Monday , May 29 2023

How is the fight against AIDS in Brazil


The first case of AIDS in Brazil is believed to have occurred in São Paulo 40 years ago, in 1980 – but the diagnosis of the disease was confirmed two years later.

When HIV was created, people with the virus were highly stigmatized. According to the schedule organized by the Oswaldo Cruz Foundation to show the evolution of the Brazilian subject, in 1982 AIDS was called “5H disease”, referring to homosexuals, hemophiliacs, Haitians, heroin users – users of injectable heroin. and sex workers. Newspapers at the time called the disease “gay plague” and “gay cancer.”

Since then, much has changed: AIDS has ceased to be an unknown disease, treatments have advanced, and from being incurable and deadly, it has been treated as a chronic disease that needs treatment for life.

However, although there is currently an advanced treatment protocol that allows people diagnosed with the HIV virus to lead a normal life in Brazil, negligence has led to an increase in the number of cases.

According to a report published by the United Nations Joint Program on HIV / AIDS (July), HIV cases in Latin America have increased by 21% since 2010. And Brazil carries a lot of weight in that figure. It is estimated that 920 thousand people currently live with HIV in Brazil – and 135 thousand people still do not know they have the virus. According to the latest bulletin published by the Ministry of Health on the subject, in 2019, the number of new cases is almost 40 thousand per year. There were 37,161 new diagnoses in 2018, such as the portfolio’s final balance sheet.

International recognition

The National STD and AIDS Program was created in 1986 by the Ministry of Health. In recent decades, Brazil has become an international example in the fight against AIDS. In 2003, the Bill & Melinda Gates Foundation recognized the quality and importance of the work, awarding the program a $ 1 million prize.

In 1991, when Brazil had 11,805 cases reported, the Ministry of Health began distributing free antiretrovirals. In 1994, an agreement with the World Bank increased the number of AIDS control and prevention measures in the country. Two years later, the law was passed, a law that guaranteed the free distribution of medicines to people with the virus.

“Since the epidemic began 40 years ago, Brazil has acted very effectively and adopted public policies against HIV since childhood. We were one of the first countries to have a strategic plan for treatment and response to HIV, so we have a lot of experience in that regard.”, says DW Brazil Claudia Velasquez, director and representative of Unaids Brazil.

According to Velasquez, the collective efforts of different sectors, governments, NGOs and communities are ensuring access to treatment. “Medications are available. We have a mandala for prevention combined with different methods, but the most effective way to combat HIV and prevent the development of AIDS is a joint effort to ensure that everyone has access to treatment.”

In addition to being a specific piece of legislation to protect people living with HIV and AIDS and guarantee the rights of Brazil, Velasquez emphasizes the role of the Integrated Health System (SUS).

“SUS provides condoms, tests, virus loading tests and antiretroviral drugs for free to residents”, continues. “Since 2018, SUS has also made pre-exposure prophylaxis (PrEP) available, which is a step forward in terms of HIV prevention. In Latin America, Brazil is the only country that distributes PrEP for free. ”

Discharge among young people

However, according to experts, especially after all the progress made in the 1990s, with new treatments – and universal access and free access to them – and awareness campaigns, the incidence of cases is increasing, especially among young people aged 14-39.

“Due to the successful treatment of the disease, the technology makes it easier for new partners to become partners, the lack of knowledge about the disease and its severity, the lack of condom campaigns and even prevention. Other sexually transmitted infections that facilitate HIV infection.”, believes Gisele Cristina Gosuen, an infectologist in charge of the HIV clinic at the Federal University of São Paulo (Unifesp).

For sociologist Alexandre Grangeiro, a public health researcher at the University of Sao Paulo (USP), a “synergy of issues” explains the rise in infections among young people.

“Throughout the epidemic, young people have been the most affected because of their own characteristics – more partners, less health and prevention experience, etc.”, points.

“However, the new generations have a new aspect to play: a section of young people have promoted a major ‘sexual revolution’, which was halted by AIDS in the 1980s and 1990s. it has led to an increase in the number of relationships and partnerships, expanding sexual networks that facilitate the circulation of HIV. ”

According to the sociologist, this scenario has resulted in “generations born after the 1990s having higher HIV rates than previous generations.”

“New sexual value would not be an issue in itself if prevention practices were linked to it”, he reflectsThe problem is that in recent years Brazil’s response to HIV has been severely hampered by the failure of major sectors of society, in part due to demobilization and, above all, a conservative and reactionary wave against new standards. “, he considers.

Missing campaign

Specialists who have been heard by DW Brazil as a problem in the current management of the Ministry of Health have pointed out the lack of an ongoing campaign to prevent AIDS.

“There is an unspoken institutional ban on developing actions to address the root causes of HIV infection and death. This is seen as a reflection of a conservative policy that deviates from the core values ​​of the law.”, examines Grangeiro.

“The issue of HIV and AIDS in Brazil has been sidelined [pelo governo federal]. To give you an idea, we don’t have a newsletter and information about 2020 ″, Infectious disease doctor Jamal Suleiman, who works on the subject at the Emílio Ribas Institute of Infectious Diseases, has commented to DW Brazil.

After reviewing the report, the Ministry of Health limited itself to sending the 2019 report and announced that the portfolio “should launch an anti-AIDS campaign, referring to Red December” – World AIDS Day. Tuesday (12/1). “No date specified yet”, stated in an email sent by the press office.

Gosuen believes that there is no constant campaign, “And not just on specific dates like Carnival and World AIDS Day” is an obstacle to the effectiveness of the Brazilian program. It also advocates for specific actions aimed at the most vulnerable populations. “People on the street, sex workers, transvestites and transsexuals and the elderly with no culture of condom use”.

Grangeiro noted that schools have reduced sex education and HIV prevention programs. “As a result, the number of young people who have reported access to sex education programs, HIV prevention and prevention methods has gradually decreased.”

Awareness in schools is also essential for the hungry. “We need to be aware from an early age of the importance of preventing sexually transmitted infections, as sex life has started earlier and earlier.”, he considers.

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