Brazil meets only one goal to end the HIV/AIDS epidemic – 07/13/2023 – Health

Brazil reached only 1 of the 3 global goals proposed by Unaids (Joint United Nations Program on HIV/AIDS) for AIDS to cease to be a threat to public health by 2030 and is still slipping in reducing the various inequalities that mark the epidemic.

So far, 91% of the 990,000 Brazilians living with HIV in the country know their diagnosis. Of these, 81% are undergoing treatment and, among them, 95% have suppressed viral load. The UNAIDS target is 95% for each situation. In 2022, the country recorded 51,000 new cases of HIV and 13,000 deaths.

The data are contained in a new global report on AIDS released by Unaids this Thursday (13), in Geneva, Switzerland.

According to Winnie Byanyima, executive director of UNAIDS, HIV responses are successful when they are based on political leadership that follows the evidence, tackles inequalities, strengthens civil society organizations and ensures sufficient and sustainable funding.

Countries such as Botswana, Swatini, Rwanda, the United Republic of Tanzania and Zimbabwe have already reached the 95-95-95 targets, and at least 16 other countries (including eight in sub-Saharan Africa) are close to doing so, according to the document. .

Worldwide, AIDS claimed one life per minute in 2022. New HIV infections are not decreasing fast enough, and millions of people are still deprived of treatment, including 43% of children. Today, there are 39 million people living with HIV—about 9.2 million still untreated and 2.1 million on treatment but without a suppressed viral load.

“The path to ending AIDS requires collaboration between the global South and North, governments and communities, the UN and member states acting together. It requires courageous leadership. The map presented in this report shows how success is possible in this decade, but only if we move forward together and with a sense of urgency”, reinforced Winnie.

According to Ariadne Ribeiro Ferreira, equalities and rights officer at Unaids in Brazil, in order to advance in meeting the first goal, diagnosis, HIV testing needs to be part of the routine of health services and the population. “Nine percent people are living normally and unknowingly transmitting the virus.”

As for the 19% who know about the diagnosis, but who are not undergoing treatment, she argues that health services follow up on these patients and create retention strategies. “You have to call, ask why you didn’t go get the medication. You have to have a closer relationship with people living with HIV/AIDS.”

The data also show that Brazil, for the second consecutive year, registers a stability of the epidemic. “It’s an indication that something is not right, a certain number of infections are happening, and people are being left behind.”

According to the report, the highest prevalence of infections in Brazil is among transgender people (30%), men who have sex with men (18%) and sex workers (5.3%).

“In Brazil, the trans population has been used politically to cause panic in society. We see bills proposing the criminalization of care, of parental acceptance. These bills cause an even stronger access barrier than all other structural barriers .”

The report also takes a stand against laws that criminalize people from key populations, or their behavior. In 145 countries, it is a crime to use or possess small amounts of drugs. One hundred and sixty-eight countries criminalize some aspect of sex work, 67 consensual same-sex sex and 20 transgender people.

According to Ariadne, some research has already shown that stigma and discrimination are present in almost all areas of life of these populations most affected by HIV. A 2019 study pointed out, for example, that 6% of trans people were discriminated against within the health services in Brazil.

For Alexandre Granjeiro, a researcher at the Faculty of Medicine at USP, social, racial, gender, age inequalities, among others, are today the main obstacles in facing the AIDS epidemic in Brazil.

He states that new prevention, diagnosis and treatment technologies also tend to be less accessed by those without social protection. “There are strategies to face this context and, if we don’t do it now, we won’t reach the targets in these groups.”

According to the researcher, there is a lot of difference in the response capacity of states and municipalities to these problems. “Many municipalities have left [o tema HIV/Aids] in the background and are also not being charged by the federal management.”

For Ariadne, from Unaids, there are states, especially those in the North region, that need not only deeper work to structure health services, but also to work on cultural aspects that make the populations most affected by HIV have difficulties in access public health, education, and work policies.

“Without these guarantees, it is much more difficult for these people to be able to maintain the treatment with antiretrovirals, which is continuous and requires a regulated diet.”

Granjeiro also points to the defunding of the STD/AIDS program over the years and the reduction in activism around the issue as factors that have contributed to the failure to achieve the goals of the United Nations.

The Jair Bolsonaro (PL) government withdrew BRL 407 million for the prevention, control and treatment of AIDS/HIV from the 2023 Budget compared to what was allocated in 2022.