Profile, distribution and continuity of use of pre-exposure risk prophylaxis for human immunodeficiency virus in Brazil: a comparative analysis between the public and private sectors (2018-2023)

This observational and retrospective study analyzed the sociodemographic profile, regional distribution, types of health services used and continuity of users on pre-exposure prophylaxis to the human immunodeficiency virus (oral PrEP) in Brazil, comparing users treated in the public and private sectors between 2018 and 2023. The data was obtained from administrative records of the Medicines Logistics Control System (Siclom), a tool used to monitor the dispensing of oral PrEP in the country. The study included 37,879 individuals who used oral PrEP during this period, of whom 31,782 (83.9%) were monitored in the public sector and 6,097 (16.1%) in the private sector. The majority of users were white men (55.1%), gay men (83.7%), with a higher level of education (70.8% had 12 years or more of schooling) and aged between 30 and 39 (43.3%). Most of the care was provided in the Southeast (63.8%), while the Northeast had the lowest share (4.8%). Although the public sector was responsible for the majority of care (78.4%), the private sector had slightly higher rates of oral PrEP continuity (80.4%). These findings show inequalities in access to and retention of oral PrEP, highlighting the need to expand public policies that promote greater equity in the supply and continuity of this preventive strategy in Brazil.