a large, diverse sample of sex professionals in Congo, alongside health officials, legal experts, human rights advocates, and policy makers, to explore preferences for differentiated and/or mainstream social and health service delivery models, assess feasibility and next steps for structural changes, and co-develop community-engaged policy and practice recommendations.
There are study limitations. The Esengo song was created to inspire dialogue in the participatory mapping workshops, but we did not specifically collect reflections from the workshop participants on the song. We also created the music video after the grant was completed, so while we shared the song in community dialogues, we did not have the opportunity to share and gather reflections on the video itself in participatory mapping workshops. While we collected qualitative open-ended feedback, there was no formal evaluation of the effectiveness of the Esengo song and/or music video in reducing stigma and fostering hope or solidarity among sex professionals (e.g. internalized stigma), and/or reducing sex work stigma and building empathy among health workers, and this is a key area for future researchers to examine. Methodologically, the integration of song-making into participatory mapping generated rich data, but it also introduced limitations regarding analysis. As the song and video were developed as knowledge translation tools rather than co-created artistic outputs, creative decisions were shaped by the academic research team and professional song producer, which may have influenced which themes were emphasized. Additionally, translation from French and Lingala may have shaped nuances of meaning, although our analysis drew on multiple team members’ perspectives.
It is also important to reflect on the practical and ethical tensions inherent in translating creative community expressions into a knowledge translation product. Although the broader study employed participatory methods, the song-making and music video production processes themselves were community-engaged rather than participatory. Community members’ responses shaped the content, emotional tone, and priorities expressed in the drawings, as well as song lyrics, beats, and musical style, yet the subsequent song making process involved decision-making authority from the academic team and music producer. To apply a community engaged creative research process with technical decision-making, we consulted with peer navigators and the community Research Assistant, who affirmed that the revised structure still reflected community-identified experiences and aspirations. Nonetheless, due to financial, technical, and logistic constraints during the song and video development, the final products involved technical processes that reflect researcher-led production rather than participatory co-production.
Despite these constraints, the Esengo music video is open access and freely available so researchers, health practitioners and communities can consider using and evaluating it in future research focused on sex professionals’ health, rights, and wellbeing. Our study is unique in focusing on song making in a low and middle-income country with sex professionals focused on envisioning a speculative and hopeful future, and in integrating visuals developed by sex professionals from a participatory mapping project into a music video.
Conclusions
Given Congolese rumba’s history as a form of cultural resilience with the potential to shift social identities and values (White, 2002), it holds promise as an empowering method for community-based research and knowledge translation to reduce stigma toward sex professionals in Congo. Transforming a song into an animated music video ensured that representations were context-specific and accessible to diverse global audiences unfamiliar with French or Lingala. This local grounding may enhance engagement by local audiences (van der Merwe & Morelli, 2022). The song and video can serve as prompts for dialogue, tools for stigma reduction trainings, and advocacy materials across platforms. Community-based organizations could also use Esengo for their own social change efforts. This community engaged approach may be adapted for other contexts, populations, and health issues to support stigma reduction, health promotion, training, and community empowerment. Future research should rigorously evaluate the impact of such arts-based stigma reduction interventions, using experimental designs, to assess their effectiveness in reducing stigma across diverse settings.
Supplemental Material
Supplemental Material - Esengo (“Joy”): Methods for Developing a Song and Animated Music Video for Reducing Stigma With Sex Professionals in Pointe-Noire, Congo
Supplemental Material for Esengo (“Joy”): Methods for Developing a Song and Animated Music Video for Reducing Stigma With Sex Professionals in Pointe-Noire, Congo by Carmen H. Logie, Sarah Van Borek, David Puvaneyshwaran, Frannie MacKenzie, Aryssa Hasham, Bibiche Mbende, Luc Magloire Anicet Boumba, Laure Stella Ghoma Linguissi, and Hugues Loemba in International Journal of Qualitative Methods.
Footnotes
Acknowledgements
We acknowledge all participants and peer researchers for their contributions.
Ethical Considerations
This study received approval from The University of Toronto Research Ethics Board (Protocol Number: 41845) and Comité d’Éthique pour la Recherche en Santé (CERS) de la Fondation Marie Madeleine GOMBES (Research Ethics Committee in Health of the Marie Madeleine Gombes Foundation).
Consent to Participate
Informed consent was obtained from all participants involved in the study.
Author Contributions
Design of study: CHL, SBV, BM, LMAC, LSGL, HL. Acquisition, analysis, interpretation of data: CHL, SVB, DP, FM, AH, BM, LMAB, LSGL, HL. Drafting and reviewing work: CHL, SVB, DP, FM, AH, BM, LMAB, LSGL. Approval of final version: CHL, SVB, DP, FM, AH, BM, LMAB, LSGL.
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Grand Challenges Canada (2022-2023) (Logie, Grant No. R-ST-POC-2205-52021), Canada Research Chairs Program (Tier 2, SSHRC, Logie).
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data Availability Statement
The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.
Supplemental Material
Supplemental material for this article is available online.
References
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