Public Health and PrEP: ethnographic explorations and literature review of the national HIV prevention policy based on antiretroviral medication
Health; Anthropology; Public Policies; HIV; PrEP
This text aims to present an exploratory investigation and literature review on a national public policy for prevention through PrEP, seeking to create methodological paths and alternative reflections that assist me in understanding its implementation in terms of quality in specialized health services and the participation of individuals in the appropriation of this new biotechnology in a localized context (in Rio Grande do Norte). PrEP (Pre-Exposure Prophylaxis) is a preventive technology currently being implemented in Brazil, seeking its rightful place within Brazilian public health policies, where the daily consumption of Truvada® (a combination of tenofovir + emtricitabine) creates a biochemical barrier in the human body that prevents HIV infection during sexual practices. The empirical work in reference hospitals was temporarily paused to make room for handmade data collection on websites, news networks, blogs, webinars, etc. Additionally, I engaged in dialogue with individuals who use PrEP through sexual encounter apps among men (Scruff and Grindr) in order to understand the elements that influence their decisions to adopt it or not. These data pointed to experiences of activism and political struggle in a digital context by HIV, AIDS, and PrEP researchers, as well as an activism consumption through the Scruff app during the period of social isolation, focused on clinical and techno-scientific identities. I aimed to understand how these identities (PrEP user and Treatment as Prevention) were activated in a context where physical contact posed a risk of infection and death from Covid-19. I sought to produce a literature review encompassing Brazilian and international contributions in the humanities and collective health sciences on PrEP. This review allowed for the understanding of certain temporal landmarks in the emergence of this national pharmacological prevention policy for HIV, considering the articulations of implementing this biomedical technology, its dilemmas, and implications regarding access, scientific debate, and politics. Therefore, through this exploratory-ethnographic effort, I aim to perceive and analyze the changes and continuities in the HIV and AIDS social world through PrEP in Brazil, four decades into its epidemic