Objectives The aim of the study was to describe the characteristics, impact and outreach of post‐exposure prophylaxis (PEP) for sexual exposure in Brazil. Methods We used secondary data from the Brazilian Ministry of Health to describe the impact of national guidelines on the frequency of prescription, user profile and antiretroviral regimens. We also estimated the number of potentially averted HIV infections attributable to PEP for consented sexual exposure between 2009 and 2017. Results A total of 260 457 PEP regimens were prescribed to individuals ≥ 14 years old; 104 613 (40.2%) were prescribed for consented sexual exposure, with an increasing frequency since 2011. Drugs used in PEP regimens underwent significant modifications during the period, reflecting national recommendations. We estimated that there were up to 3138 potentially averted HIV infections attributable to PEP for consented sexual exposure between 2009 and 2017. Conclusions In the context of a combined HIV prevention strategy, PEP is still an essential tool for individuals for whom other methods are contraindicated or fail to be applied.

BackgroundEliminating mother-to-child transmission (MTCT) of HIV, hepatitis B, and syphilis is a challenge in Brazil. Many policies have been implemented since 1986, but important gaps remain. This study aimed to describe the trends of MTCT in Brazil and evaluate the gaps and perspectives in this scenario.MethodsThis is a descriptive study conducted with secondary data publicly available in the information systems of the Brazilian Ministry of Health regarding data on HIV, syphilis, and hepatitis B in pregnant women and children from 2011 to 2021.ResultsHIV and hepatitis B have had constant rates over the years in pregnant women, with the detection rates around 0.5/1,000 live birth (LB) and 2.5/1.000LB, respectively. The same did not happen with syphilis, which has shown an increasing line in the last decade. In 2011, the detection rate of syphilis in pregnancy was 4.7/1,000LB, and in 2021 it reached 27.1/1,000LB. Regarding the trends in children, an important decrease was observed in HIV/AIDS (incidence rate from 0.17/1,000 in 2011 to 0.04/1,000 in 2021) and Hepatitis B (incidence rate from 0.9/1,000LB in 2011 to 0.5/1,000LB in 2021). For congenital syphilis, there is a continuous increase, being 3.3/1,000LB in 2011 and 9.9/1,000LB in 2021. Data from the HIV clinical monitoring showed that antiretroviral treatment coverage among pregnant women identified increased slightly between 2011 and 2021, in Brazil, from 92.3% to 94.3%. For syphilis, 82.5% of pregnant women were treated with benzathine penicillin, and 88.7% in 2011. The historical series of hepatitis B vaccination coverage in children has decreased over the years; it was 96% in 2013 and 76% in 2021.ConclusionThese data show many gaps and some perspectives in the MTCT program in Brazil. The country is close to reaching MTCT HIV elimination, but there are many challenges regarding HBV and syphilis. These data can be used to organize the strategies to improve the Brazilian response to MTCT elimination of HIV, hepatitis B, and syphilis.

During period 2 only one (10%) month had zero enrolled participants and three (30%) had enrollment of six participants, while around 40% of the months of periods 1 and 3, had zero enrolled participants and none had 6 (p=0.004). During period 2 and 3, 22 (48%) participants were enrolled from AS and 6 (13%) from HOC. Conclusions Active surveillance increased the enrolment of patients with early syphilis, and potentially limited the impact of the COVID-19 pandemic.

During period 2 only one (10%) month had zero enrolled participants and three (30%) had enrollment of six participants, while around 40% of the months of periods 1 and 3, had zero enrolled participants and none had 6 (p=0.004). During period 2 and 3, 22 (48%) participants were enrolled from AS and 6 (13%) from HOC. Conclusions Active surveillance increased the enrolment of patients with early syphilis, and potentially limited the impact of the COVID-19 pandemic.

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