HIV treatment, PrEP and PEP in Brazil: free for everyone, by law

By Ramon Martins Andrade, attorney (OAB/RJ 188.374)

As Rio de Janeiro hosts AIDS 2026, the world’s largest HIV conference, from 25 to 31 July, it is worth stating clearly what makes Brazil a historic reference on this subject: here, HIV prevention and treatment are guaranteed by law, free of charge, for anyone in the country.

Free treatment has been the law since 1996

Law 9.313/96 is direct: people living with HIV receive, free of charge, from the public health system (SUS), all the medication their treatment requires. Antiretroviral therapy is universal. It does not depend on income, contributions, private insurance or nationality: foreigners on Brazilian soil have access too. Medication is dispensed at units linked to the specialized HIV services, with a prescription and enrolment at the service.

PEP: the 72-hour emergency

Post-exposure prophylaxis is the use of antiretrovirals right after a risk situation, such as unprotected sex, sexual violence or an accident with biological material. It works best the sooner it starts, ideally within 2 hours, and has a 72-hour limit. It is offered by the SUS under a Ministry of Health protocol, and in the first hours the door is the emergency network: an UPA (urgent care unit), a hospital emergency room or a specialized service. Refusing or delaying this care is not merely a service failure: delaying health care out of discrimination is a crime in Brazil (Law 12.984/2014).

PrEP: ongoing prevention through the public system

Pre-exposure prophylaxis, the regular-use pill that prevents infection, is offered free of charge by the SUS under a Ministry of Health clinical protocol, with testing and periodic follow-up. Access runs through specialized HIV/STI services and qualified health units. In practice, availability varies from city to city, and that is precisely where knowing the administrative path makes a difference.

If medication or care is denied

A missing antiretroviral, a refused PEP at the emergency room or an unanswered PrEP waiting list are not dead ends: ask for the refusal in writing, contact the SUS Ombudsman (dial 136) and the local health department. If the failure persists, the courts exist, and for medication guaranteed by law and protocol that route tends to be fast, including free of charge through the Public Defender’s Office. Confidentiality is your right throughout: no health service may expose your HIV status.

The firm is available for a responsible review of your situation, in English.

About the author

Ramon Martins Andrade (Brazilian Bar, OAB/RJ 188.374) holds a law degree from UFRJ (2011), with master’s degrees from Université Sorbonne Nouvelle and from the Brazilian Naval War College (EGN). He is currently a researcher in Human Rights and Health at ENSP/Fiocruz.

This content is for information and education only. It does not constitute legal advice, advertising of results or any guarantee of outcome, under Rule 205/2021 of the Brazilian Bar Association (OAB).