O cuidado com a prevenção às infecções sexualmente transmissíveis deve ocorrer o tempo todo, o ano inteiro, e os diversos insumos estão disponíveis no Sistema Único de Saúde (SUS) em todo o estado. Neste Carnaval, a Secretaria de Estado de Saúde de Minas Gerais (SES-MG) reforça a importância do sexo seguro e alerta para crescimento do número de casos de infecções sexualmente transmissíveis no estado.
Entre as medidas para prevenção, foram distribuídos, aos 853 municípios mineiros, 6.903.792 de unidades de preservativos masculinos, 130.285 femininos e 298.400 unidades de gel lubrificante, que podem ser retirados nas Unidades Básicas de Saúde (UBS). Também estão disponíveis os testes rápidos para diagnóstico de IST: 65.580 para HIV; 59.060 da sífilis; 117.175 para Hepatite B e 70.250 para Hepatite C. A oferta favorece a estratégia de prevenção combinada, que consiste na utilização de mais de um método para evitar essas doenças.
Segundo a diretora de Vigilância de Condições Crônicas da SES-MG, Ana Paula Mendes Carvalho, a prevenção combinada reúne diversas estratégias, adaptadas às necessidades individuais e contextuais, visando à saúde integral das pessoas. “Entre as medidas, estão a testagem regular para o HIV, o tratamento das Infecções Sexualmente Transmissíveis, a imunização para hepatites A e B, além da Profilaxia Pré-Exposição (Prep) e Profilaxia Pós-Exposição (PEP)”.
A Prep consiste na tomada de medicamentos antes da relação sexual, visando preparar o organismo para enfrentar possíveis contatos com o HIV. Já a PEP é uma medida de urgência para situações de risco à infecção, utilizada após exposições de risco como violência sexual ou relações desprotegidas.
“A Prep é oferecida em unidades de atenção especializada e a PEP está disponível nas Unidades de Pronto Atendimento (UPA) e deve ser iniciada entre quatro e 72 horas após a exposição”, explica a diretora.
Acesso
Vítor Galdino, médico do Ambulatório de Referência em Doenças Infecto-Parasitárias (Ardip), do município de Ribeirão das Neves, compartilha detalhes sobre o atendimento e acesso à prevenção combinada. Segundo ele, a procura aos serviços de saúde do SUS é fundamental para abordar infecções sexualmente transmissíveis (IST) de forma integral. “Essa consulta, que inclui aconselhamento, não se limita ao ambulatório como o do Ardip, mas pode ser realizada em unidades de atenção primária, como o Centro de Testagem e Acolhimento (CTA). Após o diagnóstico, o tratamento pode ser iniciado no local ou por encaminhamento, de acordo com a necessidade”, explica.
No âmbito do município, ele ressalta que a introdução da Prep, em setembro de 2023, marca um avanço significativo. Cerca de 30 pacientes já estão em tratamento contínuo com a Prep, um medicamento preventivo disponível para pessoas acima de 15 anos sem HIV, com pelo menos 35 quilos, que enfrentam contextos de exposição ao vírus. O processo de acesso à Prep é simplificado e a distribuição mensal da medicação facilita a adesão ao tratamento. “As consultas ocorrem mensalmente inicialmente, seguidas por retornos trimestrais”, aponta.
Quanto à PEP (profilaxia pós-exposição), Vítor Galdino esclarece que deve ser iniciada dentro de 72 horas após a exposição ao HIV, como em casos de relação sexual desprotegida ou violência sexual. O tratamento envolve medicamentos específicos para reduzir o risco de infecção. Ele salienta que essas medidas não substituem o uso de preservativos, mas oferecem alternativas para situações específicas. “A camisinha segue relevante, porque ela protege contra as outras infecções sexualmente transmissíveis”, pontua.
Outra estratégia de destaque é a testagem regular. “A gente também tem a possibilidade de realizar testagem regular para qualquer paciente. Essas testagens duram em média 20 minutos e com elas a pessoa já tem o resultado imediato para HIV, sífilis, hepatites B e C”.
Sem estigmas
Sílvio Louzada de Oliveira, gerente do Ardip em Ribeirão das Neves, informa que o serviço foi fundado em 2003, integrando um programa municipal de atendimento a pessoas com HIV, hepatites e outras doenças infecciosas. A estrutura abrange o Centro de Testagem e Aconselhamento (CTA) e dispensação de medicamentos.
O Ardip tem atualmente cerca de 900 pessoas em tratamento com antirretrovirais e 1.680 cadastradas no sistema. O serviço também oferece atendimento dermatológico especializado, sendo referência no tratamento de esporotricose, leishmaniose, hanseníase e outras doenças. Sílvio destaca a abordagem inclusiva do Ardip, buscando desmistificar estigmas e preconceitos associados ao HIV/AIDS. “O nome Ambulatório de Referência em Doenças Infecto-Parasitárias reflete essa visão ampliada, que abrange não apenas pacientes com HIV, mas também outros casos de doenças infecciosas”, explica.
Panorama em Minas Gerais
Os números das IST no estado estão crescendo. Em 2021, foram 4.643 casos de HIV/Aids notificados. Já em 2022, foram 4.766, e em 2023, 4.753.
Em relação à sífilis adquirida, foram registrados 16.263 casos em 2021; 21.419, em 2022; e 24.071, em 2023.
Já de hepatite B, foram notificados, respectivamente, 752, 766 e 788 casos em 2021, 2022 e 2023.
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