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Oral Pre-Exposure Prophylaxis of HIV infection – PrEP in Brazil
STI, Aids and Viral Hepatitis Department
Secretary for Health Surveillance Ministry of Health Brazil
Geneva, May 24 th, 2016
Source: special studies conducted between 2009/2010 and 2013. Brazilian Ministry of Health.
Brazil: Concentrated HIV epidemic in key populations
HIV remains an infectious diseases of major public health importance in Brazil. There are estimated to be some 781.000 people living with HIV/Aids in Brazil.
Prevalence rates
Biomedical HIV prevention package in Brazil
Available at www.aids.gov.br; access on April 15, 2016
Oral PrEP containing TDF should be offered as an additional prevention choice for people at substantial risk of HIV infection, as part of combination HIV prevention approaches.
Reliable tool in preventing the transmission of HIV
Implementation of PrEP will contribute to achieving (South America e Caribbean)
PrEP studies conducted in Brazil
IPrEX Study
Sponsored/funded by DAIDS/NIH, through a grant to the Gladstone Institutes.
Location: Brazil, Peru, Ecuador, South Africa, Thailand, US.
Population: MSM and transgender women.
• Authors: Grangeiro A, et al. (BMJOpen 2015;5:e009021.)
• Funding:
Brazilian Ministry of Health National Council for Scientific and Technological Development
Truvada® donated by Gilead
• Start: PrEP Group: Jun/2016
The Combine! Study: Protocol for a Pragmatic Clinical Trial on PEP, PrEP and Combination HIV Prevention Methods in Public Clinics in Brazil
PrEP studies conducted in Brazil
PrEP uptake and associated factors among MSM and TGW in the PrEP Brasil demonstration project
Brenda Hoagland, Valdilea G. Veloso, Raquel B. De Boni, José Valdez Madruga, Esper G. Kallas, Nilo Martinez Fernandes, Ronaldo I. Moreira, Albert Y. Liu and
Beatriz Grinsztejn for the PrEP Brasil Study Team
PrEP studies conducted in Brazil
Method
Sites Oswaldo Cruz Foundation - Fiocruz/RJ University of São Paulo (USP) Referral Center for HIV Treatment (CRT/SP)
Funding: Brazilian Ministry of Health FAPESP/ FAPERJ FIOCRUZ Truvada® donated by Gilead
Preliminary Data:
1.187 individuals interviewed
(pre-screening visit)
96.3% (MSM) and 4,7% (TGW)
Median age: 29 years
HIV Positive: 9,8% - High prevalence
Funding: ICICT, Oswaldo Cruz Foundation - FIOCRUZ,
Ministry of Health
CDC GAP/Brazil
DDAHV, SVS, Ministry of Health
Goals:
Expand HIV testing options for MSM;
Develop, implement and evaluate the feasibility of an intervention based on the internet for MSM, including: information about HIV and supply HIV self-testing kits (e-testing)
Evaluation of combined interventions to increase HIV diagnosis among MSM in Curitiba.
PrEP studies conducted in Brazil
Pre-Exposure Prophylaxis (PrEP) - UNITAID
1. Pre-Exposure Prophylaxis and Linkage to Testing among sexually active older adolescents with substantial HIV Risk in Brazil, Thailand and South Africa
• Goal: Contribute to a decrease in the HIV incidence among adolescents for whom PrEP is recommended in Brazil, Thailand and South Africa. The project is part of efforts to accelerate HIV results in adolescents, MSM and Transgender Women.
• Partner's organizations: UNICEF, UNITAID, Brazilian, Thailand, South African Governments and Civil Society.
2. PrEParedness for the Rollout of Effective HIV Prevention among Key Affected Populations in Brazil, Mexico, and Peru
• Goal: to contribute to the global efforts for the rollout and further scale up of PrEP as an innovation to combination HIV prevention approaches within the national HIV and AIDS health policies of Brazil, Mexico and Peru. MSM and Transgender Women.
• Implementation institution: FIOTEC/FIOCRUZ • Support institution: UNITAID • Partner's organizations: Brazilian, Mexican and Peruvian Governments, Civil Society
and Cayetano Heredia University.
Perspectives: PrEP strategies Advisory Board: meeting in October 2015 – Guidelines for public health system; PrEP strategies:
1. Clinical guidelines (ongoing) 2. Operational guidelines (ongoing) 3. Monitoring & Evaluation (ongoing)
Key populations (PWUD, serodiscordant couples, MSM, transgender people and sex workers) Truvada registration for PrEP in analysis by national regulatory agency HIV self-testing kits: the pharmaceutical companies interested in commercializing HIV self-testing kits are making the necessary readjustments and submitting them to the analysis of national regulatory agency. PrEP as a public health policy, free-of-charge, by the end of 2016
PrEP strategies: Brazil
Acknowlegdments
Fábio Mesquita-DDAHV/MS Brazil
Adele Benzaken - DDAHV/MS Brazil
Cristina Pimenta - DDAHV/MS Brazil
Gerson Pereira - DDAHV/MS Brazil
Alessandro Caruso - DDAHV/MS Brazil
Flávia Alvarenga - DDAHV/MS Brazil
Marcelo Freitas - DDAHV/MS Brazil
João Paulo Toledo - DDAHV/MS Brazil
João Netto - DDAHV/MS Brazil
Ana Flávia Nacif - DDAHV/MS Brazil
