UNESCO in Brazil, in partnership with the Ministry of Health, is developing three national research studies of key populations to understand and record how and where HIV is transmitted. The studies are conducted with men who have sex with men, sex workers, transvestites and transsexuals.

For Mariana Braga, UNESCO in Brazil’s education officer, this research is important because "currently there is no specific national epidemiological data to identify the magnitude, trends and profile of the HIV/AIDS epidemic and other sexually transmitted infections among the transvestite and transsexual population. In order to plan preventive education activities based on evidence, it is essential to have an understanding of the behaviours, attitudes and practices of this group."

The research was cited by Adele Benzaken, the Ministry of Health’s director for STD, AIDS and Viral Hepatitis, during the International AIDS Conference, held in Durban, South Africa, from 18 to 22 July 2016. She also announced that Brazil would begin to distribute kits of pre-exposure prophylaxis call (PrEP) as a method of preventing and avoiding HIV infection. The kit will be distributed through the Unified Health System (SUS) and aims to reach the 10 million people who make up the key populations at high risk of infection.

The Prevention Gap Report issued by UNAIDS in the beginning of July, estimates that there were 830,000 people living with HIV/AIDS in Brazil in 2015. According to the studies developed in 2009 and 2010, while the population in general has an incidence of 0.4 to 0.7% of people living with AIDS, this figure rises to 10.5% for the key-population of gay individuals and men that have sex with other men, and 4.9% for sex workers. (Source: http://unaids.org.br/estatisticas/)

Research Methodology

In total there will be over 4,000 participants nationally who will be surveyed by means of questionnaires and HIV tests. The research is carried out through a statistical process, as yet little used in Brazil, called Respondent Driven Sampling - RDS, which ensures that populations that are difficult to access are included. The process works by chain referral among the population group being studied. That is, one individual will refer another and so on. RDS is generally used by health units to encourage the use of health services and also when there are limits to reaching the population to be studied.

To conduct the research with each of the population groups, partnerships were formed with other institutions. In research with transvestites and transsexuals, UNESCO in Brazil has partnered with the School of Public Health Johns Hopkins Bloomberg, ENSP/Fiocruz (the National School of Public Health/Oswaldo Cruz Foundation) and Fiotec (the Foundation for Scientific and Technological Development in Health). Fiocruz and Fiotec are also partners in UNESCO’s research with sex workers. The Federal University of Ceará is the research partner with the population of men who have sex with men. The studies began last year and the prediction is that the field work will be completed over a period of two years. The publication of initial data is expected next year.