Low adherence to HIV post-exposure prophylaxis in a small city of São Paulo state between 2011 and 2020

Abstract

Introduction: Acquired Immunodeficiency Syndrome (AIDS) is a disease caused by the Human Immunodeficiency Virus (HIV), which is acquired through sexual, bloodborne, and vertical transmission via contaminated sharp objects or contact with bodily fluids. The infection can remain asymptomatic for years, with initial symptoms being non-specific. The highest prevalence occurs among men who have sex with men, aged 40 to 49 (44.4%), and 50 or older (52.8%) in the heterosexual category.The main category in women is heterosexual (over 80%). Vertical transmission is the primary route of infection among those under 13, while it is sexual among older individuals. The majority have completed secondary education and identify as mixed-race. Treatment for HIV infection is provided through antiretroviral drugs. Post-Exposure Prophylaxis (PEP) is recommended within 72 hours of HIV exposure, and involves the use of medications to reduce the risk of infection. Objectives: To evaluate PEP adherence in the municipality of Araraquara, SP, Brazil, according to gender, age, education, marital status, race, and occupation, aiming to promote greater awareness and adherence to HIV preventive methods. Methodology: This is a descriptive cross-sectional study. Data from patients who initiated PEP at the Specialized Care Service (Serviço de Assistência Especializada - SAE) of the Araraquara Special Health Service (Serviço Especial de Saúde de Araraquara - SESA) were collected from the Juarez System’s public health information and management database. The Microsoft Power BI software program was used for data analysis. Following this step, sexual education was promoted through pamphlets and informative posters at municipal health units, focusing on challenges identified through collected information. Results: The prevalence of individuals adhering to PEP (9.2%) was higher among males aged 30 to 40, of white race, self-employed, and with completed higher education. Conclusion: The majority of individuals seeking PEP did not adhere to this preventive method, highlighting the need to raise awareness among the target population about the existence of both pre and post-sexual exposure preventive methods, and the importance of completing medication and follow-up to prevent HIV transmission.