Who this service is for
This sexual health consultation with a general practitioner is indicated for adults who:
- Want STI screening — HIV, syphilis, hepatitis B and C, chlamydia, gonorrhea — privately and without travel
- Had a risky sexual encounter and want to know which tests to do and when
- Had a risky exposure to HIV and want to assess the need for PEP (post-exposure prophylaxis) — within the 72-hour window
- Want to start PrEP (pre-exposure prophylaxis for HIV) or are already on PrEP and need follow-up
- Have symptoms that may be due to an STI — discharge, genital sores, burning when urinating, generalized rash
- Received an STI diagnosis and want guidance on treatment and how to communicate with their partner
- Want guidance on contraception and combined prevention
- Are partners of people with a diagnosed STI — and need evaluation and treatment
- Want routine STI screening as part of preventive sexual health care
- Are foreigners or expats in Brazil — care in English, Portuguese and Spanish
STIs in Brazil — the epidemiological context
The numbers are unequivocal and urgent:
Syphilis: In 2024, Brazil recorded 256,830 cases of acquired syphilis — a rate of 120.8 per 100,000 inhabitants, the highest figure in the historical series. Between 2010 and 2024, more than 1.5 million cumulative cases. Congenital syphilis — transmitted from mother to baby during pregnancy — remains one of the country’s major public health challenges, with 24,443 cases and 183 deaths in 2024.
HIV: Brazil has approximately 1 million people living with HIV. About 40,000 new infections are diagnosed each year. Access to treatment through the SUS is universal and free — but late diagnosis is a significant problem.
Hepatitis B and C: Between 2000 and 2022, 750,651 cases of viral hepatitis were confirmed in Brazil. Hepatitis B and C are sexually transmitted and progress silently — many people do not know they are infected.
Chlamydia and gonorrhea: These are the most common bacterial STIs in Brazil and worldwide — often asymptomatic, especially in women, and responsible for serious complications such as pelvic inflammatory disease and infertility when untreated.
Why diagnosis is so difficult in Brazil: the stigma associated with STIs — especially HIV and syphilis — is one of the main barriers to diagnosis and treatment in Brazil. Many people avoid getting tested for fear of the result, shame at going to a health unit, or fear of being judged by health professionals.
Teleconsultation removes these barriers.
What is included in the consultation
Risk assessment and sexual health history
The doctor performs a complete, nonjudgmental assessment of sexual health history — including sexual practices, condom use, number of partners, history of previous STIs, vaccination for hepatitis B and HPV, and current symptoms. Confidentiality is total.
Ordering a personalized STI panel
Based on the risk assessment, the doctor orders the most appropriate tests for the individual profile — avoiding unnecessary tests and ensuring that the most important ones are included. The tests are performed at private laboratories chosen by the patient throughout Brazil.
Assessment of STI symptoms
For patients with symptoms — discharge, genital sores, burning when urinating, rash — the doctor assesses the most likely diagnostic possibilities and advises on the next step, including empirical treatment when clinically indicated before test results are available.
PEP assessment — post-exposure prophylaxis for HIV
For patients who had a risky exposure to HIV in the last 72 hours — unprotected sex with a partner of unknown or positive serostatus, accident involving biological material, sexual violence — the doctor assesses the indication for PEP and advises where to obtain it urgently. PEP should be started as soon as possible after the risky exposure — and no later than 72 hours. The earlier it is started, the greater the effectiveness. Do not wait — if you had a risky exposure to HIV, schedule the teleconsultation immediately or go to the nearest urgent care service.
Assessment and initiation of PrEP — pre-exposure prophylaxis for HIV
For people at increased risk of exposure to HIV — sex workers, MSM (men who have sex with men) without consistent condom use, serodiscordant partners — the doctor assesses the indication for PrEP and advises on how to access the medication. PrEP is available free of charge through the SUS for eligible people.
Guidance on treatment — at the physician’s discretion
For diagnosed STIs or those with high clinical suspicion, the doctor advises on appropriate treatment and issues an electronic prescription when clinically indicated. Syphilis, for example, is treated with benzathine penicillin — which requires in-person intramuscular administration — and the doctor advises where to have the injection.
Guidance on communication with the partner
When an STI is diagnosed, the sexual partner or partners also need to be evaluated and treated — even if they have no symptoms. The doctor advises on how to approach this conversation and on the resources available for partner notification.
Referral to a specialized service — when indicated
For HIV, chronic hepatitis, and other STIs that require specialized follow-up, the doctor provides a referral with complete clinical documentation — including to SUS services when the patient opts for free public follow-up.
STI panel — which tests to request
The doctor customizes the test panel based on the individual risk profile. As a general reference:
Basic STI screening panel:
- HIV (antibody and p24 antigen test — "combo")
- Syphilis (VDRL and FTA-ABS or TPHA)
- Hepatitis B (HBsAg, Anti-HBs, total Anti-HBc)
- Hepatitis C (Anti-HCV)
- Chlamydia and gonorrhea — PCR in urine or swab (depending on sexual practices)
Additional tests according to risk profile:
- Herpes simplex (HSV-1 and HSV-2) — serology
- HPV — HPV screening in women is done with cervical cytology (Pap smear), which requires an in-person visit with a gynecologist
- Hepatitis A — serology when indicated
- Trichomoniasis — when compatible symptoms are present
Immune window — what it is and why it matters:
Each STI has a period after exposure during which tests may be negative even with active infection — the so-called immune window. The doctor advises when to repeat the tests to ensure reliable results.
- HIV (4th-generation combo test) — approximate immune window of 18-45 days
- Syphilis — approximate immune window of 3-6 weeks
- Hepatitis B — approximate immune window of 6 weeks to 6 months
- Hepatitis C — approximate immune window of 8-12 weeks
- Chlamydia/Gonorrhea (PCR) — approximate immune window of 1-2 weeks
PrEP and PEP in Brazil
PrEP — Pre-Exposure Prophylaxis
PrEP is a medication (tenofovir + emtricitabine) that, when taken daily and consistently, reduces the risk of HIV infection by more than 99% in people at increased risk of exposure. In Brazil, PrEP is available free of charge through the SUS for eligible people — including MSM, sex workers, trans people, and partners of people living with HIV. PrEP follow-up requires regular consultations with monitoring tests every 3 months. During the consultation, the doctor assesses whether you are a candidate for PrEP and advises on how to access the medication through the SUS or the private network.
PEP — Post-Exposure Prophylaxis
PEP is an antiretroviral medication that, when started within 72 hours after a risky exposure to HIV, significantly reduces the risk of infection. The earlier it is started, the more effective it is. In Brazil, PEP is available free of charge at Health Units, Testing and Counseling Centers (CTA), emergency rooms and UPAs. The doctor assesses the indication and advises where to obtain it urgently — including outside business hours. If you had a risky exposure to HIV less than 72 hours ago — do not wait for the teleconsultation if you cannot get an immediate appointment. Go to the nearest emergency room or UPA and request PEP.
Syphilis in Brazil — what you need to know
Syphilis is treatable — but it is often not diagnosed because it can be asymptomatic or present symptoms that disappear spontaneously, giving the false impression of cure.
How it presents:
- Primary stage — hard chancre, painless sore at the site where the bacteria entered, which disappears in 3-6 weeks without treatment — but the infection remains active
- Secondary stage — generalized rash, spots on the palms of the hands and soles of the feet, lesions in the mouth. It also disappears without treatment
- Latent stage — no symptoms, but active infection. It may last for years
- Tertiary stage — serious complications in the heart, brain and other organs — preventable with treatment in earlier stages
Treatment:
Syphilis is treated with benzathine penicillin — a low-cost, highly effective antibiotic. The intramuscular injection requires an in-person visit to a health unit — the doctor issues the prescription and advises where to have it administered. Treatment is free in the SUS.
Syphilis in pregnancy:
Syphilis in pregnant women requires urgent treatment to prevent transmission to the baby — congenital syphilis. Brazil recorded 24,443 cases of congenital syphilis in 2024 — a public health tragedy entirely preventable with diagnosis and appropriate treatment during prenatal care.
Confidentiality and sexual health
Confidentiality is one of the pillars of sexual health care. Everything you share during the consultation is protected by medical confidentiality and by the LGPD (Law 13.709/2018).
There are specific situations in which confidentiality may be weighed — when there is serious risk to the health of third parties. In the context of sexual health, this is rare — guidance on communication with the partner is always given in a way that supports the patient, not imposes.
Health data has enhanced protection as a special category of data under the LGPD.
