ABSTRACT:
The expansion of access to HIV diagnosis and treatment in Brazil is frequently presented as a success of public health policies. However, data specific to the trans population reveal asymmetries that challenge the effectiveness of the right to health. This abstract analyses aggregated data from the Brazilian Ministry of Health, focusing on trans women and travestis, to examine how formal access to health services coexists with inequalities in the continuity of care. According to the Ministry of Health, an estimated 23500 trans people are living with HIV or AIDS in Brazil, of whom 91% (21388) have been diagnosed and 80% are receiving antiretroviral therapy. Nonetheless, significant disparities persist: among the 15520 trans women and travestis, only 81% (11422) are undergoing treatment, whereas 92% of the cis population are in therapy. The most pronounced inequality concerns treatment interruption, which affects 17% of trans women and travestis and 16% of the trans population overall, compared with 8% among cis individuals. Similarly, prolonged delays in the collection of antiretroviral medication reach 15% among trans women and travestis and 14% within the trans population, more than double the 7% observed among cis individuals. These findings do not indicate the absence of public policies, but rather expose structural limits in their implementation. The central issue lies not in initial access to health services, but in the system’s inability to ensure continuity and regularity of care under conditions of substantive equality. In light of the Brazilian Constitution, particularly the principle of dignity, the data reveal a persistent gap between the normative design of public policies and their practical enforcement, evidencing a deficit of the effective realisation of the right to health. This scenario directly relates to SDG3, highlighting the challenge of ensuring healthy lives and equitable access to healthcare for all.