Luciana Bento

Brasil está na vanguarda do tratamento e prevenção do HIV na América Latina, diz revista científica

O Brasil está na vanguarda do tratamento e prevenção do HIV na América Latina, foi o primeiro a disponibilizar gratuitamente a terapia antirretroviral altamente ativa e participou de estudo que relatou a eficácia da profilaxia pré-exposição (PrEP) para prevenir a infecção em homens que fazem sexo com homens (HSH) e em mulheres trans.

A conclusão é de editorial publicado na semana passada (18) pela revista científica The Lancet HIV, que pediu aos demais países latino-americanos seguir os passos brasileiros no tema. O relato é do Programa Conjunto das Nações Unidas sobre HIV/AIDS (UNAIDS).

Profilaxia pré-exposição é mais uma ferramenta contra a transmissão do HIV. Foto: UNAIDS

Profilaxia pré-exposição é mais uma ferramenta contra a transmissão do HIV. Foto: UNAIDS

O Brasil está na vanguarda do tratamento e prevenção do HIV na América Latina, foi o primeiro a disponibilizar gratuitamente a terapia antirretroviral altamente ativa e participou de estudo que relatou a eficácia da profilaxia pré-exposição (PrEP) para prevenir a infecção em homens que fazem sexo com homens (HSH) e em mulheres trans. A conclusão é de editorial publicado na semana passada (18) pela revista científica The Lancet HIV.

O editorial cita estudo segundo o qual o uso da PrEP com emtricitabina oral diária e fumarato de tenofovir disoproxil é eficaz entre HSH e mulheres trans vulneráveis ao HIV. O texto também cita outro ensaio liderado pela pesquisadora brasileira Beatriz Grinsztejn indicando a eficácia da PrEP e sua boa adesão entre essa população. Para a publicação, tal estudo pode ser catalizador para que os demais países da região implementem a PrEP.

A revista lembra que as epidemias de HIV na América Latina e em grande parte do Caribe estão altamente concentradas entre homens que fazem sexo com homens e mulheres trans, com as taxas de infecção nessas populações permanecendo altas desde 2010.

O Peru é um caso ilustrativo, com aproximadamente 0,3% dos adultos entre 15 e 49 anos na população geral vivendo com o HIV, mas com uma taxa de prevalência de 15,2% entre HSH e de 13,8% entre mulheres trans.

No México, as estatísticas são ainda piores, com uma prevalência geral de HIV de 0,2% versus 17,1% entre HSH e de 20% entre mulheres trans. No entanto, em 2018, poucos países da América Latina e do Caribe incluíram a PrEP em seus planos nacionais de prevenção do HIV.

“Então, por que a implementação da PrEP tem sido tão lenta? Infelizmente, os suspeitos habituais, incluindo conhecimento insuficiente entre tomadores de decisões, o medo do aumento das despesas associadas à PrEP, a criminalização dos comportamentos sexuais e o estigma e a discriminação que os homens que fazem sexo com homens e as mulheres trans enfrentam em muitas partes da região conspiram para negar a PrEP a essas populações vulneráveis”, afirma o texto.

“Com sorte, esta maré parece estar mudando. Em 2018, sete países da América Latina e do Caribe planejaram projetos de demonstração da PrEP e outros três começaram a ser implementados com financiamento público local”, completa. Além disso, de acordo com a publicação, a sociedade civil latino-americana e caribenha está desempenhando papel cada vez mais importante na demanda e parceria com os governos para o fornecimento da PrEP.

Grupos ativistas regionais, como o GayLatino, declararam forte apoio à PrEP e websites como Quiero PrEP (Quero a PrEP) explicam o que é a PrEP, como funciona e como promover o acesso, posicionando a disponibilização da PrEP como um direito humano. A Organização Pan-Americana da Saúde (OPAS) também desempenhou um papel vital no avanço da agenda da PrEP na região ao educar e apoiar os tomadores de decisões na implementação, segundo a publicação.

“À medida que os países avançam com os projetos de demonstração da PrEP, eles devem garantir que a equidade no acesso faça parte de seus programas. Caso contrário, arriscam perder as pessoas que são frequentemente mais difíceis de envolver devido às mesmas condições que as tornam mais vulneráveis ​​ao HIV”, diz o editorial.

As comunidades da América Latina e do Caribe estão se mobilizando para a PrEP como a primeira adição substancial à caixa de ferramentas de prevenção do HIV (que inclui preservativos, lubrificantes, educação e aconselhamento, testagem para ISTs e outros serviços de apoio) desde o início da epidemia. A publicação conclui o editorial afirmando esperar que o projeto de demonstração da PrEP do Brasil seja decisivo para os demais países da região.


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