Continuing PrEP services for adolescents in Brazil despite COVID-19 disruptions

PrEP1519 is the first demonstration study in Latin America exploring acceptability, use, and persistence of pre-exposure prophylaxis (PrEP) amongst adolescent men who have sex with men (MSM) and transgender women (TGW) aged 15-19 years. The study is ongoing
in three cities in Brazil: Salvador, São Paulo, and Belo Horizonte. 

During the COVID-19 pandemic, the PrEP1519 study team ensured a contingency plan to minimize effects of the pandemic disruptions on people  participating in the study, to initiate and continue accessing PrEP and other sexual health services. They
use telehealth platforms such as text messages, online social media (Instagram and Facebook), and an artificial intelligence chatbot called Amanda Selfie to recruit participants, provide peer support and care. The team also provides discreet home
delivery of condoms, lubricants, douches, HIV self-tests and medicines for PrEP. In addition, in-person appointments remain possible, when necessary.

Importance of maintaining HIV prevention services during the COVID-19 pandemic

The story of Miguel (*) a young person who joined the study in July 2019 highlights the importance of maintaining HIV prevention services during the COVID-19 pandemic. While Miguel was enrolled in the PrEP programme, he reported poor adherence to
his PrEP medication. During the lockdown, he contacted the PrEP1519 team for an HIV test due to an acute viral infection. The test was facilitated under safe conditions at a PrEP1519 clinic. He tested negative for HIV, but positive for syphilis
and was treated on the same day. His partner, however, tested positive for HIV, after which Miguel was tested again for HIV. The second test confirmed that he was HIV-negative. Following his experience, Pedro is motivated to continuing his PrEP
regimen to prevent HIV. 

(*Name changed for anonimity)

A PrEP1519 participant receives a home-based HIV prevention kit during COVID-19 lockdown

A member of the clinical team conducting a PrEP1519 telehealth consultation

Rapid test for syphilis at the PrEP1519 clinic. The clinical team also advised that the participant’s partner undergo STI and HIV testing.

PrEP1519 client with the physician prescribing PrEP