Post-exposure prophylaxis (PEP) is a fundamental tool for preventing new HIV infections, but its effectiveness is threatened by delayed seeking and failure in post-prevention follow-up. This break in the care continuum compromises linkage to combination prevention. This study aimed to describe the profile of the population served at a sexually transmitted infection (STI) testing center in the city of São Paulo, Brazil, and to identify the proportion of users who did not adequately adhere to post-exposure prophylaxis (PEP) follow-up when indicated, with the goal of supporting the development of strategies to improve retention in care. Retrospective cohort using secondary data from STI testing visits between January 2018 and July 2022. Individuals aged ≥ 18 years were included. Sociodemographic and clinical variables were analyzed. Outcomes were attendance at the three recommended PEP follow-ups: at 30, 90, and 180 days. There were 4,329 visits in the period. Most patients were cisgender men (73.2%) who had sex with men (63.1%) and self-identified as White (62.7%). Median age was 30 years (IQR 25–38), schooling 14 years (IQR 11–16), and number of sexual partners in the past 12 months was 3 (IQR 1–7), with values well above the third quartile in some cases. Among first visits with rapid testing, 109 were HIV-positive (2.6%), 312 for syphilis (7.9%), 6 for hepatitis B (0.1%), and 12 for hepatitis C (0.3%). At the end of the initial evaluation, 623 individuals (14.4%) were referred for PEP and 290 (6.7%) for pre-exposure prophylaxis (PrEP). Regarding PEP follow-up, 154 patients (24.7%) returned for the first follow-up, 15 (2.4%) for the second, and only 2 (0.3%) attended the third. The results showed a critically low proportion of follow-up visits after PEP initiation. Characterizing counseling patterns by the health team and better understanding sociodemographic factors that hinder access and adherence are essential steps to develop strategies to reduce these barriers.
López et al. (2026) studied this question.