Since 2017, a sero-different gay couple (when one is HIV-positive and the other is not), residing in the municipality of Serra and, having chosen to remain anonymous, has decided to take a step in the relationship when it comes to combining HIV prevention Humanity. However, for more than a year, they have been facing difficulties accessing pre-exposure prophylaxis (PrEP), a drug intended to reduce the risk of transmission of the virus that causes AIDS. (See the full position of the municipality at the end of the text).
In August 2020, when they went for a routine exam at the Sierra Testing and Counseling Center (CTA), a. NS NS.*, both of whom, at that time, were HIV negative, took the opportunity to obtain information on the procedure for using PrEP. However, due to the epidemic, the place, according to the couple, was without a doctor, which made access to medicine impossible.
Given the justifications of the municipality’s CTA team, a. NS NS. Contacting the center started monthly for new updates. “We knew it was our right and that for us, that was the best way, as well as condoms, because of the moment we were in,” he said. NS., who later clarified that the couple live in an open relationship.
However, in more than a year, access to the drug has always been denied, on the grounds that there is no physician, and that the CTA da Serra does not have sufficient physical space to provide care and follow-up use of PrEP. “Today, their justification is: that there is no place. Which is absurd, since then, as a gay and different couple. [ou sorodiscordante]It’s our guaranteed right.” a.
According to Department of Health standards, PrEP is indicated for people at higher risk of HIV infection, such as gays, other men who have sex with men, transgender people, and sex workers. People who frequently stop using condoms in their sexual relations (anal or vaginal) may also get treatment; People who have sex, without using a condom, with someone who has HIV and is not undergoing treatment; People who frequently use post-exposure prophylaxis (PEP) for HIV; and/or people with recurrent episodes of sexually transmitted infections (STIs).
Because of this situation, the couple decided to file a lawsuit to solve the difficulties they encountered. Before that , a. NS NS. They wrote a formal complaint to the Serra Prefecture Ombudsman, but the response, according to the couple, was not satisfactory. “I’ve been sent back [a reposta] He regrets what happened, and they say they will pass it, but not without a fixed date. ” NS.
According to attorney specializing in LGBTQIA+ law, Wesley Monteverdi, who represents the couple, the lawsuit is significant, given the lack of access to PrEP and the aggravating factor of the couple who, since July of this year, have been living in a different partnership, already what a. He was diagnosed with HIV and can still be detected – treatment began about two months ago.
Additionally, Monteverdi explained that PrEP is one way a couple should do prevention along with condom use. “This is an individual right of theirs, regardless of their sera. When they tried, previously, with a negative result, this was indeed an individual right. Now, with the various serotyped partnership, this matter is exacerbated, being a necessity.”
According to the Secretary of State for Health (Sesa), throughout the state of Espirito Santo, 645 people are using PrEP, and they are registered according to the criteria set by the Ministry of Health. To take care of people in post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP) is the responsibility of the municipality” (See end of text sites that conduct PrEP care and STI testing).
However, Sessa stressed that “the adoption of safe sexual practices, such as the use of condoms or vaginal condoms, is necessary, except in cases of heterozygous couples who wish to become pregnant. The drug does not protect against other sexually transmitted diseases (such as syphilis and chlamydia). and gonorrhea).
Poor reception and delayed treatment
Aside from the difficulty of accessing PrEP, the couple reported other problems with their HIV-positive result of a. Among them, the lack of advice and welcome, by order, of the couple.
“It was like: ‘Now you use a condom and that’s it.’ That is, let’s turn around. In addition, when the result came out, due to the lack of a doctor, I had to wait a while for full examinations. It took another month. He noted. The bottom line is to start treatment as soon as possible.” a.
So, the couple said, through the service at the CTA da Serra, there is a focus on condom use, without explanations about the combined use of PrEP, for example. in this meaning, NS. He noted that one of the nurses even said that “the money is spent.” [pelo município] PrEP treatment is higher than the cost of a condom.”
Effects on the couple
All these points, according to the lawyer representing the spouses, violate constitutional principles, which are based on the right to health. “In addition, ensuring equality and non-discrimination on the basis of sexual orientation, in light of other actions previously ruled by the Federal Supreme Court.”
“We will also try to obtain compensation for moral damages as well as the delay and lack of access to the PrEP, as the couple experienced veiled homophobia when they tried to access health care and the agent tried, at all costs, to argue the importance of condoms, even in the face of their claim that they lived for Four years, in an open relationship. They wanted to have a common preventative policy in addition to condoms. It wasn’t treated as it should have been treated by a health agent,” Monteverde explained.
as a result of, a. NS NS. They are currently experiencing relationship-shaking psychological effects. NS a.Living as if nothing happened is not an option. “The concern for mental and physical health is very great. Thank God I did not have any reactions that affected my physical health, but psychologically, it shook our relationship a lot. ”
“It’s a wearing situation. We try to prevent ourselves, but the municipality is silent, we are without psychological support, we are watching as a couple. We have never had that support. For three months now, the situation has been very embarrassing. The HIV taboo is still there.” He pointed out that the problem is not coexistence with HIV, but rather the difficulties and barriers. a.
the other side
In response to the grumpyCera City Hall said it sympathizes with the condition of patients who need PrEP and invites professionals to form the team. In addition, it already offers a larger site, serving the CTA/SAE so that PrEP operates on the same site.” However, according to the note sent to the report, the municipality “is experiencing difficulties because the specialists do not attend the call. However, another measure is being adopted: We plan to provide the service on Saturdays, temporarily.”
In this sense, for such a strategy, the municipality reported that it “provides training for professionals, together with the State Department of Health. A necessary condition for the release of a specific drug for PrEP. The service was offered at HUCAM, but it has expired.”
And about the month-long period between a positive result for HIV and the start of treatment, Said da Serra explained, “This is the deadline set by the Ministry of Health. To start treatment, the patient must first undergo viral load tests, in addition to other tests to check for liver enzymes.” Only then will he go to the doctor, who will be responsible for evaluating the results and starting treatment. That’s why MS puts this period between diagnosis and the start of treatment. The network users are within the ministry’s protocol.”
Finally, the memo clarified that “at the Center for Testing and Counseling (CTA) there are psychologists to monitor patients. For this, he must request a CTA to schedule an appointment for psychiatric care, which takes place in the morning and afternoon.”
Websites that provide PrEP . care
– Hospital Cassiano Antônio de Moraes (Hucam) – Miscellaneous clinic: Avenida Marechal Campos, no number, Maruípe, Vitória;
– Parque Moscoso Reference Center: Rua Cais de São Francisco, 54, Parque Moscoso, Vitória;
– Vila Velha SAE-CTA: Avenida Castelo Branco, 1803, Jaburuna, Vila Velha;
– Abel Santana Infection Reference Center: Rua Mário Imperial, 23, Cachoeiro de Itapemirim;
– Santa Maria de Jetibá Municipal Specialist Center: Rua Henrique Eggert, s / n, Santa Maria de Jetibá;
– Health Policy Care Centre: Rua Governador Bley, s/n, Linhares;
– Aracruz specialist assistance service: Rua Padre Luiz Parenze, s / n, Aracruz;
– Customer service specialized in guaçuí: Avenida Espírito Santo, Guaçuí;
– SAE/CTA Sao Mateos: Avenida Jose Tozi, 2,552, Boa Vista, Sao Mateos;
Where is the test for HIV, syphilis, hepatitis B and C in Espírito Santo: https://bit.ly/3ubrZQR
*The initials A. and K. were used in the text to preserve the identity of the couple and do not correspond to the names heard by the report.;
Featured Image: Ludmilla Souza / Agência Brasil
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