Text produced by Isac Mascarenhas, graduating in journalism at IDP.

"A bug in the blood". This is how Georgia*'s mother explained to her daughter, still a child, that she had HIV. 22 years ago, the woman from Santa Catarina, from Faxinal dos Guedes, was born with the virus running through her veins. “When I was a child, she tried to explain it to me in her own way,” recalls the young woman who contracted the virus from her mother. 

Communication between the two has always been very open, her mother's advice guided her during her adolescence. "I have always been very active in terms of sex, since I was very young. But I always used a condom to avoid transmitting it to anyone." 

Going against Georgia, the age group between 15 and 24 years old is the one that uses condoms the least. As of September 2021, the Ministry of Health has distributed almost 198 million male condoms that can be collected at any health facility. Despite the large number, adherence is still low. 

Visit: https://app.flourish.studio/visualisation/7915482/edit

New generation, old prejudices

The National School Health Survey (PeNSE), carried out in 2019 by IBGE, revealed that only 59.1% of adolescents aged 13 to 17 used a condom during their last sexual encounter.

Juliana Paim, an adolescent psychologist, considers that resistance to protection comes from the feeling of "invincibility", typical of this stage of life. 

The psychologist also draws attention to machismo combined with misinformation that contribute to the stigmatization of condoms.

"Many girls think it's ugly for a woman to carry a condom in her bag, as that would be the boys' responsibility and they could think it's "easy", highlights the professional. "Boys still have a lot of wrong ideas about using condoms. : that takes away or reduces sensitivity, that reduces penetration time, that the orgasm is not as powerful, etc." 

Also in PeNSE 2019, only 22.1% of adolescents said they had purchased condoms from health services. For Leonardo Moura, leader of the Brazilian Movement of Young People and Adolescents Living with HIV/Aids, the lack of information about prevention has an influence on the infection of adolescents. "Young people do not recognize the health service as their space, so this makes the dissemination of health information difficult." 

— The idea of ​​prevention that most people have is that using condoms is creating barriers 

 Leonardo Moura, young leader who also lives with HIV

Combined prevention 

Although essential, condoms are not the only form of care. Currently in Brazil, the public policy to combat HIV brings the idea of ​​combined prevention. With the advancement of treatments, today there are several articulated methods to avoid contamination. Among them are: 

Testing - which can be done by the SUS through blood or saliva collection

 Prevention of vertical transmission - preventive treatment carried out on HIV-positive pregnant women to prevent transmission to the baby

Treatment of those diagnosed - just two tablets a day (there are no more "cocktails")

Pre-Exposure Prophylaxis (PrEP) 

Post-Exposure Prophylaxis (PEP) 

The last two are long antiretroviral drugs made available by the SUS for those who have had or are having unprotected sex.

Without protection, what now?

PEP is intended for those who have had an unprotected relationship and are at risk of contagion. Eliane Seidl, medical coordinator of the Com-Vivência project for people with HIV at the University Hospital of Brasília, explains that PEP aims to prevent the virus after sex. "The person must seek a health unit within 72 hours after exposure, there they will receive care and begin treatment using the medication daily." Until August this year, 116,803 units of treatment were dispensed throughout Brazil, which must be carried out over 30 days. Of the users, 25.5% are between 15 and 24 years old.  

PrEP is intended for those who are not HIV positive, but who can become infected daily. For example, people whose partner is HIV+ or sex workers. "It acts before the risk becomes evident. The patient goes to a health unit and explains their situation, if they meet the criteria, they receive the medicine to use daily and stop whenever they want. Always accompanied by the medical team", concludes the professional. According to the Ministry of Health, PrEP currently has 26,202 users. Of these, 12% are between 18 and 24 years old. Enjoy an exciting experience full of possibilities at 1xslots casino. Discover exciting games and exclusive bonuses at 1xslots casino and experience the ultimate online gaming adventure.

Those who are HIV positive can also prevent new infections with antiretroviral treatment (just two tablets a day once). In addition to reducing complications caused by the virus, the therapy reduces the viral load in the blood, making it undetectable. In other words, the patient becomes unable to transmit the virus.  

Taboo at school, infection in the body  

Entering school spaces is one of the ways to educate about sexual relations, STIs and reduce stigma and prejudice related to the disease, but it faces resistance from families and religious institutions. "Sexual education in regular education guarantees accessible and correct information that turns into knowledge", considers young leader Leonardo Moura. 

In the IBGE study, almost 40% of public school students from the 6th year of elementary school to the 3rd year of high school have already had sexual relations. The psychologist argues that talking about sex goes far beyond HIV and other infections, it is also necessary to talk about consent, respect for oneself and others, sexual pleasure and how to protect oneself from violence and abuse.

But before being a topic that is rarely discussed in schools, sex is also a taboo within families. Many parents have difficulty approaching the topic with their children, who end up looking for information from the worst possible source, pornography. "In pornography there is no use of condoms, there is no pain, all penises are big and all vulvas are beautiful", analyzes Juliana. 

— The sexual education that is given in schools is just a chapter in the biology textbook and not as a process that should be 

Juliana Paim, adolescent psychologist 

Another challenge faced by institutions and NGOs in dealing with the issue with teenagers is the way of communicating. Establishing equal communication helps the absorption of the message. Unaids, which leads the global effort against HIV/Aids, launched the campaign "It was positive, what now?" focusing on this audience. The project had the participation of digital influencers to talk to this age group on social media. "In addition to influencers, other partnerships allowed us, with quick and easily assimilated language, to talk to this audience", assessed the Organization. 

Despite the obstacles encountered during her life, now 51 years old, Georgia's mother is undergoing treatment through the SUS together with her daughter. According to the young woman, the service is excellent and there was never a lack of medication to combat the “bug”. 

— "Valuing and enjoying each day is the greatest legacy my mother will leave me" 

Georgia, mother, daughter, wife and HIV positive 

Numbers 

789
Adolescents are living with HIV today in Brazil. 533 are men. 

8.312 
Number of HIV+ pregnant women in 2019 in the country.

6.285.434  
Female condoms distributed until June 2021.

4% 
Of the people who requested PEP, they reported sexual violence.

13% 
Percentage of PrEP users reported exchanging sex for money, drugs, housing and other services. 

22,1% 
Of the teenagers in the private network, they started their sexual life between 13 and 17 years old. 

Source:
Health Surveillance Secretariat of the Ministry of Health *The names of interviewees have been changed to protect their identity.

⠀⠀⠀⠀⠀⠀⠀⠀⠀