The results of the first six months of implementation of the prophylaxis were presented during the World Conference on Aids
Published: 07/30/2018 – 05:36 PM last publication: 08/01/2018 – 10:44 AM
Considered as an important strategy to contain the number of new infections, HIV Pre-exposure Prophylaxis (PrEP) started to be offered this year by Brazil, through the Brazilian Unique Health System (SUS), in 22 cities of 11 Brazilian states. The results of such first six months of implementation of PrEP were presented by the Ministry of Health during the 22nd International Conference on Aids, held from July 23 to July 27, in Amsterdam (The Netherlands).
Since January, 2018, the prophylaxis is available at no cost for the populations most vulnerable to the infection by HIV – gays and other men that make sex with men (HSH), transgender people, sex workers, and serodifferent couples. Between January and July, 20185, aroung 6 thousand prescriptions of PrEP were performed, and 2,748 people have already started the prophylaxis in 36 Brazilian services, in 22 cities, until June, 2018 (www.aids.gov.br). In such six months, the most of the users of PrEP was of gays and other men that make sex with men (HSH) (78.9%), with smaller participation of transgender women (1.8%), transvestites (0.4%), and transgender men (0.3%). Also, 77% of people under PrEP reported to have more than 12 years of formal study.
“The big challenge in Brazil now is to extend the offer so that PrEP reaches the populations most vulnerable to HIV, such as gays and HSH black with low school background, transgender people, and sex workers. For such, we will intensify the actions of disclosure and information about the prophylaxis”, highlighted the representative of the Brazilian Ministry of Health, Adele Benzaken, director of the Department of Sexually Transmitted Infections, of HIV/Aids, and of the Viral Hepatitis (DIAHV), during the satellite session “PrEP in Real World: first lessons to extend between key populations”, held by the World Health Organization (WHO), on July 24.
“PrEP is a life style and shall be thought with the Combined Prevention, which also includes the fighting against discrimination and the guarantee of access to health and citizenship by such populations. Additionally, it helps to put the other Sexually Transmitted Infections in the agenda again”, she complements.
Representatives of ministries of health of the whole world, researchers, and institutions of other countries that waive PrEP, such as the United States, Vietnam, South Africa, Kenya, and Thailand also participated in the session. Brazil is the first country of Latin America to count on the prophylaxis among the alternatives of Combined Prevention to HIV in its public health system.
Brazil also presented the paper “The implementation of PrEP in the Brazilian National Program” (in English) written by the servant of the Ministry of Health, Clarissa Barros, which was selected to presentation of posters.
EXPANSION – From July, the service network started to be enhanced and more 24 cities will pass to offer PrEP. With such expansion, all Brazilian states will offer the prophylaxis, and the populations more vulnerable to infection by HIV will count on a total of 65 services of PrEP in 46 cities. The initial investment was R$ 8.6 million for acquisition of 3.6 million tablets in order to meet the demand for the period of one year, approximately.
The good news, according to the representative of the Ministry of Health, is that in May the Brazilian National Agency of Public Health Surveillance (Anvisa) approved the registration for commercialization of the generic drug of PrEP (emtricitabine combined with tenofovir disoproxil fumarate), which will be produced by a development partnership between the public laboratory of Farmanguinhos, of Fundação Osvaldo Cruz (Fiocruz), and Blanver industry. “Soon we will have PrEP made in Brazil”, Benkazen celebrates. According to DIAHV director, Brazil purchases each vial of the medicine for 24 dollars. “Such value is lower than in most of countries, and the expectancy is that, with the production of the generic drug, we may pay even less bringing the production to the country”, she explained.
ImPrEP WORKSHOP – Group of researchers in charge of ImPrEP Project – Valdilea Veloso (Fiocruz/Brazil), Carlos Cáceres (University Cayetano Heredia/Peru), Hamid Vega (Condesa Specialized Clinic, Mental Health Department of Mexico) and Cristina Pimenta (Ministry of Health/Brazil – promoted a workshop about implementation of PrEP in the context of medium-income countries and with concentrated epidemics. With the title “Preparation and implementation of demonstration projects of PrEP: the experience of ImPrEP in Brazil, Mexico, and Peru”, the activity had the purpose of providing subsides to the participants to start demonstration projects of PrEP among HSH and transvestite and transgender women, from the experience acquired in the development of ImPrEP.
ImPrEP – “Implementation of HIV Pre-exposure Prophylaxis in Brazil, in Mexico, and in Peru” is a project started in 2018 that will assess the implementation of PrEP as prevention strategy in the three countries. The Project is developed by research centers bound to the Ministries of Health of Brazil, Mexico, and Peru, and counts on funding of Unitaid.
Department of Surveillance, Prevention, and Control of IST, HIV/Aids, and Viral Hepatitis
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