Porto Alegre Charter Formalizes Alliance to Combat the Spread of HIV in Rio Grande do Sul

A document led by the Rio Grande do Sul Society of Infectology was delivered during InfectoTchê and brings together civil society, managers, and medical entities around prevention, early diagnosis, and treatment.

The spread of HIV in Rio Grande do Sul demands a coordinated, continuous, and evidence-based response. To this end, the Rio Grande do Sul Society of Infectology (SGI) formalized and delivered, this Saturday, May 23rd, during InfectoTchê 2026, the Porto Alegre Charter, a document that consolidates the Rio Grande do Sul Alliance for Combating HIV. The movement brings together civil society, public administrators, municipal health departments, and medical entities around strategies to expand access to prevention, diagnosis, and treatment.

The initiative, led by SGI, with support from the Medical Association of Rio Grande do Sul (AMRIGS), emerges in a context that keeps the state on alert. Data from the Ministry of Health shows that Porto Alegre remains among the territories with the greatest challenges related to HIV and AIDS in the country. In a previous bulletin, the capital of Rio Grande do Sul appeared with the highest composite index among capitals, considering indicators such as detection, mortality, and transmission in children under five years of age. In 2024, Porto Alegre registered the highest AIDS mortality rate in Brazil, with 12 deaths per 100,000 inhabitants, about three times the national average, according to a survey released from the Ministry of Health's 2025 HIV and AIDS Epidemiological Bulletin.

Among the data reinforcing the urgency of the issue, recent studies published by JAMA Network indicate that up to 1 in 18 young people between 18 and 25 years old in Porto Alegre are living with HIV, highlighting the increased risk in this age group and the need for more effective strategies for prevention, testing, and ongoing care.

The president of the Rio Grande do Sul Society of Infectology, Dimas Alexandre Kliemann, emphasized that confronting HIV involves collective responsibility, but also strengthening individual autonomy. According to him, society today has access to information, prevention, testing, treatment, and various care strategies, allowing each person to make better decisions about their health and protection.

“The fight against HIV cannot depend solely on one team or isolated actions. Today, we have all the elements so that each person can protect themselves. Perhaps this is the moment to empower each individual, because we live in a more individualized world, but we can also use this in favor of prevention. Each person has the right to choose how they want to take care of themselves, and this is also a way to confront the epidemic,” stated Dimas Alexandre Kliemann.

The proposal is structured around two main fronts. The first is the expansion of universal and regular testing, with early diagnosis and immediate initiation of treatment. This measure is fundamental to reducing complications, improving the quality of life of people living with HIV, and decreasing the transmission of the virus. The second front is the expansion of combined prevention, including access to oral Pre-Exposure Prophylaxis (PrEP) and long-acting injectable PrEP, as well as educational actions, clinical follow-up, and strategies aimed at more vulnerable populations.

The Porto Alegre Charter also proposes that the fight against HIV be understood as a shared responsibility. The central message is to integrate health services, professionals from different specialties, managers, social organizations, and scientific institutions into a network capable of welcoming, guiding, testing, treating, and monitoring people continuously.

The president of the Brazilian Society of Infectious Diseases (SBI), Ricardo Diaz, highlighted the importance of keeping HIV and AIDS on the public, scientific, and institutional agenda. According to him, in the face of health crises, climate change, and new health challenges, the topic often loses prominence, which compromises advances in prevention, diagnosis, and care.

“We are trying to keep HIV and AIDS on the agenda because this issue very easily falls out of focus during discussions. In 45 years of fighting the disease, we have seen new emergencies arise, such as pandemics, global warming, hepatitis, and other threats to public health. But, as long as there isn't a permanent effort to keep HIV and AIDS as a priority, we won't be able to make the progress we need to. That is our goal,” stated Ricardo Diaz.

Alberto Duarte, representative of the AIDS Prevention Support Group (GAPA) and civil society, warned of the impact of reduced information and prevention campaigns about HIV and AIDS. He highlighted that the lack of access to health services and public policies disproportionately affects historically neglected populations, increasing the risk of infection, late diagnosis, illness, and death.

“Information campaigns have ceased to exist, and this has a direct consequence on prevention. At the beginning of the epidemic, we spoke of civil death, because society decreed the exclusion of people with AIDS even before physical death. Today, this civil death remains present when Black, mixed-race, marginalized, and poor populations, as well as gay, transgender, and transvestite people, people experiencing homelessness, drug users, and the incarcerated population, continue to lack adequate access to health services and other public policies. This absence leads to infection, late diagnosis, illness, and death,” stated Alberto Duarte.

The director of the Department of Management of State Hospitals (DGHE) at the State Health Secretariat of Rio Grande do Sul (SES-RS) and representative of the State Government of RS, Letícia Ikeda, highlighted that the fight against HIV needs to go beyond the biomedical response, considering social vulnerabilities, life contexts, and the need for integrated action between different sectors.

“The HIV epidemic is not simply a war against an etiological agent. Those who have been on this path of care, prevention, and assistance for a longer time know that we are talking about something much bigger than the virus. It is an issue that transcends the biomedical aspect and also the health sector itself, because it involves vulnerabilities, public policies, and collective commitment,” stated Letícia Ikeda.

The formalization took place during the last day of InfectoTchê 2026, one of the main scientific meetings on Infectious Diseases in the Southern Region. The initiative presents itself as an open and collaborative movement, with the aim of placing people at the center of the HIV response, promoting equity in access, strengthening continuous care, and expanding integration between public health, the private network, medical societies, and civil society.

The president of AMRIGS, Dr. Gerson Junqueira Jr., emphasized that tackling HIV requires integration between medical specialties, public administrators, and representative entities. He stated that the Porto Alegre Charter was born as a result of a collective effort, articulated from the SGI, with the goal of expanding prevention, diagnosis, and care in Rio Grande do Sul.

“This mobilization began from a concern raised by the Rio Grande do Sul Society of Infectology and its president, Dimas Kliemann. AMRIGS (Association of Medical Professionals of Rio Grande do Sul) took on the role of bringing other medical societies together, because HIV needs to be addressed in a cross-cutting manner, involving proctology, gynecology, urology, pediatrics, dermatology, rheumatology, family and community medicine, internal medicine, and many other areas. The Porto Alegre Charter symbolizes this union and also the search for institutional support from the State Government, the State Health Secretariat, the Porto Alegre Municipal Health Secretariat, FAMURS (Federation of Municipalities of Rio Grande do Sul), and other entities, so that the manifesto can be transformed into real actions in favor of the population,” stated Dr. Gerson Junqueira Jr.

Full text of the Porto Alegre Charter - Rio Grande do Sul Alliance for Combating HIV

We, the people of Rio Grande do Sul, health professionals, activists, public administrators, medical entities, social organizations, and citizens committed to life, unite to say that we will no longer accept HIV stealing futures, widening inequalities, and silencing people in Rio Grande do Sul.

We live in a state marked by solidarity, courage, and the capacity for reconstruction. It is with this same spirit that we choose to confront an epidemic that still hurts thousands of families, especially those most vulnerable due to prejudice, misinformation, and difficulty accessing care. We know that no one wins this fight alone. HIV cannot be confronted with fear, judgment, or indifference. It must be confronted with science, acceptance, unity, and humanity.

Today, science offers us tools capable of changing the course of this epidemic. We have the means to expand testing to all people, ensuring early diagnosis and rapid access to treatment. We have the possibility of expanding combined prevention, including condoms, health education, oral PrEP, and long-acting injectable PrEP. We know that people in treatment with an undetectable viral load do not transmit HIV. We know that saving lives depends on access, information, and continuous care.

Therefore, we have made some fundamental commitments together:

• To provide quality information and combat the stigma related to HIV.

• Expand universal testing and early diagnosis throughout the state.

• Guarantee broad, dignified, and decentralized access to oral and injectable PrEP.

• Strengthen immediate and ongoing treatment for all people living with HIV.

• To promote humane care, free from discrimination and prejudice.

• To integrate civil society, health services, universities, medical entities, and public managers in a collective response.

• Listen to and welcome people living with HIV, recognizing their dignity, their voice, and their rights.

We believe that no person should be defined by a diagnosis. Every life matters. Every person deserves care, respect, and the opportunity to live fully. The fight against HIV doesn't belong only to medicine or governments—it belongs to all of us.

The Porto Alegre Charter was born as a call to action and hope. A collective commitment of the people of Rio Grande do Sul to life, to science, and to the future. Because only united will we be able to transform the reality of HIV in Rio Grande do Sul.

And because nobody can be left behind.

Written by: Marcelo Matusiak