{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T11:08:18Z","timestamp":1785841698969,"version":"3.56.0"},"update-to":[{"DOI":"10.1371\/journal.pntd.0011548","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T00:00:00Z","timestamp":1692748800000}}],"reference-count":60,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T00:00:00Z","timestamp":1691712000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100016182","name":"Universidade Federal de Mato Grosso do Sul","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100016182","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) is one of the pillars of a combination prevention strategy for reducing the risk of new infections caused by HIV. The daily use of antiretroviral drugs by individuals who are not infected with HIV is required to prevent infection. Although its efficacy has been well established in the literature, in recent years, the decreased supply of antiretroviral drugs has been associated with an increase in the incidence of sexually transmitted infections (STI) and changes in the social determinants of health. An ecological study was conducted covering a five-year period (2018\u20132022), starting from the year of initiation of PrEP administration in Brazilian state capitals.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Principal findings<\/jats:title>\n<jats:p>Descriptive analysis was performed, and the spatial distribution of study data was taken into account. Correlation analysis was used to assess the association between PrEP administration, the incidence and detection rate of STI, and socioeconomic data. The southern region showed the highest incidence rates of STI, but the northern and northeastern regions demonstrated the worst socioeconomic indicators, especially those related to illiteracy and basic sanitation. PrEP administration was significantly correlated with illiteracy (\u03c1 = -0.658), per capita income (\u03c1 = 0.622), public garbage collection (\u03c1 = 0.612), syphilis (\u03c1 = 0.628) and viral hepatitis (\u03c1 = 0.419) incidences. Further, all STI were significantly associated with illiteracy and per capita income.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Significance<\/jats:title>\n<jats:p>Our findings highlight the need to continue exploring PrEP use and rising syphilis rates. In terms of policy, PrEP administration appears to be inversely associated with regions of greater social vulnerability. Further efforts should focus on the social determinants and health needs of this population to improve access to PrEP and reduce social disparities.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0011548","type":"journal-article","created":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T17:32:56Z","timestamp":1691775176000},"page":"e0011548","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":15,"title":["HIV pre-exposure prophylaxis and incidence of sexually transmitted infections in Brazil, 2018 to 2022: An ecological study of PrEP administration, syphilis, and socioeconomic indicators"],"prefix":"10.1371","volume":"17","author":[{"given":"Paula Knoch","family":"Mendon\u00e7a Gil","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danilo dos Santos","family":"Conrado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Isabel do","family":"Nascimento","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micael Viana de","family":"Azevedo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Cesar Pereira da","family":"Cunha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel Serrano Ramires","family":"Koch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila Guadeluppe","family":"Maciel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisson Andr\u00e9","family":"Ribeiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio Concei\u00e7\u00e3o","family":"Paranhos Filho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e1rcio Jos\u00e9 de","family":"Medeiros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e1udia Du Bocage","family":"Santos-Pinto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0074-5278","authenticated-orcid":true,"given":"Everton","family":"Falc\u00e3o de Oliveira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,8,11]]},"reference":[{"key":"pntd.0011548.ref001","first-page":"1","article-title":"O panorama atual da estrat\u00e9gia da profilaxia pr\u00e9-exposi\u00e7\u00e3o (PrEP) no Brasil e os caminhos poss\u00edveis para busca da equidade em sa\u00fade.","volume":"11","author":"M Polidoro","year":"2020","journal-title":"Sa\u00fade transform. soc"},{"key":"pntd.0011548.ref002","doi-asserted-by":"crossref","first-page":"1973","DOI":"10.1097\/QAD.0000000000001145","article-title":"Effectiveness and safety of oral HIV pre-exposure prophylaxis (PrEP) for all populations: A systematic review and meta-analysis.","volume":"30","author":"VA Fonner","year":"2016","journal-title":"AIDS"},{"key":"pntd.0011548.ref003","author":"Brasil. 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