Why Is Preexposure Prophylaxis So Underused in Brazil?

Why Is Preexposure Prophylaxis So Underused in Brazil?

Roxana Tabakman

April 27, 2022

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This article was originally published in Portuguese on Medscape.

In Latin America, Brazil is the leader in the use of preexposure prophylaxis (PrEP) for prevention of infection with HIV. It was the first country in the region to establish free national access to prophylaxis through the Brazilian Public Health System (SUS) for men who have sex with men (MSM) and who are at increased risk of acquiring HIV. However, Brazilians still represent a minimal percentage of PrEP users worldwide.

The Joint United Nations Program on HIV/AIDS (UNAIDS) recommends 50% coverage for MSM and transgender individuals at very high risk of acquiring HIV. Brazil is still far from reaching this goal. Beatriz Grinsztejn, MD, PhD, is an infectious disease specialist and researcher at the Oswaldo Cruz Foundation's Evandro Chagas National Infectious Disease Institute (INI/Fiocruz) and a global expert in HIV. In an interview with Medscape Medical News, she explained, "PrEP use still needs to be expanded to an adequate level in Brazil."

A new studyon PrEP use among eligible Brazilian men, according to SUS criteria, found that higher levels of HIV knowledge were associated with increased odds of PrEP use. The investigators also considered the influence of "internalized homonegativity," a phenomenon derived from social prejudice, on adherence to treatment.

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