By Claudia Mora Cárdenas and Simone Souza Monteiro*
Since the emergence of , researchers in the areas of communication, sociology and public health have developed studies on HIV prevention campaigns. The works analyze the production, dissemination and circulation of folders, booklets, posters and social media, among other pieces of communication, and how they are interpreted by different social groups.
The use of mass communication strategies, marketing and campaigns aimed at disseminating disease prevention technologies are part of the public health actions of the government and organized civil society. Analysis of what and how they are understood by the target population groups makes it possible to identify their scope and the need for reformulation and improvement.
added to the global and national socioeconomic and political context, current AIDS control policies have focused on the early identification and treatment of infected people to reduce the circulation of HIV in the population and interrupt the transmission chain. In this direction, the expansion and diversification of the testing offer, as well as pre-exposure prophylaxis (PrEP) and post-exposure (PEP) for the HIV virus, has been prioritized.
An evaluation of posters and folders
Pre-exposure prophylaxis involves the regular use of antiretroviral drugs before exposure to HIV, and is indicated for all sexually active adults and adolescents at increased risk of HIV infection. PEP is provided for in cases of occupational accidents, sexual violence and unprotected sex, and must be used within 72 hours after exposure to HIV.
Considering that pre- and post-exposure prophylaxis are available in the SUS and have great potential for controlling the AIDS epidemic, how are these strategies being disseminated in Brazil? The federal government aims to expand the use of PrEP by up to 300% by , but it is still unclear what importance is given to communication in actions to expand the use of prophylaxis.
Based on the partnership between the Instituto Oswaldo Cruz da Fiocruz and the Instituto de Medicina Social Hesio Cordeiro da Uerj, we developed a study that explores the symbolism of folders and posters produced by government institutions and the social movement in Rio de Janeiro.
The investigation also analyzed the conceptions of health professionals and managers from Rio de Janeiro and the Brazilian Ministry of Health regarding the official dissemination of PrEP and PEP. These questions were part of a broader survey, carried out between 2019-2021, with users, professionals and managers of municipal programs in , which was funded by the Inova Geração do Knowledge Program in .
Professional turnover and conservatism
With regard to the messages in the communication pieces collected in health services in the State of Rio de Janeiro, the study showed an emphasis on the clinical dimension of prophylaxis. This was expressed in the centrality of the doctor and the digital tools to access them. Despite its importance, the implications of the use of prophylaxis in the field of sexuality are not addressed in visual and text messages.
The research showed that communication strategies for disseminating protocols and other guidelines on new technologies began with teams of health professionals. Given the high turnover of this group in the public network, these actions were qualified as a “little ant work”according to managers and professionals from 5 municipalities in the metropolitan region of Rio de Janeiro (Niterói, Rio de Janeiro, Duque de Caxias, São Gonçalo and Nova Iguaçu).
We also found that there were obstacles in the implementation of PrEP among professionals considered “conservatives”indicating moral restrictions in the provision of this preventive technology. Furthermore, in contrast to the period in which the Ministry of Health produced broad campaigns and distributed communication pieces on a national scale —especially in the 2000s—, interlocutors were economical when mentioning visible campaigns or investments in communication and appropriation of information about PrEP and PEP. Social media, reference NGOs and LGBTQIA+ citizenship policy equipment were, in turn, the most frequently evoked voices.
Communication of the preventive strategies on the agenda seems to prioritize the availability of biotechnological inputs (medicines, tests and condoms, for example). Its enunciation is relatively discreet, being carried out by multiple voices. Hence, another challenge emerges for actors and institutions responsible for promoting PrEP and PEP prophylaxis: identifying symbols, languages and communication channels to reduce the distance between the target audience and preventive strategies.
The challenge of communication
The challenges of expanding preventive prophylaxis in Brazil increase in the face of disparities in access. As revealed by the 2023 Report, the predominance of PrEP use among gay and bisexual men with high/medium income and education contrasts with the reduced demand from populations equally vulnerable to HIV, such as transgender women, sex workers, teenagers, gays/MSM (men who have sex with men) with low purchasing power and brown and black race/color. According to the report, access to PEP predominates among gay men and other cisgender MSM (62%), with a slight increase among transgender men (2%) and transsexual/transvestite women (4%), and a decline among cisgender women (33%).
The evidence can be understood by a certain erasure of AIDS as a social problem in the last decade, aggravated by the covid-19 pandemic, the resurgence of conservative discourse and the dismantling of the federal government’s sexual and reproductive health and human rights policies from 2019 to 2022.
The discussion raised by the study aims to stimulate reflection on the implications of the weakening of public communication of the response to AIDS for the realization of the right to prevention and to inquire about current perspectives. The federal government’s prevention campaign launched during the 2025 carnival period portrayed different contexts, sexual and emotional interactions and focused on the offer of different preventive inputs and their combination possibilities ().
Under the understanding that communication strategies on HIV prevention are State practices, further studies need to focus on these processes, and their symbolic and programmatic implications.
*Claudia Mora Cárdenas is an associate professor at the Institute of Social Medicine at Uerj (State University of Rio de Janeiro). Simone Souza Monteiro is a Public Health researcher at the Oswaldo Cruz Institute, Fiocruz (Fundação Oswaldo Cruz).
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