Profilaxia pré-exposição ao vírus HIV (PrEP): representações sociais de profissionais de saúde, gestores(as) e usuários LGBTQIAPN+

Abstract

In response to the Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) epidemic, the Brazilian government, in conjunction with civil society organizations and social movements, developed strategies to combat the infection, including the provision of Pre-Exposure Prophylaxis (PrEP) to HIV within the Unified Health System (SUS). PrEP consists of the combined use of antiretroviral medications capable of significantly reducing the risk of HIV acquisition, and has been gradually incorporated into Specialized Care Services (SAE) for HIV/AIDS in Brazil since 2017. In the municipality where the research was conducted, the implementation of this strategy only occurred in 2023, making it a recent service in the territory. In this context, the present study aimed to analyze the social representations of health professionals from the HIV/AIDS Specialized Care Service (SAE HIV/AIDS) and Basic Health Units (UBS), LGBTQIAPN+ users who use PrEP, and SUS (Brazilian Public Health System) managers regarding the use of PrEP in a municipality in the state of Santa Catarina. This is a qualitative, descriptive, and exploratory study based on the Theory of Social Representations (TSR). Data collection was carried out through semi-structured interviews, and the data were analyzed using thematic analysis as proposed by Braun and Clarke, employing data triangulation. The study included 8 PrEP users, 14 managers, and 11 healthcare professionals linked to the HIV/AIDS Specialized Care Service (SAE) and Primary Health Care. The results showed that PrEP is primarily represented by users as a strategy associated with safety, tranquility, and HIV prevention, while professionals and managers highlighted challenges related to the organization of services and access to prophylaxis. Among the main weaknesses identified were the centralization of PrEP dispensing in the SAE, as well as barriers related to prejudice and misinformation about the LGBTQIAPN+ population in health services. On the other hand, potential opportunities were also identified related to the role of healthcare professionals, especially nurses, in guiding, monitoring, and encouraging the use of prophylaxis, as well as in promoting safer and more comprehensive care. It is concluded that the implementation of PrEP represents an important advance in HIV prevention strategies; however, challenges remain related to expanding access, decentralizing the provision of services, and improving the quality of care provided.