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HIV Pre-Exposure Prophylaxis (PrEP) in a Brazilian Clinical Setting: Adherence, Adverse Events, Sexual Behavior, and Sexually Transmitted Infections


Tenofovir/emtricitabine (TDF/FTC) has been used as pre-exposure prophylaxis (PrEP) in preventing HIV infection. PrEP is an effective prevention tool as demonstrated in clinical trials and studies in clinical practice and was incorporated into the Brazilian public health system in December 2017. The present study was a prospective cohort that included 219 PrEP users monitored over a 10 month follow-up period in a capital city in Northeastern Brazil. Data were collected from the PrEP users’ electronic medical records platform made available by the Brazilian Health Ministry. During the observation period, there was good user retention to the prevention program (84%) and there was high adherence to medication (90%). Almost half the users (49%) presented an adverse event, although these were mild and transient, 30 days after starting prophylaxis. There was a significant reduction in creatinine clearance (p < .001), from 104.9 to 83.5 mL/min; however, there was no need for drug discontinuation. Throughout the cohort, there was no significant change in the number of sexual partners, but the use of condoms during sexual intercourse decreased (p < .001). There was a non-significant increase in the incidence of syphilis (p = .08), and there was a 50% decrease in reporting signs and symptoms of sexually transmitted infections. No cases of HIV infection were observed. PrEP proved to be an effective tool in HIV prevention, presenting few complications of adverse events.

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Hospital Universitário Oswaldo Cruz (HUOC), Programa de Pós-Graduação em Ciências da Saúde (PPGCS)–Universidade de Pernambuco, Equipe da PrEP do HUOC.


This study was financed in party by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance code 001.

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Authors and Affiliations



All authors contributed to the study conception and design. Material preparation and data collection were performed by Ana Karina Barbosa. Data analysis were performed by Ulisses Ramos Montarroyos. The first draft of the manuscript was written by Ana Karina Barbosa, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Ana Karina Pinto Barbosa.

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The authors declare that they have no conflict of interest.

Ethical Approval

The study protocol was reviewed and approved by the Hospital Universitário Oswaldo Cruz Ethics Committee, Universidade de Pernambuco, in Recife-PE, Brasil (Protocol CAAE: 00995818.9.0000.1592). It was carried out respecting all ethical principles, in compliance with the Resolution 466/12 of the National Health Council.

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Barbosa, A.K.P., Monteiro, P., Montenegro, D. et al. HIV Pre-Exposure Prophylaxis (PrEP) in a Brazilian Clinical Setting: Adherence, Adverse Events, Sexual Behavior, and Sexually Transmitted Infections. Arch Sex Behav (2022).

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  • Pre-exposure prophylaxis
  • HIV prevention
  • Sexual behavior
  • Sexually transmitted infections