More than a million people live with HIV in Brazil, estimates Ministry of Health

More than one million people are living with HIV in Brazil. According to the epidemiological bulletin of the Secretariat for Health and Environment Surveillance of the Ministry of Health, in 2022 alone, more than 16,700 cases of the infection were recorded.

The most common initial symptoms are constant fever, skin rashes, chills, headache, sore throat, muscle aches and pains in the neck, armpits or groin. When there is no treatment, HIV compromises the immune system, responsible for defending the body against diseases.

In many cases, the initial symptoms are mild and can be perceived as a momentary malaise or passing cold. When the manifestation is more intense, the signs can be confused with those of some viruses, but this varies according to the immune response of each individual.

Unlike HIV, the acquired immunodeficiency syndrome, known as Aids, caused by the virus, leads to the progressive loss of immunity. The more advanced the disease, the more fragile the organism becomes, which becomes unable to defend against so-called opportunistic infections, which can be candidiasis, pneumonia, toxoplasmosis, meningitis, tuberculosis, among others. With the lack of treatment the patient may reach the most advanced stage of the disease.

In Brazil, the highest concentration of AIDS cases is among young people, aged 25 to 39 years, with a similar distribution, being 52.4% in males and 48.4% in females.

The Ministry of Health clarifies that those living with HIV do not necessarily evolve into AIDS . There are people who can live for years with the virus in their body without showing symptoms and manifestations of the disease. In addition, antiretroviral treatment, which prevents the process of viral replication in the human body, allows people living with HIV to lead a normal life, with a health condition similar to that of people who do not live with the virus.

Understand here what is HIV viral load and how the treatment works .

Testing, early treatment, and periodic medical follow-up are key strategies for controlling and preventing the progression of the disease.

How does HIV transmission happen?

A HIV transmission happens in the following ways:

• Vaginal, anal and oral sex without using a condom with someone living with the virus and not on treatment;
• sharing sharp instruments such as syringes, nail clippers and razors;
• contaminated blood transfusion;
• during pregnancy, childbirth or breastfeeding, through vertical transmission from mother to baby.

On the other hand, the behaviors that no transmit HIV:

• Sex with correct condom use;
• kiss on the face or mouth;
• contact with sweat or tears;
• Bug bite;
• handshake or hug;
• sharing soap/towels/sheets;
• sharing of cutlery/glasses;
• share bus seat;
• pool bath;
• shared bathroom;
• blood donation;
• through the air.

Prevention

The use of condoms is the best known and most accessible method for preventing HIV infection and other sexually transmitted infections (STIs), such as syphilis, gonorrhea and even some types of hepatitis.

The external condom is made of latex and must be placed on the erect penis before penetration. The internal condom, which is made of latex or nitrile rubber, is used internally in the vagina and can be inserted a few hours before intercourse. Both types of condoms are distributed free of charge by the Unified Health System (SUS).

For people who may have been exposed to the virus, there is an urgent prevention measure, Post-Exposure Prophylaxis (PEP), which consists of the use of prophylactic medications.

Medication should be started as soon as possible, preferably within the first two hours after exposure and, at most, within 72 hours. The duration of PEP is 28 days and the person must be accompanied by a health team. Medicines are made available by SUS and must be used after the risk of contagion in situations such as:

• sexual violence;
• unprotected sexual intercourse;
• accident with sharp instruments or direct contact with biological material.

Another form of prevention is Pre-Exposure Prophylaxis (PrEP), indicated for people who do not live with HIV.

The daily use of a combination of two antiretroviral drugs (tenofovir + emtricitabine), which have a similar composition to those used in the treatment of the virus, reduces by more than 90% the chances of a person becoming infected when exposed to HIV.

Withdrawal of PrEP medication is subject to regular consultations with health services. Therefore, every three months, follow-up tests should be carried out to check the reaction to the drugs, in addition to tests for HIV, syphilis and hepatitis B and C.

The medicine begins to take effect between 7 and 20 days of use, depending on the type of sexual intercourse. PrEP is provided free of charge by the SUS. The drug can be purchased on the private network, under the trade name of truvada, only with a medical prescription.

Understand how combined prevention works in the fight against HIV .

Diagnosis

Early diagnosis of HIV, soon after infection, increases the life expectancy of the person living with the virus. The infection can be detected in at least 30 days from the risk situation. The laboratory test and the rapid test, both available at SUS, look for antibodies against HIV in the collected material.

People who have been in a situation of risk of contagion can look for basic health units (UBSs) and perform the rapid anti-HIV test. The diagnosis is made from the collection of blood or oral fluid. Rapid tests detect HIV antibodies in about 30 minutes.

These exams are carried out in the units of the public health network and in the Testing and Counseling Centers (CTA) and can be done anonymously. In the CTAs, there is also a counseling process to facilitate the correct interpretation of the result by the patient. The whole approach, from reception, examination and result, is carried out respecting the secrecy and confidentiality of information, as provided by law.