Text produced by Isac Mascarenhas, a journalism student at IDP.
“A little bug in the blood.” That’s how Georgia’s* mother explained to her daughter, when she was still a child, that she had HIV. Twenty-two years ago, this young woman from Faxinal dos Guedes, Santa Catarina, 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 was always very open, and her mother's advice guided her throughout adolescence. "I've always been very sexually active, since I was very young. But I always used condoms so as not to transmit it to anyone."
In contrast to Georgia, the 15-24 age group uses condoms the least. As of September 2021, the Ministry of Health had distributed nearly 198 million male condoms, which can be obtained at any health unit. Despite the large quantity, uptake remains low.
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New generation, old prejudices
The National School Health Survey (PeNSE), conducted 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, a psychologist specializing in adolescents, believes that resistance to protection stems from a feeling of "invincibility," typical of this stage of life.
The psychologist also draws attention to the combination of sexism and misinformation that contributes to the stigmatization of condoms.
“Many girls think it’s wrong for a woman to carry a condom in her purse, as this would be the boys’ responsibility and they might think she’s ‘easy’,” the professional points out. “Boys still have several misconceptions about condom use: that it reduces or diminishes sensitivity, that it shortens penetration time, that orgasms aren’t as powerful, etc.”
Also in the 2019 PeNSE survey, only 22,1% of adolescents said they had obtained 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 influences the infection of adolescents. "Young people don't recognize health services as their own space, so this hinders the dissemination of health information."
The idea of prevention that most people have is that using a condom creates barriers.
Leonardo Moura, a young leader who also lives with HIV.
Combined prevention
Although indispensable, condoms are not the only form of protection. Currently in Brazil, public policy to combat HIV promotes the idea of combined prevention. With advances in treatment, there are now several coordinated methods to avoid infection. Among them are:
Testing – which can be done through the SUS (Brazilian Public Health System) by collecting blood or saliva.
Prevention of vertical transmission – preventive treatment performed on HIV-positive pregnant women to prevent transmission to the baby.
Treatment of those diagnosed – just two tablets a day (the "cocktails" no longer exist)
Pre-Exposure Prophylaxis (PrEP)
Post Exposure Prophylaxis (PEP)
These last two are antiretroviral pills provided by the SUS (Brazilian public health system) for those who have had or are having unprotected sex.
Without protection, what now?
PEP is intended for those who have had unprotected sex and are at risk of infection. Eliane Seidl, medical coordinator of the Co-Living project for people with HIV at the University Hospital of Brasília, explains that PEP aims to prevent the virus after sex. “The person should seek a health unit within 72 hours of exposure, where they will receive support and begin treatment with daily use of the medication.” Up to August of this year, 116.803 units of the treatment, which should be taken for 30 days, were dispensed throughout Brazil. Of the users, 25,5% are between 15 and 24 years old.
PrEP, on the other hand, is intended for those who are not HIV-positive but who may be 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 medication 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 and full-of-possibility experience at the 1xslots casino. Discover exciting games and exclusive bonuses at [website address - implied but not explicitly stated]. casino 1xslots And experience the ultimate online gaming adventure.
Those who are HIV-positive can also prevent new infections with antiretroviral treatment (just two pills a day, once a day). In addition to reducing complications caused by the virus, the therapy lowers 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 way to educate about sexual relations, STIs, and reduce stigmas and prejudices related to the disease, but it faces resistance from families and religious institutions. "Sex education in regular schools guarantees accessible and accurate information that translates into knowledge," says youth leader Leonardo Moura.
According to a study by IBGE (Brazilian Institute of Geography and Statistics), almost 40% of students in public schools from the 6th grade 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 rarely discussed in schools, sex is also a taboo within families. Many parents have difficulty addressing the subject with their children, who end up seeking information from the worst possible source: pornography. "In pornography, there is no use of condoms, there is no pain, all penises are large, and all vulvas are beautiful," Juliana observes.
The sex education given in schools is just a chapter in the biology textbook and not a process that it should be.
Juliana Paim, adolescent psychologist
Another challenge faced by institutions and NGOs in addressing the issue with adolescents is the way to communicate. Establishing communication on an equal footing helps the message be absorbed. UNAIDS, which leads the global effort against HIV/AIDS, launched the campaign "You tested positive, now what?" focusing on this audience. The project involved digital influencers to engage with this age group on social media. "In addition to influencers, other partnerships enabled us to communicate with this audience using quick and easily understandable language," the organization assessed.
Despite the obstacles she has faced throughout her life, Georgia's mother, now 51 years old, receives treatment through the Brazilian public health system (SUS) along with her daughter. According to the young woman, the care is excellent and they have never lacked the medication to fight the "bug".
"Appreciating and making the most of each day is the greatest legacy my mother will leave me."
Georgia, mother, daughter, wife, and HIV positive.
Numbers
789
Teenagers living with HIV in Brazil today, 533 of them are male.
8.312
Number of HIV-positive pregnant women in the country in 2019.
6.285.434
Female condoms distributed until June 2021.
4%
Of the people who requested PEP, some reported sexual violence.
13 %
A percentage of PrEP users reported exchanging sex for money, drugs, housing, and other services.
22,1 %
Of the teenagers in the private school system, the majority began their sexual lives between the ages of 13 and 17.
Source: Health Surveillance Secretariat of the Ministry of Health
*The names of the interviewees have been changed to protect their identity.
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