Pre-Exposure Prophylaxis (PrEP) is an effective strategy for HIV prevention, but its access and adherence vary significantly according to sociodemographic characteristics. This study analyzed the profile of PrEP users in a region of the Brazilian Amazon, with emphasis on schooling, color/race, age group, and sexual orientation. Understanding these patterns is fundamental to guide inclusive public policies and reduce inequalities in access to prevention. Cross-sectional study with secondary data obtained from a national monitoring system, covering 1,882 users registered during the analyzed period. Variables investigated included schooling, color/race, age group, sexual orientation, and geographic location. Descriptive analysis was carried out through calculation of absolute and relative frequencies, using spreadsheet software. Most users had 12 or more years of schooling (66.6%), self-declared as mixed-race (67.5%), identified as cisgender gay men or other men who have sex with men (76.9%), and belonged to the 30–39-year age group (37.1%). Lower adherence was observed among groups with low schooling (0.9% without formal education), black (6.5%), indigenous (1.3%), transgender people (5.7%), and residents in rural areas (11%). The geographic distribution showed concentration in urban centers (89%), with predominant access to specialized sexual health services. The findings highlight structural disparities in access to PrEP, particularly among historically marginalized populations. Implementation of integrated strategies is recommended, such as: (1) educational campaigns adapted to specific cultural contexts; (2) expansion of health services in remote areas, including mobile units and partnerships with community organizations; (3) training of professionals for a non-stigmatizing approach. Future studies should investigate socioeconomic, cultural, and geographic barriers that perpetuate these inequalities, aiming to promote equity in combined HIV prevention.
Santos et al. (Sun,) studied this question.
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