Prejudice, fear, and stigma are frequent reactions when the subject is human immunodeficiency virus (HIV), a precursor to acquired immunodeficiency syndrome (AIDS).
The Red December campaign, dedicated to infection prevention and the fight against HIV and AIDS, is launched this month. It is an important campaign to educate Acre residents about ways to avoid contracting the disease.
“Any person, regardless of social class, colour, gender or sexual orientation, is at risk of infection if they are not careful,” explains the coordinator of the State Center for Sexually Transmitted Infections (STIs), Jozadac Becerra.
Thus, with sufficient information, it is possible to prevent, control infection and, above all, treat people who have already tested positive for the virus.
In this context, the state Ministry of Health (Sisakre) played its role. Since December 1, World AIDS Day, the State Center for Sexually Transmitted Diseases has strengthened the application of rapid tests in routine check-ups in all municipalities.
“These measures are implemented throughout the year, but are emphasized in the Red December campaign, which works to raise awareness about the infection,” Gozadaki stressed.
To contribute to care, the Public Network offers the Specialized Assistance Service (SAE), at Fundação do Acre (Fundhacre) Hospital, in Río Branco, with prevention and welcome measures for the population.
“At SAE, the patient has a dedicated multidisciplinary team, offering consultations, examinations, medications, condoms and a full line of care to make him feel welcome and involved,” explained infectious disease physician Serli Maria de Oliveira Lobato.
For example, the social service provided by SAE is essential when it comes to patients with sexually transmitted diseases. The service in the sector is carried out on demand, without the need for prior scheduling.
“The goal is to ensure that the patient receives quality care, either in our system or in another network, as necessary,” said social worker Charlene Brillante.
Data and care
In Acre, the record of infection with the virus in adults reached 1,667 cases between 2018 and 2023, according to data from the Reported Diseases Information System (SINAN). In the same period, 99 deaths due to complications from AIDS were recorded, and 133 pregnant women were diagnosed with HIV.
Among the cases that require the greatest attention are those of children at risk of contracting the virus during pregnancy, and postpartum mothers with HIV or AIDS. According to Sinan, five children tested positive for the infection in 2018, 2021 and 2023.
In cases of risk, at birth, preferably by caesarean section, the maternity hospital sends the baby for observation in SAE so that “it has the least chance of contamination,” explained social worker Charlene Brillhant, adding that “the mother will not be able to breastfeed to reduce the risk.”
In this way, the public system, with the support of the federal government, ensures the distribution of free infant formula until the sixth month of the newborn’s life.
Charlene added: “The mother receives enough formula to give her enough time to get to the day of her pediatrician appointment, and here a box containing six 800g cartons is delivered to Social Assistance.”
AIDS, a matter of prevention and treatment
Currently, there is no indication when the first symptoms of AIDS will appear after first contact with HIV. “Clinical manifestations depend on the degree of impairment of the patient’s defense,” notes Dr. Serli Lobato.
The infectious disease specialist also emphasized that infection with HIV is not the same as infection with AIDS: “There are patients who carry the virus and do not show any symptoms. During the AIDS phase, the patient will suffer from opportunistic infections such as tuberculosis, diarrhea, weight loss, etc.
Nurse Mariangela Guimarães, responsible for the general management of SAE, confirms the risk of tuberculosis in patients infected with HIV. However, if diagnosis and treatment are done early, and if an HIV-positive patient is adherent, “they are less likely to progress to AIDS and other complications,” Lobato added.
Prevention and testing
The first step to preventing the spread of the virus is awareness and behavior change. By using condoms, medical monitoring and routine screenings, including rapid tests for HIV and other sexually transmitted diseases such as viral hepatitis and syphilis, it is possible to prevent it.
“The first conversation is always with us in nursing. I do the first consultation with the patient, we do the rapid examination and test, and then they can start other consultations and medication treatment, as necessary,” explained SAE nurse, Joretti Soares.
Pre- and post-exposure medications
In SAE, among other medicines, there are two drug models to serve vulnerable people or people who have been exposed to HIV and AIDS, PrEP and PrEP.
He explained that pre-exposure prophylaxis involves the daily use of antiretroviral medications to prevent HIV infection in people at risk of contracting the virus, such as drug users, “sex workers and people whose partner is an HIV-positive person.” Infectious disease specialist, Serli Lobato.
Post-exposure prophylaxis, PeP, on the other hand, is a medication used after any situation in which HIV was exposed, such as a broken condom or sexual assault situations. He pointed out that the drug works to prevent the virus from settling in the body, so it is important to start treatment within a period of up to 72 hours.
If the virus stabilizes, the use of the drug is lifelong, explains SAE pharmacist Aldemir Fernandez: “The patient registers and gets the drug for free. He emphasized that we have enough stock to meet the needs of those who need it.
To maintain basic care, SAE also provides a place to collect various tests. One goal is to monitor a patient’s viral load, whether detectable or undetectable — when the immune system is preserved and the patient is not transmitting the virus.
Furthermore, Zia Hospital, a specialized sector of SAE, operates throughout the week to accommodate patients who require emergency care. “We have patients who start taking the medication and suffer from adverse reactions. Here, we can serve them and provide better assistance,” explained José Augusto Araujo, from SAI Administrative Support.
In addition to the capital, the cities of Cruzeiro do Sul and Sina Madureira already have specialized auxiliary service units. In Brasilia, the local hospital has its own sector for the care and distribution of medicines and infant formula.
AIDS has a cure, and prejudice too
In the 1980s, the disease was wrongly linked to homosexuals, perpetuating prejudice against people of different races and sexual orientations. “We have already talked about this topic and we have seen a lack of information and means of prevention, especially among young people,” explains Isabelle Senge, medical academic and trainee at Zia Hospital.
“The biggest problem we face is patient acceptance of the diagnosis due to social stigma. This is the challenge we face and shows the importance of awareness and prevention,” said intern Danielle Klein.
In this sense, the state STI Center has qualified specialists on the front lines conducting tests and caring for patients. “What we want is to encourage testing and combat this stigma,” concluded the coordinator of the government IST center, Jozadak Bezera.
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