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40 years of the National STD and AIDS Program in Brazil: a fight in constant evolution

This article is written by a student writer from the Her Campus at Casper Libero chapter.

Have you ever had any STD, or known someone who had it? Well, according to UNAIDS’ 2022 statistics, more than 36 million people all over the globe live with HIV, and a million of them are located in Brazil, mainly in bigger cities. And I bet you wonder why, after all these years, there are still considerable numbers of STD cases. Religion, taboo, homophobia, lack of sexual education, poor health conditions, the list goes on… 

Where it all began

Let’s start from the beginning, in the 20th century, at the peak of the AIDS pandemic. Studies show that HIV originally came from apes transmission to humans in central Africa, therefore hitting the Caribbean to New York, the epicenter of a massive number of cases, then being exported to Europe, Australia, and Asia. 

Brazil got its first cases in the 80s, and along with what happened globally, came a myriad of misinformation and prejudice toward some groups affected by the disease, the “5 h’s”: homosexuals, hookers, hemophiliacs, Haitians, and heroin addicts.  This intolerant misinformation caused apathy by the affected group, so straight white men and women would think “I’m not a homosexual, so it’s never gonna happen to me”. Little did they know that HIV was contracted by blood transfusion, not a divine punishment that picks nationality, gender, or sexual orientation. 

However, unfortunately, HIV became centered in black and trans people too, as an extension of their marginalization in society, as healthy and educational awareness rarely reaches this group. This brings attention to the fact that the perpetuation of this problem is associated with social inequality.

How a drug decreased HIV

Antônio Drauzio Varella, a Brazilian doctor, oncologist, scientist, and writer, was the pioneer of the AIDS Program in Brazil and fought against the “gay plague” denomination because, by that, people would start to deflect health care needed, like preservatives and sharing of syringes to apply heroin in their bodies, like HIV couldn’t reach them. 

A remarkable intervention by the doctor is his action in Carandiru, a penitentiary in São Paulo, where the majority of the detainees had HIV disseminated to women, and consequently their babies, in intimate visits. 

Drauzio acted for more than 10 years there until the prison was deactivated. The action consisted of the distribution of condoms, organization of speeches, and awareness of contamination methods. As a result of the awareness of sharing syringes fatality, the application of heroin decreased and was replaced by the use of crack.

On the bright side, the action decreased the HIV occurrence at the prison. But at the same time, it initiated another pandemic: the use of crack inside and outside of Carandiru. For more information about the complex history of Carandiru, I strongly recommend the movie Carandiru, based on Drauzio’s book: Estação Carandiru.

Achievements in Brazilian healthcare

Brazil was the first country in Latin America to contain HIV, due to Instituto Oswaldo Cruz researchers, in Rio de Janeiro in 1987. At the same time, AZT started to be sold to seropositive patients, lately identified as less effective as a treatment. In addition to that, people began to complain about the medicine’s price, leading to the reduction of 20% of the price.

After the creation of Sistema Único de Saúde (SUS), Brazil’s public and free health service, in 1988, the rest of the 20th century was full of wonderful new developments like the free distribution of antiretrovirals, new medication, and HIV medical procedures in public hospitals that helped and still help thousands of people in the country. But even then, the fight is not over.

What can still be done?

The main prevention that several health professionals and educators defend is sexual education for children, to prepare them for initiation of sexual activities, mainly in adolescence. However, taboo and religious conservative ideas are the main obstacles to launching this initiative. In the 80’s, churches were strongly against the use of preservatives, as that implied marriageless sex. 

Although the use of condoms is essential in sexual activities, that doesn’t prevent 100% of the risk of contraction. That’s due to some other STDs like herpes, genital warts, and syphilis as they spread through physical contact. The ideal approach to your sexual partner is an honest conversation about exams, past partners, and the possibility of carrying STDs. After all, talking about STDs shouldn’t be uncomfortable. If you’re with someone worthy, they shouldn’t judge your conditions.

The representation of seropositives should be bigger too, as the best awareness comes from media portrayal. From a historical point of view, as I mentioned before, Carandiru and Estação Carandiru are the best to understand how it all began in Brazil, especially in prisons.

Beyond that, the most important representation is also the positive one, like the normalcy of living with HIV, as is represented in Where We Go From Here by Lucas Rocha. In this book, there are three different points of view: a recently discovered seropositive man, an experienced seropositive, and another character who represents society’s stigma, as he discovered that his ex was seropositive and then became fearful and bitter about the situation.

It’s true that nowadays, AIDS is not a big problem as it was 40 years ago, but we still have to be vigilant and careful as other STDs are still on the loose and a lot of misinformation still has power over society. Let’s fight for the normalization of the topic of STDs with partners and publicly, inclusive sexual education in schools, and investment in public policy to diminish social inequality, a factor shown to be propelling and perpetuating the virus problem.


The article above was edited by Clarissa Palácio.

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18-year-old brazilian journalism major at Cásper Líbero that writes about culture, behaviour and entertainment.