OBJECTIVES: The clinical protocol and therapeutic guidelines (PCDT) specify the use of daily oral combination tenofovir (TDF) and emtricitabine (FTC) in a single tablet. This is the only PrEP available in Brazil. Despite the integrated prevention methods, the incidence of human immunodeficiency virus (HIV) was 43,403 new cases in 2022 in Brazil.

In this context, this study aims to estimate the number of new HIV infections and associated costs over 10 years considering the use of oral PrEP TDF/FTC as the only prevention strategy.

METHODS: A predictive model was developed to estimate the number of HIV infections and associated costs for men who have sex with men (MSM) and transgender individuals. Scenario 1 considered the population aged 15-30 years; and scenario 2: 15 years and above. The study accounted for primary (target population) and secondary HIV infections (impact due to increased number of people living with HIV [PLHIV]). Estimations were based on literature data, HIV transmission risk by exposure, and HIV infections records in Brazil from 2012-2022. HIV management costs encompassed diagnosis, HIV treatment, HIV-related comorbidities/co-infections, monitoring, emergencies, and hospitalizations.

RESULTS: For scenarios 1 and 2, approximately 214,000 and 479,000 new HIV infections were estimated over a 10-year period, respectively. Regarding costs, approximately 7.2 billion and 17.3 billion Brazilian reais were estimated for scenarios 1 and 2. Costs related to comorbidities/co-infections, emergencies, and hospitalizations represented a substantial economic burden for the system (5 billion and 13 billion reais in scenarios 1 and 2).

CONCLUSIONS: This analysis presented the consequences of considering oral PrEP as the only prevention method. Literature data already present the lack of adherence and low persistence as an important gap. In this way, new PrEP options that increase adherence and extend persistence are needed, reinforcing the importance of a prevention strategy combination.