Teleprep and Pep as Innovative Strategies for Hiv and Sti Prevention – Environmental Sustainability Impact

Pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) are well-established strategies for the prevention of HIV and STIs such as viral hepatitis and syphilis in Brazil and worldwide. However, difficulty in reaching vulnerable populations living far from major urban centers is one of the main limitations to achieving a greater impact on preventing effective transmission. Brazil’s geographic size and physical barriers hinder transportation and access. However, the growth of technology enables remote access to care in these regions as a strategy with significant impact. In addition, it is well known that the planet requires care, and carbon emissions from fossil fuels are a major threat with direct impact on the environment. A statewide telemedicine service for PrEP and PEP care was implemented. After the first 6 months of services, transportation savings for patients living in cities outside the capital and also in the central region were calculated using geolocation. The number of kilometers not traveled was converted into carbon-equivalent emissions for the environment and into the number of trees that would be required for carbon compensation. Our objective was to evaluate how virtual care impacted the environment and thus strengthen the importance of this new strategy for HIV and STI prophylaxis in Brazil. There were 2,661 requests for care from December/24 to June/25, with 78.2% related to PrEP, 15.7% to PEP, and 6.13% to HIV and STI testing. A total of 91.99 thousand kilometers were not traveled, equivalent to 2.09 thousand kg CO₂ eq not emitted, sparing 16 trees needed to neutralize this CO₂ over 30 years. Considering TelePrEP alone, 67.61 thousand kilometers were not traveled, equivalent to 1.54 thousand kg CO₂ eq not emitted, sparing 11 trees needed to neutralize this CO₂ over 30 years. Technological solutions such as TelePrEP and PEP can also help protect the environment. In a world where excessive water consumption is required to support increasingly powerful data-processing machines, reducing carbon-equivalent emissions is an effective strategy with meaningful impact on global warming, climate change, and human health.