Os efeitos da profilaxia pré exposição ao vírus da imunodeficiência humana na saúde sexual de pacientes de um município gaúcho

Abstract

Pre-Exposure Prophylaxis (PrEP) entails the administration of antiretroviral medications to uninfected individuals who are at a heightened risk of contracting the Human Immunodeficiency Virus (HIV). This approach has been central in the international endeavor to combat HIV and AIDS. However, there is evidence suggesting PrEP may influence sexual behavior and the occurrence of other sexually transmitted infections (STIs). This study aimed to evaluate the effects of PrEP on the sexual behavior and health of patients in a city in the north of Rio Grande do Sul, Brazil. Methods: 26 patients, under the care of a Specialized Health Service (Serviço de Atenção Especializada de Passo Fundo) using prophylactic antiretrovirals, underwent individual interviews with the application of an assessment instrument, along with the examination of their medical records. Results: 57.7% of participants reported to have used condoms “most of the times” prior to initiating PrEP. Following its initiation, this number declined to 26.9%. Furthermore, 19.2% of participants observed an increase in the number of sexual partners after starting the treatment and 57.7% acknowledged multiple sexual partners (two or more) after treatment. Concerning the frequency of Sexually Transmitted Infections (STIs), it is worth noting that 34.5% of cases were identified before patients were given PrEP, while 7.7% were diagnosed post-PrEP initiation. Intriguingly, 7.7% of participants received STI diagnoses both before and after PrEP use. Diagnosed STIs included chlamydia trachomatis (3.8%), HPV (3.8%), genital herpes (3.8%), hepatitis C (3.8%), gonorrhea (7.6%), and syphilis (38.4%). Conclusions: The study uncovered that merely 12.5% of patients sought care based on guidance from a healthcare institution. Subsequently, there was a noteworthy decrease in condom usage (42.9%) and a notable increase in the number of sexual partners (19.2%) followig PrEP initiation. Additionally, patients lacking access to mental health support displayed an elevated ocurrence of infections, underscoring the profound impact of social determinants on health.