Adoption and Expansion of Pre-Exposure Prophylaxis (PrEP) in Brazil

• DOI: https://doi.org/10.22533/at.ed.1595225030112

• Palavras-chave: Pre-Exposure Prophylaxis; HIV prevention in Brazil; Public health policy; Sociocultural barriers; Healthcare accessibility.

• Keywords: Pre-Exposure Prophylaxis; HIV prevention in Brazil; Public health policy; Sociocultural barriers; Healthcare accessibility.

• Abstract: INTRODUCTION Pre-Exposure Prophylaxis (PrEP) has emerged as a key tool in HIV prevention strategies in Brazil, demonstrating significant potential to reduce HIV incidence among high-risk populations. The introduction of PrEP within the Unified Health System (SUS) has facilitated free access to eligible individuals, particularly in urban centers. However, disparities in access and utilization persist, influenced by geographic, economic, and sociocultural factors, including stigma and misinformation. OBJETIVE To critically evaluate the adoption and expansion of Pre-Exposure Prophylaxis (PrEP) in Brazil, focusing on its public health impact, accessibility, and sociocultural barriers. METHODS This is a narrative review which included studies in the MEDLINE – PubMed (National Library of Medicine, National Institutes of Health), COCHRANE, EMBASE and Google Scholar databases, using as descriptors: “Pre-Exposure Prophylaxis” AND “HIV prevention in Brazil” AND “Public health policy” AND “Sociocultural barriers” AND “Healthcare accessibility” in the last 5 years. RESULTS AND DISCUSSION The results highlight the effectiveness of PrEP in reducing HIV incidence, particularly among men who have sex with men and transgender populations, while emphasizing challenges in adherence and awareness. Geographic disparities in access were noted, with rural regions facing significant barriers compared to urban areas. Sociocultural dynamics, including stigma and misinformation, were significant determinants of PrEP utilization. Healthcare providers’ roles in advocacy and patient education were also identified as critical components for the success of PrEP implementation. CONCLUSION In conclusion, PrEP holds transformative potential for HIV prevention in Brazil but requires a multifaceted approach to overcome barriers in accessibility, equity, and awareness. Strengthening healthcare infrastructure, integrating community-based initiatives, and addressing stigma are essential to optimize the impact and sustainability of PrEP programs nationwide.