In six months of operation of PrEPara Salvador, 68 adolescents have already adhered to the use of HIV pre-exposure prophylaxis, called PrEP. In total, more than 120 young people were recruited to participate in the study, which focuses on virus prevention among gay adolescents, men who have sex with men (MSM), transvestites and transgender women, aged 15-19. The data was released during an international evaluation meeting, held from October 9-11, at Casarão da Diversidade, in Salvador’s Historic Center.
The project headquarters hosted a number of world leaders engaged in HIV programs and actions across South America and Africa who came to Salvador to learn about the local study and share experiences. PrEP 15-19 is also held simultaneously in Belo Horizonte and São Paulo. “It is a time to evaluate and monitor the progress of the research in these first six months, and promote the integration between these three Brazilian sites, international groups and funding agencies,” explains Inês Dourado, a professor at the UFBA Institute of Collective Health, who leads the project in Salvador, as well as being representative of the three cities for the funding agency Unitaid and the World Health Organization (WHO).
In Salvador, the research objective is to reach 400 participants in two years. Through the project, young people have access to a multidisciplinary program for the prevention of sexually transmitted infections (STIs), highlighting the distribution of PrEP, a daily medication composed of two antiretrovirals, combined in a single length, which prevents HIV infection. up to 98%. During the visit, world leaders learned about the project facilities and the activities carried out by the local team of professionals.
“Since we started, young people were already excited about joining the study, not only because of the protection that comes from PrEP, but because of the possibility of fighting stigma with those living with HIV, especially the LGBT population,” he says. Professor Marcelo Castellanos (ISC / UFBA), who is part of the project team in the Bahian capital.
The study is also coordinated in the city by professors Laio Magno, from the Bahia State University (Uneb) and Luís Augusto da Silva, from the Professor Milton Santos Institute of Humanities, Arts and Sciences (IHAC / UFBA).
PrEP 15-19 is the first in Latin America that seeks to demonstrate the effectiveness of prophylaxis among youth and adolescents. “Many countries do not even allow HIV testing for those under age without the guardian’s follow-up. And there are still countries that criminalize homosexual relationships, ”says Maeve Mello, regional HIV prevention advisor at the Pan American Health Organization (PAHO / WHO). For her, the Brazilian project serves as an example for advancing an agenda of diversity and the rights of children and adolescents.
Among the international groups that participated in the meeting is ImPrEP, Project for the Implementation of HIV Pre-Exposure Prophylaxis in Brazil, Mexico and Peru. The study began to be implemented in 2017 and is the result of a joint effort between the Brazilian Ministry of Health and the Oswaldo Cruz Foundation (Fiocruz). The goal is to provide antiretroviral drugs to about 7,500 non-HIV-infected adults in the three participating countries.
“We evaluate all the time so that society can benefit from the beginning of our effort and investment,” says Valdilea Veloso, director of the Evandro Chagas National Institute of Infectious Diseases (INI / Fiocruz) and lead researcher at ImPrEP.
In Peru, the survey operates in six cities, including Lima / Callao, provinces that account for 71% of the country’s AIDS cases. For Carlos Cáceres, director of the Center for Interdisciplinary Research on Sexuality, AIDS and Society / CIISSS (Peruvian Cayetano Heredia University / Peru), responsible for coordinating the study there, in addition to offering medicines, PrEP has become an important channel for early diagnosis of sexually transmitted infections. “As the participant needs to make an appointment every three months, it is possible to make an assessment of diseases that until then could be asymptomatic”, points out.
The meeting was also attended by representatives of the South African Department of Health and WITS University (Johannesburg), responsible for supporting studies and implementation of PrEP use among female adolescents in that country.
In Latin America, only Brazil and Chile have adopted PrEP as a public policy to combat the spread of HIV in the adult population. Since January 2018, prophylaxis has been offered in our country by the Unified Health System (SUS). As of June this year, 10,350 people have started using PrEP through units spread across 27 states. There are already 192 services registered in Brazil so far.
In recent years, the epidemic of the HIV virus has imposed obstacles to the control of AIDS in the country and challenges researchers to develop studies that seek increasingly efficient prevention strategies. Ministry of Health data show that the number of people living with HIV jumped by over 700% in 10 years (2007-2017) among 15- and 24-year-olds.
Of the population served by PrEP SUS, 77% are men who have sex with men or those who claim to be gay. Most care, about 43%, is made up of young people between 18 and 29 years old. “We are working with the teams to expand access to the most vulnerable people, those with the least education, the lowest socioeconomic status and who are not in the service,” explains Cristina Pimenta, representative of the Ministry of Health, who attended the meeting.
She also drew attention to the effectiveness of prophylaxis in reducing HIV cases in the surveyed population. “The idea is to continue and strengthen PrEP in Brazil. We are excited to receive the results of adolescents and incorporate this experience into PrEP public policy in our country. ”vvvv