Objectives The aim of the study was to describe the characteristics, impact and outreach of post‐exposure prophylaxis (PEP) for sexual exposure in Brazil. Methods We used secondary data from the Brazilian Ministry of Health to describe the impact of national guidelines on the frequency of prescription, user profile and antiretroviral regimens. We also estimated the number of potentially averted HIV infections attributable to PEP for consented sexual exposure between 2009 and 2017. Results A total of 260 457 PEP regimens were prescribed to individuals ≥ 14 years old; 104 613 (40.2%) were prescribed for consented sexual exposure, with an increasing frequency since 2011. Drugs used in PEP regimens underwent significant modifications during the period, reflecting national recommendations. We estimated that there were up to 3138 potentially averted HIV infections attributable to PEP for consented sexual exposure between 2009 and 2017. Conclusions In the context of a combined HIV prevention strategy, PEP is still an essential tool for individuals for whom other methods are contraindicated or fail to be applied.

Background The vaginal microbiome and genital tract inflammation play an important role in HIV transmission and birth outcomes in South Africa. Intravaginal practices (IVPs) such as cleansing may influence the microbiome and levels of inflammation. IVPs are commonly practiced by women in South Africa, however, studies generally only include collection of data on cleansing and insertion of herbs. Methods We conducted an exploratory study to obtain insight in the variety of IPVs practiced by women in the rural Eastern Cape province of South Africa. Group discussion was held with participants (n=10) in an STI workshop and additional information was obtained through snowballing. Participants were two medical doctors, two project managers, two nurses, and four counsellors/social workers. IPVs that participants were aware of or had heard about were recorded. Results Other than intravaginal cleansing and insertion of herbs, participants had knowledge of women inserting a variety of substances in their vagina such as snuff (tobacco powder), ice cubes, toilet refreshener, Chinese pills, uvutha wabafazi (a traditional vaseline-like ointment), Indian holy ash, soft drinks and Vicks VapoRub. Intravaginal use of live organisms (Kombucha aka Amoeba mabhebeza, frogs and snakes) was also known. In addition, genital steaming practice is common using water with salt, onion, avocado seeds, guava leaves. Finally, external and internal sanitary packs created of potato sack or newspaper are used. The purpose of all these practices was to enhance male sexual pleasure, genital health, for sexual fortune and energy, and for traditional healing purpose. Conclusion Studies of genital tract microbiome and inflammation in women in rural South Africa should take a wide range of IPVs into account. Further research is required to document the frequency and geographic spread of these practices, and their impact on genital health.

prevalences were reported among 16-19 year olds for CT 13% (95% CI; 10.8-16.4), NG, 12% (95% CI; 9.7-15.1) and TV, 17%(95% CI; 13.7-21.1). There were 17,848 STI tests conducted in 2010 and among females aged 16-34; 33 Background The availability of point of care(POC) tests for infectious diseases has revolutionised the provision of health care for remote rural populations without access to laboratories. However, little attention has been given to quality assurance for POC tests. In a screening project that tested 45,226 adults of both sexes by 268 Health Care Workers(HCWs), in remote indigenous populations in the Amazon region of Brazil, where the overall prevalence of syphilis was 1.6%, and of HIV 0.1%, we evaluated the use of Dry Tube Specimens(DTS) for External Quality Assurance(EQA) for POC HIV and Syphilis tests. Methods The EQA programme was implemented from March 2010 to March 2011 using DTS panels developed by a reference laboratory, containing samples with negative and positive results at different antibody concentrations, for HIV and Syphilis infection. These were re-suspended and tested in the communities by each HCW. We also conducted stability tests for the panels at the reference laboratory. Results Results from 268 HCWs, responsible for implementing the POC tests at six Indigenous District(DSEI) participated in the EQA programme, showed a concordance rate of 90% for syphilis and 93% for HIV (Kappa coefficients of 0.74 and 0.78 respectively) with reference laboratories for a total of 1,608 determinations. The highest rate of inaccurate diagnoses occurred in positive samples of very low antibody concentration (40% for syphilis and 11.9% for HIV). The stability tests showed that titers were stable for up to one week at 30°C in dry conditions. Conclusion The results show that errors in the interpretation of POC test results were identified by the EQA programme using DTS. The use of POC tests for syphilis and HIV is now recommended as a policy by the Brazilian government. EQA/using DTS can help to improve the quality of these screening programmes and is already being implemented nationally.