Some 100 000 more people living with HIV in Brazil are set to receive life-saving antiretroviral therapy (ART) under a major new initiative that will offer early treatment to all HIV-positive adults. It is estimated that between 430 000 and 520 000 people are living with HIV in Brazil — just over 300 000 of which are currently accessing treatment.
The initiative will not only enable more people living with HIV to stay alive and well, it is also part of the government’s efforts to harness the preventative impact of antiretroviral therapy to stop new HIV infections. Antiretroviral therapy is a powerful HIV prevention option as studies have shown that it can reduce the risk of transmitting the virus to a sexual partner by up to 96%.
According to Minister of Health Alexandre Padilha, the proposal put forward in Clinical protocol and therapeutic guidelines for managing HIV infection in adults cements Brazil’s leadership in the global AIDS response. “We are resuming a leading role in the response to the AIDS epidemic in the world. Currently, only two countries — the United States and France — recommend the use of early treatment,” he maintained. Fábio Mesquita, Director of the Department of STDs, AIDS and Viral Hepatitis, added, “Brazil will be the first developing country to adopt the policy of treatment as prevention.”
Key populations at the heart of new protocol
It is hoped that the new initiative will help to stem the advance of the virus, particularly among people most affected by HIV such as young men who have sex with men, sex workers, the transgender community and injecting drug users. For example, for men who have sex with men the estimated HIV prevalence is over 10%, more than 20 times higher than in the general population.
Reaching all people with life-saving services is high on Mr Padilha’s agenda. “We need to use all the available measures to reduce transmission, and the new protocol’s proposals should create a positive impact on the reduction of transmission of the HIV virus in these populations,” he said.
The Clinical Protocol document also sets out ways in which to clearly define and simplify treatment regimens, while strengthening adherence and the long-term effectiveness of antiretrovirals. There are plans to introduce a combined fixed dose, a 3-in-1 medication, as the preferred first-line regimen. This treatment is scheduled to be available in 2014.
"Brazil is once again showing bold leadership in the response to AIDS — and is doing so in an open and inclusive manner, through public consultation,” said UNAIDS Country Coordinator Georgiana Braga-Orillard. “The initiative will improve the lives of people living with HIV and reduce deaths due to AIDS across the country.”
The report is now under public consultation until 5 November and will be finalized before the end of the year.
A complete text of the proposed new protocol is available at: www.saude.gov.br/consultapublica