Over the past 30 years, Brazil has established itself as a reference around the world in the treatment of AIDS. Since 1996, the country’s public healthcare system has offered free treatment to all HIV-positive patients, which has helped dramatically reduce the mortality rates among people infected. But where Brazil fails is in preventing new cases, as roughly 40,000 people get infected by the HIV virus each year.

The Ministry of Health estimates that 866,000 people live with the AIDS virus in Brazil—of which 731,000 have already been diagnosed. By September 2018, 585,000 had undergone treatment and received anti-retroviral medication by way of the public healthcare system. In 2018, the country invested BRL 1.7 billion in the Department of HIV-AIDS, a budget funded entirely by the federal government.

Richard Parker, who heads the Brazilian Interdisciplinary AIDS Association (ABIA), worries that the number of infections may spike in the next few years, due to the future administration’s unwillingness to allow schools to deal with sexuality and disease prevention. Luiz Henrique Mandetta, who was picked by President-elect Jair Bolsonaro as the future Minister of Health, said that sex education is a subject to be dealt with exclusively by parents and their children, with no interference whatsoever from teachers.

For Mr. Parker, such a stance shows that prevention policies—which have already been neglected over the past decade—will be left further behind. He also worries that neither the president-elect nor his entourage have ensured the continuity of free AIDS treatment and access to medication currently offered by the government. “Above all, it is paramount that we continue with the policies that have been successful.”

Other actors are less alarmed. Director of UNAIDS Brasil Georgiana Braga-Orillard ponders that “in Brazil, treatment is guaranteed by law.” She continues: “We have already seen different administrations taking over without changing the policies as the legislation leaves no margin for interpretation: the government must ensure free treatment for AIDS patients.”

Why Brazil still fails in preventing AIDS

While mortality rates among people infected with the AIDS virus have dropped since Brazil started offering free medication for patients, new infections continue to rise. In 2017, there were 42,400 reported infections in the country— six percent more than the previous year. Many experts draw a link between the two pieces of data: as AIDS stopped being treated as a death sentence, many people—especially younger generations who didn’t live through the AIDS outbreak in the 1980s—became more careless.

The government, however, is also to blame. According to a recent ABIA report, the budget for prevention campaigns has been cut over the past decade. “As the Bullet, Bible, and Beef Caucuses* gain space in Congress—turning the parliament into the most conservative of democratic times—a regressive agenda of sexuality and gender has been put forward, leading to the reduction of programs focused on men who have sex with other men.”

In 2012, a prevention campaign destined for young LGBTQ people and a 2013 campaign aimed at prostitutes ended up being censored after pressure from conservatives in Congress.

That explains why the rate of people infected with the AIDS virus is so disproportionally concentrated within this population. Of the new cases registered in 2017, 73 percent of the people are men, 54 percent of which have had same-sex intercourse. It is the highest rate since 2007, when the Ministry of Health begins its epidemiological count.

According to a paper published in the journal Medicine, while “the HIV prevalence in the general population is estimated to be 0.4 percent at the national level, but much higher rates are found among men who have sex with men (10.5 percent).” Among trans people, it jumps to 31 percent. Also according to the article, “among men, the AIDS detection rate has increased over the last 10 years, especially in those aged between 15 and 19 years, 20 and 24 years, and those 60 years or older. From 2006 to 2015, the AIDS detection rate among men aged 15 to 19 years more than tripled (from 2.4 to 6.9 cases/100,000 inhabitants).”

“I believe we still can’t face the stigma, the discrimination, and inequality like we should,” says Mr. Parker.


* “Bullet, Bible, and Beef” refers to the prominent parliamentary fronts which back public security, Evangelical Christianity, and agricultural producers, respectively.

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SocietyDec 01, 2018

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BY Gustavo Ribeiro

An award-winning journalist with experience covering Brazilian politics and international affairs. His work has been featured across Brazilian and French media outlets.