Pre-Exposure Prophylaxis (PrEP), the HIV prevention pill, has come to Brazil.
Brazil is the first country in Latin America to provide PrEP for free to its citizens, and the PrEP Brazil rollout has received some great coverage in The New York Times, but questions linger over whether the amount of PrEP available will be enough to meet the country’s need. Are economics being prioritized over the health of the people of Brazil?
The Health Ministry will provide 3.6 million tablets for the first year. Those once-daily pills will be dispensed through 36 services of the Unified Health System (SUS) in 22 Brazilian cities. While that sounds good initially, those numbers translate into PrEP coverage for only about 10,000 individuals. Brazil has over 200 million people.
When you look at it that way, the math of the PrEP Brazil rollout isn’t so great.
If that weren’t bad enough, PrEP won’t be available on-demand. It will only be available at certain locations to certain people — key populations like men who have sex with men (MSM), sex workers, trans people and HIV-negative people in a relationship with an HIV-positive partner.
MSM are disproportionately impacted by HIV. UNAIDS estimates 1 in 10 MSM have HIV. This highly effective HIV prevention option could greatly benefit gay men in Brazil, but the amount of PrEP available does not compare to the tremendous need among MSM.
Even by UNAIDS‘ most conservative estimates, there are 2 million MSM in Brazil. As we pointed out earlier, there’s only enough for 10,000 people, or less than 0.5% of the MSM population.
The gay social networking app Hornet, in partnership with UNAIDS Brazil, conducted a PrEP survey of its users in Brazil. Over three weeks, 3,218 responses were collected. Of those, 27% reported being HIV-positive, and 36% were likely to use PrEP in the next six months. There is a high level of HIV among MSM in Brazil, and these men are interested in — and deserve diversity in — their prevention options.
Many MSM, particularly young MSM, are unaware that the HIV prevention pill exists or how to get it. Unfortunately there haven’t been enough wide-scale PrEP education campaigns in Brazil. As a result, the community has had to step in to try and raise awareness about PrEP.
Hornet created PrEP education materials, mobilized PrEP advocates and enlisted social media influencers to create videos and news stories about the HIV prevention pill. Hornet also launched a PrEP social education campaign entitled “Quero Minha PrEP” (“I Want My PrEP”). PrEP users have bravely stepped forward to tell their stories in hopes of initiating a conversation around PrEP and reducing stigma.
Health care is a fundamental human right. All people must have access to antiretroviral medication regardless of HIV status. If a government is truly committed to LGBT rights, it must invest in the lives of its LGBT community.
The PrEP Brazil rollout can have a profound impact on the HIV epidemic in the country, but it will require a forceful response from government, businesses and community.