Experts emphasize that rapid diagnosis, combined prevention and stigma-free information are decisive in the fight against HIV in Brazil
The Red December campaign, dedicated to raising awareness about HIV/AIDS and other sexually transmitted infections (STIs), is gaining strength in a scenario that requires continuous attention.
Even though new diagnoses are relatively stable, the numbers show that the challenge remains. Since 1980, Brazil has recorded 1,165,599 cases of AIDS, with an annual average of 36,000 new registrations over the last five years, according to the HIV and AIDS 2024 Epidemiological Bulletin of the Ministry of Health.
For infectious disease specialist Paulo Antônio de Carvalho, from the Franco da Rocha State Hospital, managed by CEJAM in partnership with the Department of Health of the State of São Paulo, progress has been made in access to treatment, but prevention must be strengthened.
“Demand for testing has increased among people who have been in risky situations, which is positive. Nevertheless, we need to accelerate early diagnosis to reduce new infections.”he declares.
Immunological window and test accuracy
Among the main doubts of the population is the so-called immunological window, the period between infection and detection of the virus. According to the expert, fourth generation tests, currently the most used, make it possible to identify HIV between 15 and 30 days after exposure. Self-tests have a longer window, around 90 days.
“Rapid tests have accuracy equivalent to laboratory tests. The error occurs when the negative result is interpreted outside of the appropriate time frame,” explains Carvalho, reinforcing the importance of career guidance.
PEP, PrEP and treatment adherence
Seeking care soon after possible exposure is essential to evaluate the use of PEP (post-exposure prophylaxis). “PEP works best when started immediately and should be used for 28 days. After 72 hours, the effectiveness decreases significantly”warns the infectious disease specialist.
PrEP (pre-exposure prophylaxis) is considered an essential tool for the most vulnerable populations, provided it is used correctly. “It does not replace the condom, because it does not prevent other STIs”he emphasizes.
With adequate treatment adherence, most patients achieve an undetectable viral load between 90 and 180 days. Maintained for at least six months, this condition ensures that HIV is not transmitted sexually, a concept known as Undetectable = Untransmittable (U=U). “This data reduces stigma and shows that it is possible to live with quality”strengths.
Primary care as a gateway
Primary health care continues to be the main point of contact for those seeking advice or experiencing symptoms suggestive of STIs. General practitioner Juliana Almeida, from UPA Campos dos Alemães, in São José dos Campos, explains that signs such as sores, discharge, persistent fever and enlarged lymph nodes sound the alarm.
“Welcoming without judgment allows patients to report risky situations more easily”he declares. The flow includes rapid tests from the first consultation, follow-up in the following weeks and ongoing educational actions.
For experts, developing information and fighting stigma are fundamental steps. “With access to testing, combined prevention and treatment adherence, it is possible to prevent new cases and improve the lives of people living with HIV”concludes Carvalho.
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