From Click to Protection: Telehealth as a Gateway to Prep and Pep in the Brazilian Public Health System (Sus)

To eliminate HIV transmission, the World Health Organization (WHO) recommends pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) as key strategies. Both methods require appropriate counseling for efficacy and therapeutic safety, as well as testing, prescription, and follow-up over extended periods. In Brazil, specialized centers are often overburdened, and prophylaxis is not always prioritized despite its global relevance. Because of these structural and social barriers, many individuals do not benefit from these prevention strategies, highlighting the need for new approaches to expand access among the most vulnerable populations. Telemedicine services were launched in December 2024, with access via digital platforms or mobile applications. Any individual can make a request directly from their mobile phone, which is routed to a regulation center. The consultation date and time are then confirmed via WhatsApp along with a link for connection. Patients are evaluated by physicians or pharmacists, who provide prescriptions and lab requests. This study aimed to evaluate the impact of implementing a telemedicine-based PrEP and PEP service, with the goal of validating and expanding this approach nationwide. This was an observational and descriptive study conducted at a state telehealth center between December 2024 and June 2025, corresponding to the first six months of service implementation. The analysis was based on consolidated data from initial and follow-up consultations, as well as sociodemographic information such as gender and municipality of residence. The service recorded an average of 352 requests per month, totaling 2,661 requests – of which 78% were for PrEP. Among the requests, 45.87% were made by men, and 38.12% came from residents of the state capital where the service was implemented. Within the PrEP sector, identified as the area of highest demand, there were 1,928 requests (average of 275 per month). The service already covered 79 municipalities. Only 7.9% of patients required referral for in-person follow-up. TelePrEP and TelePEP represent effective and accessible approaches for HIV prophylaxis, reducing the burden on specialized centers, preventing stigma associated with in-person visits, and offering a simple, scalable implementation model. It is technology as a tool within the Unified Health System (SUS) to promote broader access to healthcare.