The newly appointed director of the National Program for Sexually Transmitted Infections and HIV/AIDS (PNISTVIH), Bárbara Flor de Lima, highlighted the need to reorganize the response on the ground in light of the growing number of Pre-Exposure Prophylaxis (PrEP) users and the high proportion of late diagnoses.
The report “HIV Infection – 2025,” released today, indicates that Portugal recorded fewer cases of HIV infection in 2024, totaling 997 cases, but around 54% of the diagnoses occurred late, mainly among heterosexual men aged 50 or over.
The document also notes an increase in the number of people covered by PrEP, described as an “important prevention strategy,” both in hospital environments and through prescription and dispensing at community pharmacies, predominantly among men who have sex with men.
Prepared by the Directorate-General for Health (DGS) and the National Institute of Health Ricardo Jorge (INSA), the report advocates for the expansion of consultations in primary health care and community-based organizations, stating that “only in this way will it be possible to increase access, coverage, and contexts of PrEP prescription, impacting the reduction of new HIV infections.”
Bárbara Flor de Lima stated that the increase in the number of users calls for a broader reorganization of services, not just for PrEP, but also for the diagnosis of STIs and sexual health.
The program director acknowledged that there has been a delay in accessing initial consultations, particularly at the hospital level, where expansion capacity is near its limit.
Therefore, she explained, the restructuring will include creating new consultations in primary health care to improve access, strengthen screening for STIs and HIV, and ensure “greater testing.”
Asked about the timeline for the restructuring, Bárbara Flor de Lima considers it possible to move forward as early as 2026, explaining, however, that the pace will depend on the internal organization of each local health unit and coordination with community structures, a process that may take time to be fully implemented.
However, she assures that “it could be initiated very shortly,” noting that some units have already started organizing and implementing multidisciplinary consultations in this scope.
Infectology observed that the creation of local health units provides an opportunity to integrate primary health care and community structures in joint projects, enabling “a more effective response” in this area.
With this restructuring, she summarized, it is expected “a better response capacity and also access to testing, counseling, and screening,” as well as “further reducing the number of new cases” and contributing to the reduction of the still high proportion of late diagnoses.
The goal is to bring Portugal closer to the UNAIDS 95-95-95 target: to diagnose 95% of people with HIV, treat 95% of those diagnosed, and ensure suppressed viral load in 95% of those treated, ideally before 2030.
According to the report, in 2024, approximately 68,000 rapid HIV tests were carried out in various health and community structures, as well as the prescription and performance of more than 625 tests within the scope of primary and hospital healthcare of the SNS, noting a decrease in the number of rapid tests conducted compared to 2023.
Additionally, 5,659 self-tests were dispensed, maintaining the growing trend in the number of self-tests dispensed annually by community pharmacies.
Last year, more than 6.6 million external and internal condoms and over 1.8 million packs of lubricant gel were distributed through PNISTVIH.
The Needle Exchange Program enabled the distribution of over 960,000 syringes in 2024, totaling around 66 million among the population of injecting drug users since its implementation.
