Even with a record number of people under HIV treatment, new strategies to contain the epidemic are needed

Young people are presenting higher HIV incidence rates than presented by the 1980 and 1990s generations

This January the federal government released the numbers of people under HIV treatment in the Unified Health System (SUS) has increased by 97% – from 231 thousand in 2009 to 455 thousand last year. Despite being a positive indicator regarding virus control, the mobilization around the theme can still be improved. Specially after the World Health Organization (WHO) stating that in 2015, the number of HIV infected people decreased worldwide, but increased in Brazil.

What would be missing to reduce the numbers in the Country? According to Doctor Alexandre Grangeiro , we need to focus in the new generation of Brazilians who did not meet the epidemic at its peek and bring back the society to discuss about the theme.

For Doctor Alexandre, who is a researcher at the Preventive Medicine Department at the Sao Paulo University (USP), the current approach on the importance of prevention must be reviewed. We need to use the communication techniques that are closer to these generations, and they must go beyond the condom approach, he explains.

He stresses this young generation has showed higher HIV incidence rates than those from the 1980s and 1990s, when the epidemic had its boom worldwide. As it seems, if this trend continues, from now on we will have a stronger epidemic than we had in the past, he said.

As for mobilization around HIV, the researcher believes the Government and civil society have lead smaller efforts in the theme. Several sectors have reduced their actions, as education. This happens precisely when the epidemic begins to change its behavior, increasing the number of cases, he alerts.

Importance of the treatment

Even with the need to change actions against the HIV, Doctor Alexandre stresses the importance of the increasing number of people living with HIV under treatment. Besides this, according to the federal government, 91% of the adults living with HIV who are under treatment for at least 6 months, already have an undetectable viral load in the body. The greatest problem is that the treatment dropouts remains very high.

Part of this advance owes to a criteria change on when to begin the treatment, what allowed to increase the total of people who have been taking the antiretroviral cocktail. This allows to decrease the number of people in the society able to unintentionally transmit the virus, besides avoiding early deaths of infected people.

With the change in the criteria, we can have a more significant impact. When diagnosing and immediately linking these people to treatment, we are sure to have avoided the virus dissemination in some level, what we could not achieve years ago, Doctor Alexandre explained.

Marginalized groups

Another aspect pointed by the researcher is the greater variety of preventive methods available today. Among them, pre-exposure prophylaxis (PrEP), which consists on taking a drug before sexual intercourse, and post-exposure prophylaxis – use of antiretroviral drugs hours after sexual intercourse.

The scientist says the use of these methods increases the protection against the virus in the groups that use them, but the problem lays on the other direction: those who are in the sideline of the health services and prevention methods.

I dont think these new methods offer any loss for prevention, they only increase the options for those already motivated, those who are commited. This is a good thing, but we still have the challenge to reach those people with no motivation for prevention, he finished.…