Treatment guarantee for all reduces 16% of AIDS cases and AIDS-related deaths in Brazil

Brasilia, 27 November, 2018 - Brazil reaches 30 years of fighting against HIV/AIDS, with a drop in the number of AIDS-related deaths in the country. According to the new Epidemiological Bulletin released on Tuesday (27/11) in Brasilia, the mortality rate from the disease decreased in four years, from 5.7 deaths per 100 thousand inhabitants in 2014 to 4.8 deaths in 2017. The treatment guarantee for all, launched in 2013, and improvements in diagnosis contributed to the decline, in addition to the expansion of the access to testing and the reduction of time between diagnosis and initiation of treatment. The Health Ministry has also launched a new advertising campaign to mark the 30th anniversary of World AIDS Day.

"It's the first time in over 20 years that Brazilian have seen such decline in national AIDS-related deaths," says Adele Benzaken, director of the Ministry of Health's Department of Surveillance, Prevention and Control of Sexually Transmitted Infections, HIV/AIDS and Viral Hepatitis. She recalled that the last time the country recorded such a significant drop was between 1996 and 1997, with the advent of Highly Active Antiretroviral Therapy (HAART) for all people living with HIV (PLHIV).

The new numbers of the epidemic reveal that, from 1980 to June 2018, 926,742 AIDS cases were identified in Brazil, an annual record of 40,000 new cases. In 2012, the AIDS detection rate was 21.7 cases per 100 thousand inhabitants, and in 2017, it was 18.3, which means it suffered a reduction of15.7%. In four years there was also a fall of 16.5% in the mortality rate from the disease, from 5.7 per 100 thousand inhabitants in 2014 to 4.8 deaths in 2017.

Commenting on the new data, Health Minister Gilberto Occhi said that in addition to celebrating the achievements in expanding care, it is necessary to reflect on the importance of prevention. "Brazil has made its contribution in the fight against the disease, with the guarantee of treatment and offer of tests to identify the virus, but it is necessary to raise awareness of the population, especially of the young people, regarding to the need for prevention. Only with the use of condoms, we will avoid and fight against HIV/AIDS", the minister explained.

The HIV Epidemiological Report also shows a significant decline in vertical transmission of HIV - dropping 43% (from 3.5 to 2.0 cases per 100 thousand inhabitants) between 2007 and 2017. A Raltegravir (RAL)-containing regimen has been recommended as first-line for pregnant women, after 14 weeks of pregnancy, since 2017. RAL has had a significant impact on virological suppression among pregnant women and, thus, on vertical transmission.

In 2017, the detection rate was of 2.8 cases per 100 thousand inhabitants. In the last 7 years, however, there has been a 56% reduction in HIV infections in exposed HIV-infected children after 18 months of follow-up. The new data also shows that 73% of new HIV infections occur among males, with 70% of cases among males ranging in age from 15 to 39 years.

The Unified Health System (SUS) provides quick tests for the detection of the virus in the health units of the country. In 2018, 12.5 million units were distributed. As the detection of the virus impacts on the early onset of the treatment,and, as of January, the public network will also offer the self-test of HIV to key populations and people/partners who have been pre-exposed to the virus. Next year, 400.000 units will be distributed, initially as a pilot project in the cities of São Paulo, Santos, Piracicaba, São José do Rio Preto, Ribeirão Preto and São Bernardo do Campo, Rio de Janeiro, Curitiba, Florianópolis, Salvador, Porto Alegre, Belo Horizonte, and Manaus.

The HIV self-test is already sold in the country's private pharmacies, but the results can't be used for the definitive diagnosis. In case of a positive result, the Ministry of Health directs the user to seek the health service for complementary tests. In the HIV self-test boxes, distributed by the SUS, there will be a 0800 number from the manufacturer for questions and guidance to users. This service will work 24 hours and 7 days a week. In addition, the user can ask questions about Disque Saúde 136 and on the website In addition to testing, the Federal Government also finances HIV / AIDS treatment in the country. Since 2013, antiretrovirals (ARVs) can be accessed at health facilities by HIV-positive people regardless of how many viruses they have in the body. Since the introduction of treatment for all, by September of this year, 585.000  people with HIV / AIDS were under treatment in the country. Most, 87%, make use of dolutegravir, one of the best medicines in the world that is freely available in the SUS.

The drug increases the chances of viral suppression (which is a decrease in HIV viral load in the blood) by 42% in adults compared to the previous treatment, using efavirenz. In addition, the virological response with dolutegravir is faster: in the third month of use more than 87% users already present viral suppression, according to studies carried out by the Ministry of Health.


The report was launched alongside the Ministry of Health's new HIV media campaign, during an event celebrating the 30 years of World AIDS Day and Brazil's achievements in the field. As part of the celebration, the Ministry of Health spread an immense patchwork quilt of messages - sent in by thousands of people across Brazil - on the lawns outside the country's government buildings.

The campaign will begin on November 28th, 2018. As part of the celebrations on December 1, the Health Ministry will rescue the production of quilts with messages of optimism for those living with the virus. The Ministry will extend a mosaic, formed by these quilts, on one of the lawns of the Esplanade of the Ministries. The material was produced by thousands of people in various parts of the country who used a digital platform to produce their message in support of the cause.


Brazil's Ministry of Health has been offering PrEP since the beginning of 2018, alongside condoms and Post-Exposure Prophylaxis (PEP), in 73 health services across Brazilian states. PrEP was dispensed to almost 15 thousand people at least once during roll out by SUS. Of the total number of people on PrEP, 43% (2.582) are 18-29 years old; 80% (4.803) are gay men and other men who have sex with men.


The publication encompasses the results of clinical monitoring for the year 2017 and the first nine months of 2018, through September 30. By 2017, an estimated 866,000 people living with HIV in Brazil, of which 559,000 are men and 307,000 are women. Of this total of 866 thousand people, 84% (731 thousand) were already diagnosed; 75% (548,000) were on antiretroviral therapy; and 92% (503,000) had undetectable viral load.

The goals stipulate that by 2020, all people living with HIV in the country be diagnosed; that 90% of people diagnosed are on treatment; and that 90% of the people in treatment reach an undetectable viral load (viral suppression, or reduction of virus circulation in the blood to less than 1,000 copies / mL).

Acess the Campaing's website here

Access the Epidemiological Bulletin here

See the presentation "30 years of the International AIDS Day" here

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