Avaliação da política de enfrentamento ao HIV/AIDS em Fortaleza-CE a partir da execução da PrEP (Profilaxia Pré-exposição) no SAE Emanuel Gomes Pinto

Abstract

Since the first records were made in the 1980, Brazil has been dedicated to the treatment and implementation of actions to combat HIV/AIDS, which have been improved over the decades. In 2017, the Unified Health System (SUS) incorporated Pre-Exposure Prophylaxis (PrEP), which consists of the use of antiretroviral drugs by individuals who do not have the human immunodeficiency virus (HIV) but are at risk of acquiring it. Considering this context, the main objective of this research is to evaluate PrEP as a prevention strategy within the scope of the HIV/AIDS policy in Fortaleza, during the period from 2022 to 2024. To this end, a case study was carried out at the Emanuel Gomes Pinto Specialized Care Service (SAE), which also operates as a Testing and Counseling Center (CTA) and is located next to a Basic Health Unit (UBS). Prophylaxis was analyzed as one of the strategies that integrate combined prevention actions, which involve biomedical, social, and structural components. This approach recognizes the complexity of the HIV pandemic and the diversity of contexts and needs of key populations. Therefore, the central question of the research is: How was PrEP developed as an HIV prevention measure in Fortaleza-CE, based on the experience of SAE Emanuel Gomes Pinto in the period from 2022 to 2024? The theoretical methodological framework was based on in-depth evaluation (Rodrigues, 2008), characterizing the research as qualitative and structured through a case study. Data production involved 19 semi-structured interviews, bibliographic and documentary research, and direct observations, recorded in a field diary. The prioritized interlocutors were users, researchers, and professionals from the SAE multidisciplinary team, and the information collected was analyzed through data triangulation. The study was submitted to the Research Ethics Committee (CEP) of the Fortaleza School of Public Health and to the Committee of the Federal University of Ceará, the latter through the Plataforma Brasil, and received the appropriate favorable opinion for the study to be carried out. The results identified strengths that can serve as an example for other locations, such as the partnership with the “A Hora É Agora” Program, the networking and the experience accumulated by the team. However, challenges were highlighted, such as insufficient reach to all key population groups and the need for new investments and research to ensure the adequate dissemination of prevention information to society. In addition, the importance of overcoming barriers such as 11 stigma and prejudice is highlighted, because the greater the adherence to PrEP and prevention strategies, the lower the number of new HIV infections in Fortaleza, consolidating this prophylaxis as a relevant tool for public health.